Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Drugs for Diabetes Mellitus - Ch. 60 > Flashcards

Drugs for Diabetes Mellitus - Ch. 60 Flashcards

(102 cards)

Start Studying
1
Q

What can untreated diabetes lead to?

A

Heart disease
kidney disease
eye disease
Erectile dysfunction (impotence)
Nerve damage
Immunosuppression
Poor wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are symptoms of diabetes mellitus?

A

Unusual thirst
Frequent urination
Weight change (gain or loss)
Extreme fatigue
Blurred vision
Frequent infections
Slow healing cuts/bruises
Numbness/tingling in hands and feet
Trouble getting an erection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percent of people have each type of diabetes mellitus?

A

Type 1 = ~10%
Type 2 = ~90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Type 1 diabetes?

A

Lack of insulin production
Production of defective insulin

-Need exogenous insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What complications can arise due to type 1 DM?

A

Retinopathy
Nephropathy
Neuropathy
Diabetic ketoacidosis (DKA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drug therapies are available for Type 1 DM?

A

Insulin (required treatment)
Certain oral antihyperglycemic agents can be used as adjuctive agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Type 2 DM?

A

Cause by insulin deficiency and/or insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is insulin resistance?

A

Reduced number insulin receptors
Receptors less responsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Gestational diabetes?

A

Hyperglycemia onset during pregnancy that resolves at the end of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medications are used for Gestational diabetes?

A

Insulin is normally medication of choice
Metformin may be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What testing is available for diabetes mellitus?

A

Blood glucose measurement
Glucose tolerance test
% HbA1c (glycated hemoglobin)
Average blood glucose over the past 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is glycated Hb?

A

Glucose + hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Compare the proportion life-time of RBCs 3 months in non-diabetic and diabetics? (HbA1c)

A

Non-diabetic = 4-5.9%
Diabetic = >6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are insulins?

A

Function as a substitute for endogenous hormone
Effects are the same as normal endogenous insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do insulins improve a diabetic’s ability to do?

A

Take up glucose into cells
Make proteins and TGs
Make glycogen from glucose in liver
Convert glucose to fatty acids in adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the types of insulins?

A
  1. Rapid-acting
  2. Short-acting
  3. Intermediate-acting
  4. Long-acting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the onset of Rapid-acting?

A

10-15 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the peak of rapid-acting?

A

60-90 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the duration of rapid-acting?

A

3-5 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Examples of rapid-acting insulins?

A

Insulin lisper (Humalog)
Insulin aspart (NovoRapid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is rapid-acting insulin taken?

A

With each meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the onset of short (fast) acting?

A

30-60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the peak of short acting?

A

2-3 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the duration of short-acting?

