Hypoglycemic

Question 1

Insulin is produced by

Answer 1

the beta cells of the pancreas

Question 2

glucagon is produced by

Answer 2

the alpha cells of the pancreas

Question 3

what is glucose stored as

Answer 3

glycogen

Question 4

where is glucose stored

Answer 4

liver muscle (glycogen) and adipose tissue (triglycerides)

Question 5

When is insulin matured

Answer 5

when it gets cleaved from the C peptide and once its transferred from the ER to the vesicle

Question 6

How is insulin secreted

Answer 6

there is an increase in blood glucose, glucose enters the B cells, glycolysis occurs which increases the amount of ATP, this causes the ATP sensitive K channel to close, which causes a build up of K in the cell and causes depolarization, this causes VG Ca channel to open and the influx of Ca releases the vesicles in which insulin is stored

Question 7

What is the net effect of insulin on the liver

Answer 7

inhibition of glucose output

Question 8

This secretagogues drug increases insulin release and sensitivity to insulin while also decreasing glucagon

Answer 8

sulfonylureas (tolbutamide and glyburide)

Question 9

this secretagogues drug close K channels in islet cells which increases more insulin and is given before meal

Answer 9

Meglitinides

Question 10

Sulfonylureas drugs (oral)

Answer 10

tolbutamide and glyburide

Question 11

meglitinide drugs (oral)

Answer 11

repaglinide and nateglinide

Question 12

what drug can you use in combination with meglinitides (repaglinide/nateglinide)

Answer 12

Metformin

Question 13

Metformin

Answer 13

Biguanide (oral gent; sensitizers)

Question 14

How does Metformin work

Answer 14

Decreases the glucose production by the liver and decreases glucose absorption in the gut; also increases insulin sensitivity in the muscle and adipose tissue

Question 15

Because Metformin doesn’t release insulin, what side effect doesn’t occur

Answer 15

Hypoglycemia (when used alone)

Question 16

What type of patients should you not give Metformin to

Answer 16

Renal, Liver, or heart failure

Question 17

Can Metformin decrease the body weight

Answer 17

yes

Question 18

This oral hypoglycemic drug is an agonist for nuclear peroxisome proliferator-activated receptor gamma (PPAR)

Answer 18

Thiazolidinedione (sensitizer) (Rosiglitazone and Pioglitazone)

Question 19

Rosiglitazone

Answer 19

Thiazolidinedione

Question 20

Pioglitazone

Answer 20

Thiazolidinedione

Question 21

This drug reduces insulin resistance in peripheral tissues and is used mono-therapy or combination with insulin or sulfonylureas

Answer 21

Rosiglitazone and Pioglitazone (thiazolidinedione)

Question 22

Which thiazolidinedione is restricted in the US and banned in Europe (increases chance of bladder cancer)

Answer 22

Rosiglitazone

Question 23

This drug inhibits alpha-glucosidase in the gut (given with meal)

Answer 23

A-glucosidase inhibitors

Question 24

Acarbose

Answer 24

A-glucosidase inhibitor

Question 25

Voglibose

Answer 25

A-glucosidase inhibitor

Question 26

Miglitol

Answer 26

A-glucosidase inhibitors

Question 27

These drugs decrease intestinal absorption of starch, dextrin, and disaccharides (inhibit glucose absorption in the gut) and studies show it an also increase sensitivity to insulin

Answer 27

A-glucosidase (acarbose, vogliose, miglitol)

Question 28

These drugs are specifically for type II diabetes

Answer 28

Incretins and DPP-4 inhibitors

Question 29

These drugs inhibit DPP-4 and increase blood concentration of incretin GLP-1

Answer 29

DPP-4 Inhibitors

Question 30

Sitagliptin

Answer 30

DPP-4 Inhibitors

Question 31

Saxagliptin

Answer 31

DPP-4 Inhibitors

Question 32

Linagliptin

Answer 32

DPP-4 Inhibitors

Question 33

This drug is prescribed with diet and exercise; can be used alone or in combo with metformin

Answer 33

DPP-4 inhibitors (sitagliptin, saxagliptin, and linagliptin)

Question 34

How are DPP-4 inhibitors administered

Answer 34

orally

Question 35

You need an injection with this peptide analog

Answer 35

GLP- agonists (exenatide and liraglutide)

Question 36

What are the side effects of GLP agonists

Answer 36

pancreatitis, thyroid C-cell tumors, CV (heart attacks)

Question 37

This drug inhibits gastric emptying, reduces bowel movements, helps control feeding, and reduces weight

Answer 37

GLP-agonists

Question 38

This protein is responsible for 90% of glucose reabsorption in the kidney

Answer 38

Sodium-glucose transport proteins (SGLT2)

Question 39

what is the MOA of SGLT2 blockers

Answer 39

promotes elimination of glucose in the urine (blocks reabsorption) and is associated with small weight loss

Question 40

SGLT2 blockers (oral) can be used in which type of diabetes

Answer 40

Both type 1 and 2 (type 1 needs to be used in combo with insulin)

Question 41

This drug also cannot be used orally, has to be given subq before meals

Answer 41

Amylin analogues (pramlintide)

Question 42

What is the MOA of Amylin analogues (pramlintide)

Answer 42

slows gastric emptying, (increases absorption of glucose in the gut), proteins satiety and suppresses glucagon (can decrease body weight)

Question 43

What type of diabetes is amylin used for

Answer 43

Type 1 and 2

Question 44

These two drugs' target organ is the liver and decreases insulin resistance

Answer 44

Metformin and thiazolidinediones

Question 45

These two drugs' target organ is the pancreas and increase insulin secretion

Answer 45

Sulfonylureas and Meglitinides

Question 46

These two drugs' target organ is the muscle and increases insulin sensitivity

Answer 46

Metformin and thiazolidinediones

Question 47

This drug's target organ is adipose tissue and decreases insulin resistance

Answer 47

Thiazolidinediones

Question 48

This drug's target organ is the stomach and decreases absorption of glucose in the GI system

Answer 48

alpha-glucosidase inhibitors

Question 49

Review: what drugs decrease body weight

Answer 49

Metformin and Amylin (pramilintide)

Question 50

Review: What drugs can decrease glucose absorption

Answer 50

Metformin and acarbose/voglibose/miglitol

Question 51

Review: what drugs can decrease glucose reabsorption

Answer 51

Dapagliflozin

Question 52

Review: what drugs can increase insulin sensitive in tissues and organs (increase glucose uptake)

Answer 52

Tolbutamide/Glyburide, Metformin, Rosiglitazone/Pioglitazone

Question 53

Review: what drug decrease insulin resistance

Answer 53

Metformin and Rosiglitazone/Pioglitazone