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Flashcards in Pharm 5 Deck (30)
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Anti-androgen used for hirsutism in females

Cyproterone acetate

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Alpha cells in the pancreas

Produce glucagon

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Beta cells in the pancreas

Produce insulin

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Beta cells are found

Islets of Langerhans - centrally

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Delta cells in the pancreas

Produce Somatostatin

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Endogenous insulin

Normal C-peptide

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Very rapid acting insulin, having fastest onset and shortest duration of action

Lispro & Aspart

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Short acting, crystalline zinc insulin used to reverse acute hyperglycemia

Regular (Humulin R)

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Ultra long acting insulin, has over a day duration of action

Glargine (Lantus)

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Major SE of insulin

Hypoglycemia

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Transporter of glucose --> liver for glycogen synthesis

GLUT 2

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Transporter of glucose --> muscle and adipose --> TG storage and activation of LPL

GLUT 4

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Examples of alpha-glucosidase inhibitors (AGI)

Acarbose, miglitol

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MOA of AGI's

Inhibit brush border enzyme in intestine--> delay absorption of glucose --> dec post-prandial hyperglycemia

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SE of AGI's

Flatulence (do not use beano to tx), diarrhea, abdominal cramps

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Alpha-glucosidase inhibitor associated with elevation of LFT's

Acarbose

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MOA of nateglinide

Closes K+ channel --> rapid and transient insulin release

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Biguanide

Metformin

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Drugs available in combination with metformin

Acroplus Met progutazone and metformin, Janumet and Janumet XR Sitagliptin and Metformin, Glyburide, glipizide, and rosiglitazone

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MOA of metformin

Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity

Weight loss*

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Most important potential SE of metformin

Lactic acidosis = CI in renal failure

Can also exacerbate CHF

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Meglitinides

Repaglinide

Nateglinide

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MOA of repaglinide

Short acting insulin analogue --> Insulin release from pancreas

Faster and shorter acting than sulfonylurea
Less hypoglycemia than metformin

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First generation sulfonylurea

Chlorpropamide, tolbutamide, tolazamide, etc.

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Second generation sulfonylurea

Glyburide, glipizide, glimepiride, etc.

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MOA of sulfonylureas

Close K+ channel --> Depolarization --> Ca influx --> insulin release

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Common SE of sulfonylureas, repaglinide, and nateglinide

Hypoglycemia

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Sulfonylurea NOT recommended for elderly because of very long half life

Chlorpropamide

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Thiazolidinediones

Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)

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Reason troglitazone was withdrawn from market

Hepatic toxicity