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Pharm Flashcards

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1
Q

lispro, aspart, glulisine

A

Insulin, rapid acting

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2
Q

regular (insulin)

A

insulin, short actin

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3
Q

NPH

A

insulin, intermediate acting

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4
Q

detemir

glargine

A

insulin, long acting

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5
Q

which insulin prep treates DKA (IV)

A

Regular

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6
Q

risks/ concerns for insulin preparation

A

hypoglycemia, lipodystrophy, rare hypersenstiivty reactions

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7
Q

onset of action for insulin rapid acting

A

15 mins. peak 45-75 mins

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8
Q

Amino acid substitution at C terminal of insulin beta chain prevents what in lispro

A

prevents polymeraizaiton; allows for rapid absorption from injection site

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9
Q

which insulin prep is not preferred for mealtime bolus infusion

A

regular insulin

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10
Q

polymerizes into hexamers + dimers delaying time to dissociate after injection

A

regular insulin

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11
Q

crystalline suspesion of insulin with protamine and zinc

A

NPH

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12
Q

which insulin prep is a fatty acid bound to one of lysine amino acid

A

Detemir

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13
Q

Glargine is ____ soluble at phsyiologic ph, causing it to precipiate at injection site and be slowly release into circulation

A

less

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14
Q

first line therapy in dm 2

A

metformin (biguanides)

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15
Q

this drug inhibits hepatic gluconeogensis and action of glucagon, increases glycolysis, increases peripheral glucose uptake. increases insulin sensitivity

A

metformin

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16
Q

Most serious side effect of metformin

A

lactic acidosis (thus CI in renal insufficeincy). also gi upset

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17
Q

why can metformin be used in dm1 as well

A

bc can be used in pt’s without iselt function

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18
Q

chlorpropamide, tolbutamide

A

first gen sulfonylureas

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19
Q

glimepiride, glipizide, glyburide

A

second gen sulfonylureas

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20
Q

No use in type I dm

A

sulfonylureas

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21
Q

mechanism of action of sulfonylureas

A

close K+ channel in pancreatic beta cell membrane: causes cell depolariziation: leads to insulin release via increase Calcium influx

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22
Q

which second gen sulfonylurea are long acting

A

glimepiride, glyburide

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23
Q

short acting second sulfonylurea

A

glipizide: lower incidence of hypoglycemia compared to glimepiride, glyburide

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24
Q

SE sulfonylurea

A

risk of hypoglycemia increase in renal fialure, weight gain

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25
first generation sulfonylurea side effect
disulfiram like effects | flushing w alcohol consumption
26
glitazones/thiazolidinediones drugs
pioglitazone | rosiglitazone
27
increases insulin sensitivity in peripheral tissues. also binds to PPAR-gamma nuclear transcription regulator
pioglitazone/rosiglitzaone.
28
stimulates AMPK: oral insulin drug
metformin
29
glitazones upregulate what genes
``` GLUT 4 (increase glucose uptake) adiponectin (cytokine secreted by fat tissue that increases # of snsulin responsive adipocytes and regulates FA oxidation ```
30
increases adiponectin,
glitazones
31
glitazone does what TNF a and leptin
decrease
32
SE of oral drug that causes weight gain
glitazones
33
se of glitzones
``` weight gain(bc increase fat storage in apdocytes and increase # of adipocytes) edema, HF, increase risk of fractures ```
34
meglitinides
nateglinide, repaglinide
35
stimulates post prandial insulin release by binding to K+ channels on B cell membranes (site differs from sulfonylureas)
meglitinides
36
which oral diabetic drug has a low risk of hypoglycemia
glitazones. because mechanism is increasing insulin sensitivty in peripheral tissues
37
SE of meglitiindes
weight gain, hypoglcyemia
38
GLP 1 analogs drug
inulin, exenatide, liraglutide(sc injection)
39
SE of GLP 1 analogs:
nausea, vomiting, pancreatitis, modest weight loss
40
mechanism of action for GLP 1 analgos
increase glucose dependent insulin release, decrease glucagon release, decraes gastic emptying, increase satiety
41
GLP 1 does what to satiety
induces it
42
DPP-4 inhibitors drugs
linagliptin, saxagliptin, sitagliptin
43
DPP-4 inhibitors inhibit what
DPP4 enzyme that deactivates GLP-1, thereby increases glucose dependent insulin release, decrase glucoagon release.
44
SE of dpp4 inhibitors
mild urinary or respiratory infections; weigth neutral; does not cause hypoglycemia bc glucose dependent
45
amylin analogs
pramlintide
46
mechanism of action for amylin analgos
decrease gastric emptying, decrease glucagon
47
se of amylin
hypoglycemai, nausea
48
Sodium glucose co transporter 2 inhibitors (SGLT2)
canagliflozin, dapagliflozin, empagliflozin
49
mechanism of action for SGLT2 inhibitors
block reabsorption of glucose in PCT: increase renal glucose excretion
50
SE of SGLT2:
glucosuria, UTI's vaginal yeast infections, hyperkalemia, dehydration (orthostatic hypotension), wt loss
51
alpha glucosidase inhibitors
acarbose | miglitol
52
amylin is used for type I and II Dm
true
53
mechanism of action for a glucosidase inhibitors
inhibit intestinal brush border a glucosidases. (disacharides). delayed carbhydrolysis and glucose absorption : decrease postprandial hyperglycemia
54
SE of acarbose, miglitol
GI distrubances
55
ADH antagnoists drugs
conivaptin, tolvaptin
56
desmorpressin acetate
central DI, von willebrand disase, sleep enuresis
57
Somatostatin use
acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices
58
mechanism of action of cinacalcet
sensitizes ca2+ sensing receptor (casr) in parathyroid gland to cirucalting Ca 2+: decrase PTH
59
use of cinacalcet
primary or secondary hyperparathyodrism
60
fludrocortisone
synthethic analog of aldosterone with little glucocortioid effects
61
use of fludrocortisone
mineralocorticoid repalcement in primary adrenal insufficiency
62
thioamides drugs
propylthiouracil, methimazole
63
mechanism of action for methimazole, propylthiouracil
blocks thyroid peroxidase,inhibiting oxidation of iodide and organification and coupling of iodine: inhibits thyroid hormone synthesis.
64
Propylthiouracil also blcoks what
5'-deiodinase : decreases periphreal conversion of T4 to T3
65
Ptu blocks
Peripheral conversion
66
PTU is used in first trimester of pregnancy: not methimazole becaes
methimazole : teratogenicity
67
methimazole used in 2nd/3rd trimester of pregnancy bc
PTU induced hepatoxciity
68
SE of propylthiouracil, methimazole
skin rash, agranulocytosis, aplastic anemia, hepatotoxicyt.
69
what is given prophylacitcally to protect thyroid from excessive accumulation of radioactive 131 i
potassium iodide
70
analog used to treat HIV associated lipodystrophy
tesamorelin (GHRH analog)

Pharm (13 decks)

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