Pancreatic Hormones and Anti-Diabetic Drugs Flashcards Preview

PHARMACOLOGY 4.0 > Pancreatic Hormones and Anti-Diabetic Drugs > Flashcards

Flashcards in Pancreatic Hormones and Anti-Diabetic Drugs Deck (65):
1

soluble crystalline zinc insulin that is now made by recombinant DNA techniques to produce a molecular identical to that of human insulin

regular insulin

1

Total daily insulin requirement in units is equal to the weight in pounds divided by 4; The type of therapy prescribed in patients with type 1 DM and as well as some type 2 DM

INTENSIVE Insulin Therapy

1

safest sulfonylureas for elderly diabetics

Tolbutamide

1

MOA of Thiazolidindiones

decrease insulin resistance; Ligands of peroxisomes proliferator activated receptor gamma (PPAR-y)

2

Drug Interaction of Pioglitazone

Gemfibrozil

3

in alpha glucosidase inhibitor treatment, only 2 sugars can be transported out of the human lumen. What are these?

Glucose Fructose

4

If Chlorpropamide is given >500mg daily, it increases the risk of

jaundice

5

Chlorpropamide is contraindicated in

Elderly

5

Approved for use for pre-prandial use in person with type 1 & 2 DM

Pramlintide

6

Rosiglitazone adverse effect

Fluid retention, Heart Failure, Bone fracture

7

this appears to be reduced during long term metformin therapy

Absorption of Vit B12

8

intermediate acting insulin analogs

Neutral protamine hagedorn/isophane insulin

9

MOA of insulin secretagouges

 Increase insulin release from the pancreas  Reduction of serum glucagon levels  Closure of K channels in extrapancreatic tissue

11

Soluble “peakless" insulin analog

Insulin Glargine

12

1st Generation sulfonylureas that is well absorbed but rapidly metabolized in the liver

Tolbutamide

12

1st Generation sulfonylureas that is slowly metabolized in the liver

Chlorpropamide

12

promotes glucose uptake in adipose tissues and utilization and modulates synthesis of lipid hormones or cytokines

Thiazolidinediones

13

Stimulates very rapid and transient release of insulin from beta cells thru closure of ATP-sensitive K channel

Nateglinide

13

alpha glucosidase inhibitors

Acarbose Miglitol

14

a condition where low titer of circulating Ig G anti insulin antibodies that neutralize the action of insulin to neglible extent develops in most insulin treated patient

Immune insulin resistance

15

for controlling postprandial glucose excursion

Repaglinide

15

delays the digestion and absorption of starch and disaccharides

alpha glucosidase inhibitors

16

MOAof Sitagliptin

Inhibits Dipeptidyl Peptidase Increases circulating levels of GLIP1 and GIP

17

delayed absorption when taken with food

Glipezide

18

First incretin therapy to become available for treatment of diabetes

Exenatide

19

diagnosed in person with type 2 DM , characterized by profound hyperglycemia and dehydration

Hyperosmolar Hyperglycemic Syndrome

20

in combination therapy, what is the initial therapy?

Biguanides

22

short acting insulin analog

Regular insulin

23

Insulin sensitizer

Pioglitazone

24

First line therapy for type 2 DM

Metformin

26

an abnormal or degenerative condition of the body’s adipose tissue

Lipodystrophy

27

Second Generation Sulfonylureas with shortest half life

Glipezide

29

Most recently developed long acting insulin analogue Dose dependent onset of action

Insulin Detemir

31

1st Generation sulfonylureas

Tolbutamide Chlorpropamide Tolazamide

33

Complications of insulin therapy

Hypoglycemia Immunopathology of Insulin therapy Lipodystrophy

33

More slowly absorbed than other sulfonylureas

Tolazamide

34

Reduces Cardiovascular events in Diabetes

Acarbose

35

Categories of Oral Anti-Diabetic Agents

1. Secretagougues: (Sulfonylureas, Meglitinide, D-phenylalanine derivatives) 2. Biguanides 3.Thiazolidinediones 4. a-glucosidase inhibitors 5. Incretin based 6. Amylin analog

35

Minor MOA of Biguanides

 Impairment of renal gluconeogenesis, slowing of glucose absorption from GIT  Increase glucose to lactate conversion by enterocytes  Direct stimulation of glycolysis in tissues  Increased glucose removal from blood  Reduction of plasma glucagon levels

36

ADR of Acarbose

Flatulence, diarrhea and abdominal pain

37

MOA of Glucagon-like Polypeptide (GLP-1) receptor agonist

Potentiation of glucose mediated insulin secretion

39

Rapid acting insulin analogs

Insulin Lispro Insulin Aspart Insulin Glulisine

40

Second Generation Sulfonylureas that causes flushing with alcohol ingestion

Glyburide

41

in combination therapy, what is the 2nd line of therapy?

Insulin Insulin Secretagogues TZD Incretin based therapy Amylin analog Glucosidase inhibitor

42

Glucagon-like Polypeptide (GLP-1) receptor agonist

Exenatide

44

Major MOA of Biguanides

Activation of AMP kinase to reduce hepatic glucose production

45

most common complication of insulin therapy and usually results from inadequate carbohydrate consumption, unusual physical exertion or too large dose of insulin

Hypoglycemia

46

Nateglinide is important in treatment of

isolated post prandial fasting glucose level

47

Drug interaction of glucagon

Warfarin

48

does not increase weight and provoke hypoglycemia (insulin sparing drug)

Metformin

49

long acting insulin analogs

Insulin detemir Insulin Glargine

51

Prescribed only for certain people with type 2 DM who are felt not to benefit from intensive glucose control

Conventional Insulin Therapy

53

Single dose of 1mg has been shown to be effective

Glimepiride

54

Not recommended for use in type 1 DM; Approved for use as monotherapy for type 2 DM

Rosiglitazone

55

Referred as sliding scale regimen

Conventional Insulin Therapy

56

adjunctive therapy in persons with type 2 DM treated with metformin or metformin plus sulfonylureas with suboptimal glycemic control

Exenatide

57

Provide reproducible, convenient background insulin replacement

Insulin Glargine

58

Treatment for DKA

Aggressive IV infusion and Insulin therapy

59

Shown to lower HvA1c level by 0.7%

Sitagliptin

60

Clinical consequences of regular insulin administration

early postprandial hyperglycemia late postprandial hypoglycemia

61

Glucagon precursor intermediate made up of 69 amino acid peptide

Glucentin

62

Synthetic analog of Amylin

Pramlintide

63

Second Generation Sulfonylureas

Glyburide (Glibenclamide) Glipezide Glimepiride

64

major site of action of TZD's

Adipose Tissue

65

insulin delivery systems

Standard mode of insulin treatment (SQ) Portable Pen Injections Continuous Subcutaneous insulin infusion device (CSIID)