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Pharma; Re 2 > Endrocrine drugs 3: Anti-diabetes > Flashcards

Endrocrine drugs 3: Anti-diabetes Flashcards

1
Q

representative for insulin secretagogues

A

glipizide

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2
Q

metformin class

A

biguanide

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3
Q

amylin analog rep

A

pramlintide

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4
Q

thiazolidinediones rep

A

pioglitazone

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5
Q

incretin modulator reps

A

GLP-1 analog
-exenatide

DPP-4 inhibitor
-sitagliptin

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6
Q

SGLT2 inhibitor rep

A

canagliflozin

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7
Q

insulin secretagogues

A

1st GEN SUR
Chlorpropamide
Tolbutamide
Tolazamide

2nd GEN SUR
Glipizide
Glimepiride
Glyburide
Glibenclamide
Gliclazide

MEGLITINIDES
Repaglinide
-GLINIDE

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8
Q

1st gen SUR

A

1st GEN SUR
Chlorpropamide
Tolbutamide
Tolazamide

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9
Q

2nd gen SUR

A 
2nd GEN SUR
Glipizide
Glimepiride
Glyburide
Glibenclamide
Gliclazide
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10
Q

MEGLITINIDE

A

MEGLITINIDES
Repaglinide
-GLINIDE

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11
Q

Insulin sensitizers

A

metformin

tzd (pioglitazone, rosi-, tro-)

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12
Q

insulin secretagogue with the least incidence of hypoglycemia

A 
NATEGLINIDE
(meglitinide)
-may be used in ckd patients
-used in diabetics with sulfa allergies
-s/e: URTI
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13
Q

MOA OF BIGUIANIDES

A
  1. activates AMP-stimulated protein kinase leading to inhibition of hepatic and renal gluconeogenesis
  2. stimulates glucose uptake and glycolysis in peripheral tissues
  3. slows gluocse absorption from the GI tract
  4. reduces plasma glucagon levels

metformin and TZD bypass the insulin receptor. both act via gene expression to sensitize tissue receptor to insulin

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14
Q

DOC for obese diabetics

A

metformin

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15
Q

metformin remarks

A

no hypoglycemia
no weight gain (in fact, modest weight loss)
-caauses decrease in endogenous insulin production by increasing insulin sensitivity - “INSULIN SPARING EFFECT”

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16
Q

s/e of TZD

A

weight gain
bone fractures
cardiovascular events, MI (rosiglitazone)
hepatotoxicity (troglitazone)
inc’d risk of bladder cncer by 63% -pioglitazole

17
Q

brothers of acarbose

A

miglitol

voglibose

18
Q

anti-diabetic that can cause acte pancreatitis

A

exenatide (GLP1 agonist)

19
Q

anti-diabetic that can cause nasopharyngitis

A

stiagliptin (DPP4 inh)

20
Q

anti-diabetic with possible thyroid ca risk

A

liraglutide (glp1 agonist)

21
Q

bile acid sequestrant

A

colesevelam

  • lowers glucose through unknown mechanism
  • used in type 2 dm
  • s/e: malabsorption of fat-soluble vitamins and steatorrhea
22
Q

rimonabant

A

blocks cannabinoid-1 rceptors
reduces apetitie

uses

  • obesity
  • smoking cessation
  • drug addiction

s/e
-suicidality, depression

23
Q

anti-obesity that’s a relative of methamphetamine

A

sibutramine

phentermine
-appetite suppressant which is an amphetamin derivative

24
Q

necrolytic migratory erythema

A

glucagonomas

25
Q

MOA of TZD

A

THIAZOLIDINEDIONES

  • increases target tissue sensitivity to insulin by activating PPAR-γ
  • increases uptake of glucose to adipocytes and skeletal muscles
  • inhibits hepatic gluconeogenesis
26
Q

most common toxic effects of metformin

A

GI (20%; DIARRHEA, nausea, vomiting, anorexia)

other toxicities

  • vit B12 defi (interference with calcium-dep abs of B12-IF complex)
  • lactic acidosis (sometimes, esp in renal failure, radiocontrast)

lower dose in elderly who may limited renal reserve and in those with eGFR 30-45 mL/min per 1.73 m^2

27
Q

anti-dm with proven CV benefit

A

liraglutide (GLP-1 agonist)

empagliflozin (SGLT2 i)

28
Q

no hypoglyceia

A 
gliptin (dpp4)
glutide (glp)
gliflozin (sglt2i)
glitazone (tzd)
metformin (biguanide)
29
Q

with hypoglycemia

A 
insulin
SUR
Meglitinide (least among secretagogues, esp NATEGLINIDE)
Acarbose (when taken with SUR)
Pramlintide (amylin analog)
30
Q

anti-dm with diarrhea side effects

A

acarbose
metformin
dulaglutide

31
Q

exenatide MOA

A
  1. activates GLP-1 receptors
  2. augments glucose-stimulated insulin release from pancreatic B cells
  3. retards gastric emptying
  4. inhibits glucagon secretion
  5. produces satiety
32
Q

Repaglinide

A

Meglitinide (insulin secretagogue)

33
Q

Gliclazide

A 
2nd GEN SUR
Glipizide
Glimepiride
Glyburide
Glibenclamide
Gliclazide
34
Q

Tolbutamide

A

1st GEN SUR
Chlorpropamide
Tolbutamide
Tolazamide

Pharma; Re 2 (12 decks)

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