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pharm exam 2 > lecture 9 > Flashcards

lecture 9 Flashcards

1
Q

what are some of the signs of diabetes?

A

frequent urination, increased thirst, hunger and tiredness

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2
Q

complications of diabetes?

A

stroke, heart attack, kidney disease, eye disease, and nerve damage

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3
Q

3 things used to diagnose diabetes?

A

fasting plasma glucose test, oral glucose tolerance test and measurement of glycated hemoglobin test

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4
Q

explain type 1 diabeties

A

beta cells produce no insulin. insulin dependent

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5
Q

explain diabetes 2

A

don’t produce enough insulin, insulin resistant. related to obesity

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6
Q

Lisper, aspart, and glulisine have what type of time action?

A

fast acting

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7
Q

detemir and glargine have what type of time action?

A

slow (basal)

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8
Q

two functions of insulin?

A

allow glucose to come into the cell and to inhibit glucose production from pyruvate in the liver

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9
Q

what is glitazone?

A

insulin sensitizer

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10
Q

what is metformin?

A

insulin sensitizer

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11
Q

what is a good drug for combination therapy with other drugs?

A

metformin

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12
Q

metformin acts upon what?

A

AMPK

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13
Q

NAME 4 THINGS METFORMIN DOES DEALING WITH LIPID METABOLISM?

A

decrease Acetyl coa carboxylase, increase FA transport to mitochondria, increase FA oxidation, decrease lipolysis

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14
Q

name 4 things metformin does to glucose metabolism?

A

increase glut 4, increase ate production, increase glycogen synthesis and decrease gluconeogenesis

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15
Q

contraindications for metformin?

A

type 1 dm, renal failure, liver failure, congestive heart failure

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16
Q

side effects of metformin?

A

GI cramping, okay with food. lactic acidosis risk

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17
Q

pioflitazone and rosiglitazone (TZD) are what?

A

sensitizers

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18
Q

pioglitazone good for people what what?

A

renal insufficiency

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19
Q

problem when pioglitazone?

A

delayed action: onset 3 weeks, full effect 10-12 wks

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20
Q

side effects of pioglitazone

A

weight gain, liver function abnormalities ( ALT), fluid retention, anemia and fractures of long bones in women.

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21
Q

rosiglitazone may cause what? and should be avoided for patients with what?

A

angina, or MI. ischemic heart diseases

22
Q

contraindications for pioglitazone?

A

type 1 DM, prego, liver disease, anyone younger than 18.

23
Q

sulfonyllureas and glinides are what

A

insulin secreters

24
Q

glucagon like peptide incretins are what

A

secretors

25
Q

glimepiride, glipizide, glyburide are all what

A

sulfonylureas

26
Q

disadvantages to sulfonylureas

A

hypoglycemia, weight gain, secondary failure due to gradual loss of beta cels common

27
Q

contraindications to sulf

A

type 1 dm, allergy, hyperemia in older its, cautious for woman

28
Q

name some of the effects of incretin?

A

secreted from GI, decrease appetite, decrease gastric emptying, increases insulin release

29
Q

DPP-4 inhibitors are what

A

secretors

30
Q

DPP-4 enzymes usually do what?

A

decrease GLP-1 enzymes which normally would increase glucose

31
Q

Sitaglipin (Januvia®), Saxagliptin (Onglyza®), Linagliptin (Tradjenta®) Alogliptin (Nesina®) are what

A

DPP inhibitors

32
Q

DPP-4 inhibitors used in mono therapy for what

A

diet and exercise

33
Q

DPP-4 inhibitors used in combination therapy with what?

A

metformin, TZD, SU or SU +met and now insulin

34
Q

DPP4 inhibitor should NOT be used for what 2 things?

A

type 1DM, and for treatment of diabetes ketoacidoses

35
Q

side effects of Gpp4 inhibitor?

A

few side effects- but GI adverse reactions

36
Q

eventide is what

A

GLP1 analog

37
Q

adverse effects of exentide

A

nausea and vommiting, not recommended for renal failure. hypoglycemia only with SU

38
Q

alpha glucosidase inhibitors do what?

A

limit glucose influx from gut. competitive inhibition of hydrolytic enzymes in git, delay and prolong glucose absorption.

39
Q

acarbose and miglitol (Precose® and Glyset®) are what

A

alpha glucosidase inhibitors

40
Q

side effects of alpha glucosidase inhibitors?

A

diarrhea and flatulence

41
Q

Canagliflozin and Dapagliflozin are what?

A

SGLT-2 inhibitors

42
Q

SGLT-2 inhibitors DO WHAT

A

decrease renal threshold for urinary excretion of glucose, diuretic effect, lower blood pressure, contribute to weight loss, risk of bladder infections

43
Q

what decreases glucose production?

A

glitazones

44
Q

what decreases glucose absorption?

A

acarbose (alpha glucosidase inhibitors)

45
Q

what increases insulin production?

A

SU, GLP1, and DPP4 inhibitors

46
Q

what increase peripheral glucose utilization?

A

glitazones

47
Q

what increase glucose excretion

A

SGLT2 inhibitors= canagliflozin

48
Q

4 steps of type 2 diabetes treatment?

A

diet and exercise, mono therapy, combination oral agents, and insulin

49
Q

mono therapy is treated with what

A

metformin and life style

50
Q

combination agents treated with what

A

metformin + SU, TZD GLP1 analogies or DPP4 inhibitots

51
Q

insulin stage treated with what

A

insulin and everything from combination stage

pharm exam 2 (7 decks)

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