Non-insulin type 2 diabetes Drugs

Question 1

Sulfonylureas

Answer 1

(glipizide, glyburide) stimulate pancreas to secrete more insulin & make tissues more responsive to insulin. Effective only when pancreas is capable of producing some insulin. (cannot be used in type 1 diabetes)

Question 2

Meglitinides

Answer 2

(repaglinide, nateglinide) stimulate pancreas to secrete more insulin, repaglinide lowers BS by closing K+ channels of pancreatic beta cells. Shorter acting/should be taken with meals.

Question 3

Thiazolidinediones

Answer 3

(glitazones- piolitazone, rosiglitazone) decrease insulin resistance at the tissue level and may also decrease glucose production.

Question 4

Alpha-Glucosidase Inhibitors

Answer 4

(acarbose, miglitol) delay absorption of carbohydrates in small intestine, which decreases the expected rise in post prandial glucose after a meal

Question 5

DPP-4 Inhibitors

Answer 5

(gliptins- sitagliptin, saxagliptin) enhance the actions of I cretin hormones, stimulating the release of insulin & suppressing the release of glucagon after eating, keeping blood glucose from elevating after meals.

Question 6

Incretin Mimetics

Answer 6

(exenatide) non-injectable drugs, mimic effect of endogenous incretin. Gastric emptying is slowed, stimulating the glucose-dependent release of insulin, inhibiting the release of glucagon, and suppressing appetite.

Question 7

Biguanides

Answer 7

(metformin) increases insulin sensitivity without causing hypoglycemia. Helpful with patients who are obese or who have hyperlipedemia because it also helps decrease weight, BP, and plasma lipids. (used in treatment of type 2 diabetes) slows production of glucose in liver/ decreased hepatic production of triglycerides and cholesterol

Question 8

Glyburide (sulfonylurea)

Answer 8

Route: PO
Onset of action: 0.25—1 hour
Peak: 1-2 hours
Duration: 12-24 hours
Half-life: 5-6 hours
Well absorbed in GI tract. Protein binding 99%. Metabolized in liver. Primarily excreted in urine. Not removed by hemodialysis.

Question 9

Repaglinide (meglitinide)

Answer 9

Route: PO
Onset of action: almost immediate
Peak: 1 hour
Duration: 4 hours
Half-life: 1 hour
Metabolized in liver and excreted in feces. Blood levels of insulin rise and fall in parallel with levels  of repaglinide.

Question 10

Piolitazone (thiazloidinedione)

Answer 10

Route: PO
Onset of action: almost immediate
Peak: 2 hours
Duration: unknown
Half-life: 16-24 hours
Food slows absorption. Metabolized in liver, and excreted in urine

Question 11

Acarbose (alpha - glucosidaze Inhibitor)

Answer 11

Route: PO
Onset of action: almost immediate
Very little drug is absorbed, systemic effects minimal, acts locally in intestine to slow absorption of carbs and is eliminated in feces

Question 12

Sitagliptin (DPP-4 inhibitor)

Answer 12

Route: PO
Onset of action: almost immediate
Peak: 1-4 hours
Duration: unknown
Half-life: 12 hours
Most of drug is excreted unchanged in urine.

Question 13

Exenatide (incretin mimetic)

Answer 13

Route: SubQ
Peak: 2.1 hours
Duration: unknown
Half-life: 2.4 hours
Excreted unchanged in urine. Patients w/ mild to moderate renal impairment: clearance reduced only slightly. Should not be used in patients with end-stage renal disease; clearance is reduced significantly.

Question 14

Diabetes mellitus

Answer 14

Complex disorder of carbohydrate, fat, & protein metabolism resulting from lack of insulin secretion by beta cells of the pancreas or from defects of insulin receptors.

Question 15

Diabetic Ketoacidosis (DKA)

Answer 15

Severe metabolic complication of uncontrolled diabetes, if untreated can result in coma/death

Question 16

Glucagon

Answer 16

Hormone produced by alpha cells in the islets of langerhans that stimulates the conversion of glycogen to glucose in the liver.

Question 17

Glucose

Answer 17

(dextrose) simple sugars that serves as source of energy. Find in foods & is the final breakdown product of complex carbs in body

Question 18

Glycogen

Answer 18

Polysaccharide that is the major carbohydrate stored in animal cells

Question 19

Glycogenolysis

Answer 19

Breakdown of glycogen to glucose

Question 20

Hemoglobin A1C

Answer 20

Hemoglobin molecules bound to glucose molecules; blood levels of hemoglobin A1C are used in monitoring/diagnosing diabetes

Question 21

Hyperglycemia

Answer 21

Fasting blood glucose level 126 mg/dL or higher

Non-fasting 200mg/dL or higher

Question 22

Hypoglycemia

Answer 22

Blood glucose level less than 70mg/dL or

Above 50mg/dL with signs & symptoms of hypoglycemia

Question 23

Insulin

Answer 23

Naturally occurring hormone secreted by beta cells in pancreas in response to increased levels of glucose in blood

Question 24

Polydipsia

Answer 24

Chronic excessive intake of water, common in uncontrolled diabetes

Question 25

Polyphagia

Answer 25

Excessive eating, common symptom of uncontrolled diabetes

Question 26

Polyuria

Answer 26

Increased frequency urinary output, common symptom of diabetes

Question 27

Type 1 diabetes mellitus

Answer 27

Genetically determined autoimmune disorder | Complete or nearly complete lack of insulin production; commonly arises in children/adolescents

Question 28

Type 2 diabetes mellitus

Answer 28

Common in adults due to inactivity/weight gain | May be controlled by lifestyle modifications, oral drugs, or insulin (not necessarily insulin dependant)