Pharmacology - Chapter 56 - Drugs for Diabetes Mellitus

Question 1

Diabetes Mellitus - Greek word ___/ Latin word ___.

Answer 1

Greek - fountain.

Latin - honey.

Question 2

Diabetes Mellitus - disorder of ___ metabolism.

Answer 2

Carbohydrate.

Question 3

Type 1 -

Type 2 -

Answer 3

Type 1 - Insulin Dependent.

Type 2- Insulin Resistant.

Question 4

Insulin - synthesized in the ___ by ___ ___ located in the ___ of ____.

Answer 4

pancreas/beta cells/islets of Langerhans.

Question 5

Insulin - secreted by…..

Answer 5

Glucose.

Question 6

Insulin Function is primarily __ (anabolic or catabolic) - which means it promotes conservation of energy and buildup of energy stores.

Answer 6

Anabolic.

Question 7

Insulin Deficiency is __ (catabolic or anabolic) - which means it is destructive.

Answer 7

Catabolic.

Question 8

Type 1 - destruction of ___ cells and __ insulin produced.

Answer 8

Pancreatic Beta Cells/no insulin produced.

Question 9

Type 2 - ___ binding of insulin to its receptors, ___ responsiveness of receptors to insulin.

Answer 9

Reduced/Reduced.

Question 10

What are some principle signs of diabetes?

Answer 10

Hyperglycemia, which causes polyuria, polydipsia (excessive thirst and fluid intake), Ketonuria (excess keton in the urine), weight loss.

Question 11

What are some long-term complications of Diabetes?

Answer 11

Hypertension, stroke, heart disease, nephropathy, neuropathy, impotence, etc.

Question 12

How to treat Type 1 and 2?

Answer 12

Type 1 - Insulin Replacement

Type 2 - Oral hypoglycemics and/or insulin with diet/exercise!

Question 13

What are the 2 types of insulin?

Answer 13

Natural and Modified!

Question 14

What are the 4 types of modified insulin?

Answer 14

Lispro (Humalog), Neutral Protamine Hagedorn (NPH), Lente, Ultralente

Question 15

Oral Hypoglycemics - - What does it do? - Sulfonylureas (Orinase)

Answer 15

Promotes insulin secretion.

Question 16

Oral Hypoglycemics - - What does it do? - Biguanides metformin (Glucophage)

Answer 16

Decrease glucose production by liver and increase glucose uptake by muscle, decrease insulin resistance.

Question 17

Oral Hypoglycemics - - What does it do? - Alpha- Glucosidase Inhibitors (Acarbose)

Answer 17

Decrease rise in blood glucose.

Question 18

Oral Hypoglycemics - - What does it do? - Thiazolidinediones (Troglitazone) -

Answer 18

decrease insulin resistance, increase glucose uptake by muscle and decrease glucose production by liver.

Question 19

What is the typical treatment choice? Like….1-4

Answer 19

Sulfonylureas, Biguanides Metformin, Alpha Glucosidase inhibitors, and then Thiazolidinediones.

Question 20

Ketoacidosis - the __ severe manifestation of insulin deficiency.

Answer 20

Most severe.

Question 21

Ketoacidosis - characterized by…

Answer 21

hyperglycemia, production of ketone acids, hemoconcentration, acidosis, and coma.

Question 22

How do we treat ketoacidosis?

Answer 22

Restoration of insulin, correction of acidosis, replacement of lost water and salt, normalization of potassium, normalization of glucose level.

Question 23

Drug Selection for Diabetes - Step 1

Answer 23

Implement lifestyle - caloric restriction, exercise, lose weight, etc.

Question 24

Drug Selection for Diabetes - Step 2

Answer 24

Initiate treatment with one oral drug. A lean patient would need Sulfonylurea, because lean patients are more insulin deficient. A heavier patient would get Metformin.

Question 25

Drug Selection for Diabetes - Step 3

Answer 25

Treat with TWO oral drugs, like Sulfonylurea + Arcabose, or Metformin + Acarbose

Question 26

Drug Selection for Diabetes - Step 4

Answer 26

Treat with drug + insulin replacement.

Question 27

Drug Selection for Diabetes - Step 5

Answer 27

Treat with Insulin alone.

Question 28

Drug Selection for Diabetes - Step 6

Answer 28

Insulin + Thiazoledinedione