insulin and hypoglycaemics Flashcards
(29 cards)
name 4 types of parenteral insulin
short duration intermediate
long lasting
mixed intermediate and fast action
name 3 short duration insulins, what is their time of onset and duration?
insulin aspart insulin glulisine insulin lispro onset - 30-60 mins duration 3hrs
name an intermediate insulin
isophene insulin
name 4 long lasting insulins, what is their time of onset and duration?
insulin detemir insulin glargaine insulin zinc suspension protamine zinc insulin onset: 1-2hrs peak: 4-12hrs duration: 16-35hrs
name 3 mixed intermediate and fast acting insulins
biphasic insulin aspart
biphasic insulin lispro
biphasic isophene insulin
name the 7 classes of hypoglycaemic therapies used in type 2 diabetes
K ATP channel inhibitors GLP-1 receptor agonists DDP-4 inhibitors biguanides (insulin sensitizer) thiazolidinediones alpha -glucoside inhibitors SGLT2 inhibitors
name two types of K ATP channel inhibitors
Sulponylureas
meglitinides
name 2 short acting sulponylureas
gliclazide
tolbutamide
name 4 long lasting sulponylureas
chlorpropamide
glibenclamide
glipizide
glimepiride
name 2 meglitinides
repaglinide
nateglinide
what is the mechanism of action of K ATP channel inhibitors?
- small molecule antagonist of K atp channels
boost release of insulin; enhance normal physiology of glucose-stimulated insulin release
(mimic action of glucose)
what is the mechanism of action of GLP-1 receptor agonists
peptide agonist of GLP-1
increasing GLP-1 serum levels which release increatin hormones thus boosting insulin release
(increatin mimetic)
why can GLP-1 not be used to increase GLP-1 serum levels?
it is broken down by endogenous enzyme DPP-4
name 2 GLP-1 receptor agonists
exenatide
liraglutide
name 2 DPP-4 inhibitors
sitagliptin
vildagliptin
what is the mechanism of action of DPP-4 inhibitors?
inhibits enzyme DPP-4 which breaks down GLP-1, thus increasing GLP-1 serum levels and promoting insulin release
(incretin mimetic)
what are the side effects of DPP-4 inhibitors?
vomiting dyspepsia gastritis oedema headache dizziness fatigue upper resp. infection UTI gastroenteritis
name a biguanide (insulin sensitizer)
metformin
what is the mechanism of action of biguanides?
agonist of AMP -activated protein kinase (AMPK)
prevents hepatic production of glucose
overcomes insulin resistance by improving insulin sensitivity
name 2 types of insulin sensitizer
biguanides
thiazolindinediones
name 3 thiazolindinediones (insulin sensitizers)
pioglitazone
rosiglitazone
glimepiride
describe the mechanism of action of thiazolindinediones
activates PPARy (a regulatory protein involved in transcription of insulin-sensitive genes which regulate glucose and metabolism)
what is the main target of thiazolindinediones?
adipose tissue
name an alpha - glycosidase inhibitor
acarbose
