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Flashcards in Endocrin Pharm Deck (56)
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1

What are the rapid acting insulins?

Iispro Aspart Glulisine

2

Mech of lispro aspart glulisine?

Bind insulin receptor (tyrosine kinase activity). Liver: increase glucose stored as glycogen. Muscle: increase glycogen, protein syntesis; increase K+ uptake. Fat: increase TG storage

3

clinical use of rapid acting insulins

DM1, DM2, GDM (postprandial glucose control)

4

What are the SE of rapid acting insulins?

hypoglycemia, rare hypersensitivity

5

What is the insulin, short acting?

regular

6

What is the clinical use of the regular short acting insulin?

DM1, DM2, GDM, DKA (IV), hyperkalemia (+glucose), stress hyperglycemia.

7

What is the intermediate acting insulin?

NPH

8

Clinical use of NPH

DM1, DM2, GDM

9

What are the long acting insulins?

Glargine, Detemir

10

Glargine, Detemir Clinical use?

DM1, DM2, GDM (basal glucose control)

11

Biguanides (Metformin) mech of action?

Exact mech is unknown. Decreased gluconeogenesis, increased glycolysis, increased peripheral glucose uptake (insulin sensitivity)

12

Metformin clinical use?

oral. first-line therapy in type 2 DM. Can be used in patients without islet function.

13

Metformin toxicities

GI upset; most serious adverse effect is lactic acidosis (thus contraindicated in renal failure)

14

Whatare the first generation sulfonylureas?

Tolbutamide, Chlorpropamide

15

What are the second generation Sulfonylureas?

Glyburide, Glimepiride, Glipizide

16

Sulfonylureas mech

Close K+ channel in beta cell membrane, so cell depolarizes which triggers insulin release via Ca++ influx

17

Sulfonylureas clinical use

stimulate release of endogenous insulin in type 2 DM. Require some islet function, so useless in type 1 DM

18

Sulfonylureas SE

Risk of hypoglycemia increase in renal failure. First generation: disulfiram-like effects. Second generation: hypoglycemia

19

What are the Glitazones/thiazolidinediones?

Pioglitzone, Rosiglitazone

20

What is the mech of the glitzones/thiazolideinediones?

increase insulin sensitivity in peripheral tissue. binds to PPAR glamma nuclear transcription factor

21

Clinical use of glitzones/thiazolideinediones?

monotherapy in type 2 DM comined with biguanides, sulfonylureas, or insulins.

22

SE of glitzones/thiazolideinediones?

weight gain, edema. hepatotoxicity, heart failure.

23

What are the alpha glucosidase inhibitors

Acarbose. Miglitol

24

What is the mech of alpha glucosidase inhibitors?

Inhibit intestinal brush border alpha glucosidases. Delayed sugar hydrolysis and glucose absorption which leads to decrease postprandial hyperglycemia.

25

What is the clinical use of the alpha glucosidase inhibitors?

monotherapy in type 2 DM or in combination with above agents

26

What are the toxicities of alpha glucosidase inhibitors?

GI disturbances

27

What is the Amylin analog?

Pramlintide

28

Mech of the amylin analog pramlintide?

decrease gastric emptying, decrease glucagon

29

Clinical use of the amylin analog pramlintide?

Type 1 DM and Type 2 DM

30

SE of the amylin analog pramlintide?

hypoglycemia, nausea, diarrhea