Endocrine II

Question 1

What do the Islets of Langerhans produce?

Answer 1

insulin, glucagon

Question 2

Action of insulins (2)

Answer 2

inhibits catabolic actions, anabolic actions

Question 3

The effects of this are predominantly opposite to insulin

Answer 3

glucagon

Question 4

tx goals of diabetes

Answer 4

avoid ketoacidosis, reduce long term complications, reduce hypoglycemic events, prevent diabetes

Question 5

Types of absorption delayed insulin

Answer 5

neutral protamine hagedorn, ultralente, insulin glargine

Question 6

types of insulin

Answer 6

speed of onset, duration of onset

Question 7

Speedy insulins

Answer 7

lispro, aspart

Question 8

Insulin pumps provide these features (2)

Answer 8

steady injection rate, can program for boluses

Question 9

Hypoglycemia involves what adverse effects?

Answer 9

reduced cognition, impaired sympathetic response, coma, seizure, brain damage, death

Question 10

This analog is used to increase satiety and reduce post meal glucagon secretion

Answer 10

amylin analog

Question 11

What vaccine is in trial to prevent type 1 diabetes?

Answer 11

glutamic acid decarboxylase 65 vaccine

Question 12

Immunomodulation in type 1 diabetes is achieved via this vaccine

Answer 12

BCG

Question 13

Hallmarks of type 2 diabetics

Answer 13

insulin resistance, gradual loss of islet beta cells

Question 14

T/F: ketoacidosis is common in type 2 diabetes

Answer 14

false, but can happen in later stages

Question 15

These drug classes increase insulin secretion

Answer 15

1st and 2nd generations sulfonylurias, meglitinides

Question 16

What type of pt do you avoid sulfonylurias in?

Answer 16

hepatic and renal failure pt

Question 17

1st generation sulfonylurias adverse effects?

Answer 17

drug interactions- sulfa and warafin; hematologic tox; prolonged hypoglycemia; tachyphylaxis

Question 18

What pt do you avoid 2nd generation sulfonylurias?

Answer 18

CVD and elderly

Question 19

3 preps of 2nd generation sulfonylureas

Answer 19

glipizide, glyburide, glimepiride

Question 20

These drugs have a fast onset, short duration and hepatic excretion

Answer 20

meglitinides

Question 21

Ending of the meglitinides?

Answer 21

-glinide

Question 22

What drugs are used to reduce insulin resistance?

Answer 22

biguanides, thiazolidinediones

Question 23

Drug of choice for most type 2 diabetes?

Answer 23

metformin

Question 24

What are the adverse effects of biguanides?

Answer 24

GI side effects

Question 25

Biguanide caution about lactic acidosis in these pt

Answer 25

COPD, chronic renal or hepatic disease

Question 26

How do thiazolidinediones work?

Answer 26

enhance tissue sensitivity to insulin

Question 27

Which glitazone increases the risk of an MI?

Answer 27

rosiglitazone

Question 28

How do GLP-1s work?

Answer 28

decrease glucagon secretion, responsible for incretin, increase pancreatic beta cell mass

Question 29

DPP4 inhibitors do what?

Answer 29

prevents GLP-1 and incretin from being broke down and will stimulate insulin release inhibiting glucagon release

Question 30

2 GLP-1 Names

Answer 30

Liraglutide (Victoza), Linagliptin (Trajenta)

Question 31

T/F GLP-1 facilitates weight loss

Answer 31

T

Question 32

2 names of DPP4 inhibitors

Answer 32

Sitagliptin (Januvia), Saxagliptin (onglyza)

Question 33

GLP-1 legal issues

Answer 33

pancreatitis and pancreas cancer

Question 34

T/F DPP-4 are oral pills?

Answer 34

True

Question 35

FDA warnings of DPP-4?

Answer 35

severe and disabling joint pain

Question 36

Do DPP-4s have a low risk of hypoglycemia?

Answer 36

yes

Question 37

T/F alpha-glucosidase inhibitors change microbiome of GI Tract and more CO2 is made.

Answer 37

true

Question 38

MOA of SLGT- inhibitors

Answer 38

enhance glucose excretion in the urine by blocking na/glucose co-transporter

Question 39

Empagliflozin (Jardiance), Dapaglifloxin (Farxiaga), Canaglifloxin (invokana) are what type of drugs?

Answer 39

SGLT-2

Question 40

Adverse effects of gliflozines

Answer 40

increased risk of ketoacidosis, limb amputations, UTI, crotch gangrene

Question 41

benefits of adding SGLT-2 drugs?

Answer 41

MI and CHF protection

Question 42

common protocol for type 2 diabetes meds?

Answer 42

lifestyle mods + metformin