Glucose Pharmacology Flashcards
What is the normal percentage of hemoglobin that is glycosylated in a healthy human?
5-6%
Year 2025. One of your patients is diabetic with a plasma glucose levels of 225 mg / dL and 11% HgA1c levels.
You ask him to shape up, alter diet, do some exercise and takedaily medication of metformin.
Your patient comes back after two months and his
glucose levels are 100 mg / dL (normal)
and HgA1c levels are still 11% (normal ~ 5-6%).
What is your conclusion?
A. HgA1c measurements are wrong
B. Glucose measurements are wrong
C. Patient is noncompliant most of the time
D. Time to put him on another class of drug
C. Patient is noncompliant most of the time
What are Biguanides (metformin)?
- # 1 oral hypoglycemic drug
- it is an insulin sensitizer
- decreases gluconeogenesis in liver (acts in liver)
What is the effect of excercise of GLUT 4 channels?
-nearly doubles them
How do Alpha-glucosidase inhibitors (acarbose) work?
- inhibits alpha-glucosidase in intestinal brush border
- decreases amount of glucose absorbed
- decreases post-meal hyperglycemia
What is the suffix of Sulfonylureas?
***ide
-keep in mind, lots of other drugs also end in -ide
What are the contraindications of metformin?
- renal insufficiency
- GFR <60 (increased likelihood of lactic acidosis)
How do Thiazolidinediones (***glitazones) work?
- target peroxisome proliferator-activated receptors in adipose tissue
- increase insulin sensitivity
A 23 year-old woman at 24 weeks gestation presents for routine prenatal care. She has no history of diabetes and recent fasting glucose level prior to her pregnancy was normal. However, at this visit a 50g oral glucose tolerance test is significantly elevated at 160 mg/dl (normal
C. Insulin
does not cross placental barrier
A 50-year-old man is diagnosed with type II diabetes mellitus on routine screening. His physician decides to start him on an oral hypoglycemic agent.
Which of the following drugs requires intact beta-cell function in order to work?
A. Acarbose B. Glyburide (a sulfonyl urea) C. Insulin D. Metformin E. Miglitol
B. Glyburide (a sulfonyl urea)
Metformin is an insulin sensitizer and is the most frequently prescribed drug to treat Type II diabetes.
After prescribing Metformin, you will closely monitor the
functioning of:
A. Liver B. Kidney C. Pancreas D. Adipose E. Muscle
-B. Kidney
How does food in the GI tract stimulate insulin release?
- receptors on intestinal cells cause release of GLP-1 and GIP (Incretins)
- they cause increased insulin secretion and decreased glucagon secretion at islet cells
What does oral glucose load result in more insulin release than IV glucose?
-oral glucose stimulates release of incretins from duodenum, which stimulate insulin secretion and inhibit glucagon secretion
How do SGLT 2 inhibitors treat diabetes?
- block glucose reuptake in PCT
- more glucose excreted in urine
- side effect of hypovolemia
52-year-old female with type II diabetes mellitus presents to your clinic as a new patient. She brings you a list of all the oral hypoglycemic agents she is currently taking.
Which of the following drugs works by targeting
an enzyme responsible for degrading incretins?
A. Exenatide (Byetta) B. Glyburide (sulfonyl urea) C. Metformin D. Acarbose E. Sitagliptin (Januvia)
-E. Sitagliptin (Januvia)