A

6-7 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Example of short-acting insulin?
Regular insulin (Humulin R or Novalin R)
26
How is regular insulin administered?
SC IV infusion pump IM (rarely)
27
What is the onset of intermediate-acting?
1-3 hours
28
What is the peak of intermediate-acting?
5-8 hours
29
What is the duration of intermediate-acting?
10-18 hours
30
Example of intermediate-acting insulin?
NPH (neutral protamine Hagedorn)
31
What is NPH?
Intermediate-acting insulin: Isophane insulin suspension Cloudy appearance
32
What insulins are basal therapy insulins?
Intermediate and long-acting
33
What is the onset of long-acting?
90 minutes
34
What is the peak of long-acting?
No pronounced peak
35
What is the duration of long-acting insulin?
24 hours
36
Example of long-acting insulins?
Insulin glargine (Lantus)
37
What is insulin glargine?
Long-acting insulin Clear, colourless solution
38
What does diabetes Canada recommend the use of to achieve good glycemic control?
Base insulins + rapid acting insulins
39
What are the 3 components of BBIT?
1. Basal insulin (long-acting) 2. Bolus (short-acting or meal-time) insulin 3. Correction insulin
40
What is the target glucose range for BBIT?
5-10 mmol/L
41
What is the purpose of BBIT?
Prevents blood sugar highs and lows
42
What can occur if too much insulin is taken?
Hypoglycemia
43
What is the alert value for Hypoglycaemia?
<3.9 mmol/L
44
What are the levels for Hypoglycemia?
Level 1 - 3.0 & 3.9 mmol/L Level 2 - <3.0 mmol/L Level 3 - Needs assistance to treat
45
What are warning signs of hypoglycemia?
CNS effects SNS activation (gives early symptoms)
46
What can hypoglycaemia possibly cause?
Coma and death
47
What does insulin interact with?
B-Blockers Alcohol Glucocorticoids Epinephrine Furosemide and thiazide diuretics
48
What happens when Beta blockers interact with insulins?
Increase hypoglycaemic effect -Blood glucose lowers
49
What do Beta-blockers do to lower blood glucose levels?
Reduce glycogenolysis (glycogen to glucose) -Exacerbates insulin-induced hypoglycemias Also can mask signs of SNS activation (tachycardia, palpations)
50
What happens when Alcohol interact with insulins?
Increase hypoglycaemic effect -Blood glucose lowers
51
What does alcohol do to lower blood glucose levels?
Reduces liver glycogenolysis
52
What happens when Glucocorticoids interact with insulins?
Reduce effect of insulin -Blood glucose levels increase
53
What happens when Epinephrine interacts with insulins?
Reduce effect of insulin -Blood glucose levels increase
54
What happens when furosemide and thiazide diuretics interact with insulins?
Reduce effect of insulin -Blood glucose levels increase
55
What should you ensure when insulin is ordered?
Correct route Correct type Timing of the dose Correct dose -Second check, co-sign
56
What are diabetes drugs used for?
Lower blood glucose levels in patients with type 2 diabetes in addition to diet and lifestyle changes
57
What diabetes drugs target the pancreas?
Insulin secretagogues
58
What are Insulin secretagogues?
Increase insulin production in Type 2 DM Act on Beta cells of pancreas
59
What are the classes of Insulin secretagogues?
1. Suphonylureas 2. Non-suphonylureas
60
What are examples of Suphonylureas?
Glyburide chlorpropamide, tolbutamide glimepiride, glipizide (Glucotrol)
61
What does glyburide do?
Stimulate insulin secretion from beta cells Improve sensitivity to insulin in muscles, liver and fat (easier to take up) Decreasing rate of insulin metabolism and breakdown via liver
62
What is the most common adverse effect of sulphonylureas?
Hypoglycemia -usually mild but can be severe
63
When are sulphonylureas taken?
Taken with breakfast usually one per day (orally)
64
What are Non-suphonylureas?
meal-time drugs Short-half life
65
Examples of Non-suphonylureas?
Repaglinide, nateglinide
66
What is the difference between the classes of Insulin secretagogues?
Same drug target but different duration of action
67
Examples of Thiazolidinediones (TZDs)?
Rosiglitazone pioglitazone
68
How are Thiazolidinediones (TZDs) administered?
PO
69
What are incretins?
Released by intestinal contents to stimulate insulin release -GLP-1 ((glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic peptide)
70
What breakdown incretins?
Enzyme DPP-4 dipeptidyl-peptidase 4
71
What diabetes drugs act on the incretin pathway?
Gliptins (DPP-4 inhibitors) incretin mimetics SGLT-2 inhibitors
72
Examples of Gliptins (DPP-4 inhibitors)?
Sitagliptin (Januvia) saxagliptin linagliptin
73
Examples of incretin mimetics?
Excenatide (byetta) liraglutide, semaglutide, dulaglutide (daily/weekly) New drug: Tirzepatide (GIP and GLP-1 agonist)
74
What is Exenatide?
Synthetic form of a saliva protein of the Gila monster -Synthetic GLP-1 mimetic
75
What adverse effects are associated with incretin mimetics?
Decrease appetite (weight loss drug) Major AE = GI upset
76
What do DPP-4 enzyme inhibitors (Gliptins) do?
Reduce incretin metabolism -High plasma incretin levels
77
How are Gliptins administered?
Oral once daily with or without food -type 2 only
78
How is Exenatide administered?
SC
79
What diabetic oral drug site of action is the liver?
Biguanides
80
Example of biguanide?
Metformin (oral)
81
What does metformin do?
Decrease hepatic production of glucose Increase tissue sensitivity to insulin, increases uptake of glucose
82
Metformin does NOT cause what?
Hypoglycemia -Doesn't increase insulin secretion from the pancreas
83
What can metformin use lead to?
Net weight loss
84
What adverse effects are associated with Metformin?
GI disturbances: nausea, diarrhea, decreased appetite Lactic acidosis -rare, 50% mortality
85
When is lactic acidosis caused by metformin a concern?
People who have renal insufficiency
86
When is metformin taken?
2-3/day with meals to reduce GI adverse effects
87
What is the newest group of type 2 DM drugs?
Na-Glucose transporter inhibitors
88
What do Na-Glucose transporter inhibitors do?
Inhibit glucose transporter in the nephron (PT) sodium-glucose transporter subtype 2 (SGLT2) loss of glucose in urine (plus water)
89
Examples of Na-Glucose transporter inhibitors?
Canagliflozin Dapagliflozin empagliflozin
90
What adverse effects are associated with Na-Glucose transporter (SGLT-2) inhibitors?
Increased urination -hypotension, dizziness possible UTIs
91
What do Thiazolidinediones (TZDs) do?
Decrease insulin resistance "insulin sensitising agents" Increase glucose uptake and use in skeletal muscle Inhibit glucose and TG production in the liver
92
What warnings are there for rosiglitazone (advandia) use?
Increased risk of angina, MI and heart failure
93
What are other injectable diabetes drugs are there?
Amylin mimetics
94
What is amylin?
Co-released with insulin =delays gastric emptying and inhibits glucagon secretion -reduce postprandial glucose
95
Example of amylin mimetic?
Pramlitide
96
What is Pramlintide?
Acts as amylin Supplement to insulins (Type 1 and 2) SC INJECTION
97
What do alpha-glucosidase inhibitors do?
Reversibly inhibit the enzyme alpha-glucosidase in the brush border of the small intestine Inhibits digestion of oligo and disaccharides Delayed absorption of glucose
98
Examples of alpha-glucosidase inhibitors?
Acarbose Miglitol
99
How must alpha-glucosidase inhibitors be taken?
With meals to prevent excessive postprandial blood glucose elevations
100
What do oral/non-insulin agents interact with?
Glucocorticoids
101
What does glucorticoids do to oral/non-insulin agents?
Decrease the effect of hypoglycaemic medication -increase blood glucose
102
If hypoglycemias occurs what should you do?
Give glucagon if required Eat 120-200 mL clear fruit juice, glucose tablets/gel, tsp of corn syrup/honey or drink a non-diet soda After liquid snack eat a meal soon like crackers or half a sandwich monitor blood glucose

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions