Pharmacology of Diabetes Flashcards Preview

Regulatory Physiology and Pharmacology > Pharmacology of Diabetes > Flashcards

Flashcards in Pharmacology of Diabetes Deck (27):
1

What are the treatments for T1DM?

insulin injection, islet transplants
gene therapy

2

When is insulin used?

T1DM life saving
gestational

3

What is the risk with insulin injections?

patients may give themselves too much

4

What is the v.short acting insulin?

lispro

5

What is the short acting insulin?

regular

6

What in the intermediate acting insulins?

NPH and lente

7

What is the long acting insulin?

ultra lente

8

What is the ultra long acting insulin?

glargine

9

What is significant about lispro?

lysine B28
proline B29
must be used in combination with long acting

10

What is significant about glargine?

glycine A 21
2 arginine on the end of B
single bedtime dose

11

Why is transplant and stem cells not appropriate therapy?

needs 3 donors per person and costs a lot
body would probably attack new beta cells

12

What are the treatments for T2DM?

Incretins
Sulfonylureas
Glitazones
Biguanides
a-glucosidase inhibitors
DIET and EXERCISE

13

How does metformin work?

insulin sensitiser
biguanide
activates AMPK
inhibits glucose production and increases uptake by liver

14

What is good about metformin?

reduces the risk of MIs and increases survival
it doesnt cause hypo
antihyperinsulinemic

15

What is the problem with metformin?

only works in about 50% cases
small amount of people causes lactic acidoses
not pleasant to take - intestinal problems
resistance occurs after a few years
combination therapy is common

16

How do sulfonylureas work?

stimulate insulin secretion from pancreatic islets
regulate K-ATP channels by binding to SUR proteins

17

What are the problems with sulfonylureas?

relatively expensive
danger of hypoglycemia
weight gain

18

How do glitazones work?

bind PPAR y transcription factor and regulate genes involved in lipid and carbohydrate metabolism
induce glucose uptake in fat, liver and muscle cells

19

What are the problems with glitazones?

very expensive
some weight gain
gives some patients edema
often used with SURs so hypoglycaemia is a risk

20

What are the problems with glitazones?

very expensive
some weight gain
gives some patients edema
often used with SURs so hypoglycaemia is a risk

21

What is a-carbarose?

fungal metabolite that slows carbohydrate digestion and thus absorption

22

What are the problems of a-carbarose?

minor benefits for some major GI side effects
only used if patient has real difficulty reducing calorie intake

23

How do incretins work?

slow gastric emptying which decreases hunger
increases insulin secretion
protects the pancreas

24

What is the problem with incretins?

must be injected
short half life at present

25

What is a new therapy coming out?

SGLT2 inhibitors

26

What is the effect of SGLT2 inhibitors?

lowers blood glucose as less is reabsorbed in the urine and gut
independent of insulin and low risk of hypoglycaemia

27

What is the issue with some SGLT2 inhibitors?

some minor UTIs