MCQ's: Diabetic Drugs Flashcards Preview

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Flashcards in MCQ's: Diabetic Drugs Deck (30)
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1
Q

Metformin:

  1. Metabolised in?
A

Not metabolised, excreted unchanged in the urine. Undetectable in the plasma at 24 hours after a single dose.

2
Q

What class of drug is metformin? What’s it’s mechanism of action?

A

A biguanide hypoglycaemic.
Enhances peripheral action of endogenous insulin.

Therefore decrease intestinal glucose uptake and decreases peripheral glucose utilisation.

3
Q

What is metformins half life?
Time to peak concentration?
Duration of action?

A

6 hours.

Peak concentration at 1-3 hours.

Duration of action 8-12 hours.

4
Q

True or false: Biguanides stimulate pancreatic insulin release?

A

False.

They decrease gluconeogenesis.
Increase glycolysis.
Decrease glucose absorption intestinally.

5
Q

What type of diabetics is metformin used in?

A

Adult onset diabetes.

Young diabetics on insulin can precipitate ketonuria if treated with biguanides as well.

6
Q

Protein binding of metformin?

A

Neglible protein binding.

7
Q

Mechanism of action if sulfanylureas?

A

Increase insulin secretion but do not affect production. Bind to a receptor coupled to increase Calcium entry into pancreatic beta cells.
They displace insulin from pancreatic islet 13 cells.

Enhance insulin’s ability to glucose uptake into muscle and fat cells.

8
Q

Examples of sulfanylureas?

A

Glibenclamide, tolbutamide, chloroproramide.

9
Q

Effect on thiazides on hypoglycaemia induced by sulfanylureas?

A

Thiazides antagonise effect of hypoglycaemia.

10
Q

haematological side effects of sulfanylureas?

A

Leucopenia, agranulocytosis, thrombocytopenia caused by tolbutamide and chloropropramide.

11
Q

T/ F:
1. Gliclazide- protects beta cells from hyperglycaemic damage.

  1. Gliclazide- reduces atheromatous plaque build up.
  2. Chlorpropramide is metabolised and excreted by the kidney
A
  1. True
  2. True
  3. False. Chlorpropramide undergoes no significant metabolism and is excreted very slowly, largely unchanged in the urine.
12
Q

Insulin pH?

A

pH 7, neutral insulin

13
Q

True or false:

60-80% of insulin can be lost due to binding to the IV fluid container and tubing.

A

True

14
Q

What percentage of secreted insulin is degraded and where?

A

80% in the liver and kidneys

Hepatic glutathione transhydrogenase breaks insulin molecule down to its constituent peptide chains.

15
Q

Half life of endogenous insulin?

A

10-20 minutes

16
Q

T/F regarding insulin:
1. It’s action involves 2nd messenger

  1. Polypeptide if 4 chains
  2. Increase cAMP in the liver
  3. Increase K+ uptake into cells
  4. Increases protein synthesis in ribosomes
A
  1. True
  2. False- formed of 2 chains. Alpha and beta.
  3. False.
  4. True
  5. True
17
Q

Insulin effect on cAMP in liver?

A

Reduced cAMP - this actively decreases potassium in hyperkalaemia.

18
Q

What hormone does insulin inhibit?

A

Lipase

19
Q

Insulin facilitates glucose uptake into?

A

The pituitary, peripheral tissue (fat/ muscle), fibroblasts, liver.

20
Q

Molecular form of insulin?

A

Molecular weight of 5600 Da

Comprised of two polypeptides alpha and beta that are strongly bound by 2 covalently bonded disulphide bridges.

21
Q

Insulin can be blocked by which drug?

A

Atropine

22
Q

What PDE inhibitor can stimulate insulin?

A

Theophylline

23
Q

Effect of A2 and B2 agonists on insulin?

A

A2- decrease insulin secretion

B2- increase insulin secretion

24
Q

Sulfanylureas tend to cause weight loss? T/F

A

False

25
Q

Sulfanylureas have a shorter or longer half life than biguanides?

A

Longer half lives than biguanides

26
Q

Which diabetic medication can cause ketonuria?

A

Metformin

27
Q

Insulin secretion can be blocked by which drug?

A

Atropine

28
Q

Which amino acids stimulate insulin release?

A

Leucine and Arginine

29
Q

What hormone can inhibit insulin secretion?

A

Somatostatin

30
Q

How does insulin affect cAMP?

A

Decreases cAMP in the liver