Insulin and other drugs Flashcards Preview

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Flashcards in Insulin and other drugs Deck (26):
1

drugs for type 1 (3)

1. insulin
2. insulin analogs
3. insulin formulaitons

2

drugs for type 2 (8)

1. biguanides
2. sulfonylureas
3. meglitinides
4. thiazolidinediones
5. incretins
6. gliptins
7. glucosindase inhibs
8. SGLT2 inhibs

3

when is normal insulin peak

2-3 hours

4

what is stucture of insulin

2 chains - A chain of 21AA and B chain of 30AA

5

3 insulin analogs

1. lispro
2. aspart
3. glulisine

6

what is advantage of analogs (2)

1. fast acting
2. short life- less hypoglycemia

7

how are analogs made to work faster

don't aggregate the same way, so pass into blood sooner

8

what is intermediate acting insulin

NPH insulin - regular with protamine attached

9

what are 2 long acting insulins

1. detemir 12hr- binds to albumin
2. glargine 24hr- preciptates at injection site

10

when are insulins used

type1 and seomtimes type 2

11

how does insulin funciton (3)

1. GLUT transported
2. glucose metabolism
3. gene expression
4. glycogen synthesis

12

what happens normally when feeding

insulin up > fuel deposition and utilization

13

what happens normally when fasting

epi, glucagon, glucocort up > fuel mobilization

14

what are insuling requirments for peak and basal levels

1. peak - handle calories after meal
2. basal - promote utilization of glucose to prevent excessive fuel

15

5 potential adverse reactions to insulin

1. hypoglycemia
2. allergy
3. local lipodistrophy - due to site of injection
4. presbyopia - visual disturbances due to osmotic changes
5. edema - Na retention at kidney

16

what are biguanides (metformin)

acts on AMP protein kinase to cause lower glucose production in liver and in creased muscle uptake

17

adv and disadv. of biguanides

adv - no hypoglycemia
dis -GI and lactic acidosis

18

how do sulfonylureas and meglitinides work

1. block K channels so get less polar membrane potential
2. cell depolarizes
3. Ca comes in
4. secretes insulin

19

what is major side effect of sulfonylureas and meglitinides

hypoglycemia - esp sulfonylureas

20

3 potentiating drug of sulfonylureas and meglitinides

1. proprnalol
2. sulfonamides
3. anti-coagulants

21

how do thiazolidinediones work

act at PPAR receptors on small fat cells to redistribute fatty acids and improve glucose utilization

22

SEs of thiazolidinediones (3)

1. weight gain
2. water retention
3. increase risk of MI

23

how do incretins work (3)

similar to GLP-1 -
1. slow gastic emptying
2. improve insulin production in B-cells
3. decrease glucagon

24

how do SGLT-2 inhibs work

inhibs. Na-glucose transporter so pee out more glucose

25

SE of SGLT-2

yeast and UTIs because of all the sugar pee

26

how do glucosidase inhibs work (2)

1. inhibs carb digestion in gut
2. delay glucose uptake in gut

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