Pharmy pharm pharm Flashcards by Sam Stanfield

L cells release?

Glucagon-like peptide-1 (GLP-1)

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K cells release?

Glucose-dependent insulinotropic polypeptide (GIP)

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DPP-4 inactivates what two hormones?

GLP-1 and GIP

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Residual carbohydrates in the bowel leads to?

Flatulence and diarrhea

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Alpha cells secrete?

Glucagon

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Beta cells secrete?

Insulin and amylin

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Delta cells release?

Somatostatin

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What does somatostatin do?

Acts locally to decrease beta cell release

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Insulin is cleared via the _______

kidneys

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How many units of insulin are degraded by the kidney every 24 hours?

6-8 units

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What promotes glucose uptake by tissue cells, promotes protein synthesis, and provides for glucose storage?

Insulin

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What maintains blood glucose between meals and in fasting state?

Glucagon

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What is released in response to increased blood glucose (besides insulin)?

Amylin

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Growth hormone will have what effect on glucose levels?

Increases glucose levels

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“Hypoglycemia begets hyperglycemia” refers to what?

Somogyi effect

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What could you do before bed to reduce Somogyi effect?

Eat protein

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How is Dawn phenomena different from Somogyi effect?

Dawn phenomena

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What is our rapid acting insulin?

Lispro

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What is our short acting insulin?

Regular insulin (Humulin-R)

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What is our intermediate acting insulin?

Neutral Protamine Insulin (Humulin-N)

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What is our long acting insulin?

Long-acting Glargine Insulin (Lantus)

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What type of insulin can be given IV?

Regular Insulin

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Where does Invokana work?

It inhibits glucose reabsorption in proximal renal tubule

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T4 accounts for what percentage of thyroid hormone produced?

80-90%

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T3 accounts for what percentage of total thyroid hormone produced?

10-20%

Calcitonin is released from??

Parafollicular C cells

What is Fludrocortisone prescribed for?

Addison's disease and resistant orthostatic hypotension

Deficient mineralization of bone is called?

Osteomalacia

Early or mild bone thinning is called?

Osteopenia

Significant bone thinning with or without fracture is called?

Osteoporosis

How long does bone resorption take?

2 weeks

How long does bone formation take?

3 months

Parathyroid stimulates?

Bone resorption

Estrogen controls?

Osteoclast activation

Calcitonin inhibits?

Osteoclast activity

BMD > 2.5 SD below mean for same sex young adult on DEXA means what?

Osteoporosis

Epinephrine _____ blood glucose levels secondary to stress, hypoglycemia

raises

In fasting, strenuous exercise, and stress situations _____ levels increase

Growth hormone (and others) -- but growth hormone filled in the blank based on his slides

What drug stimulates pancreatic beta-cell release of insulin?

Glipizide

This drug is a Meglitinide and is used in replacement of Glipizide when people have a sulfa allergy

Repaglinide

Is insulin released in a continuous or pulsatile fashion?

Pulsatile

What is the half life of insulin in the periphery?

15 minutes

GLUT-1 transporters go where in the body?

All tissues including nervous system

GLUT-2 transporters go where in the body?

Pancreatic beta-cells and liver cells

GLUT-4 transporters go where in the body?

Skeletal muscle and adipose tissue

What are macrovascular complications of diabetes?

CAD, CVA, and PVD

What are microvascular complications of diabetes?

Retinopathy, Nephropathy, Neuropathy

Almost all type 2 diabetic patients will end up on what types of drugs?

ACE-inhibitors, statins, and aspirin

What classes of drugs decrease insulin resistance?

Biguanides, TZD's

What classes of drugs decrease hepatic gluconeogenesis?

Biguanides, amylin analogue

What classes of drugs decrease glucose absorption?

Alpha-glucosidase inhibitors and bile acid sequestrants

True or False Sulfonylureas can cause weight gain and hypoglycemia concerns

TRUE

Is Glipizide a first or second generation sulfonylurea?

Second

What is our amylin analogue?

Pramlintide (Symlin)

What are our GLP-1 agonists?

Exenatide (Byetta) and Liraglutide (Victoza)

What is the difference between Exenatide and Liraglutide?

Not much... Exenatide can increase warfarin effect

What is our DDP-4 inhibitor?

Sitagliptin (Januvia)

Breaking it down, 1. GLP-1 and GIP do what to blood sugar? 2. DDP-4 does what do GLP-1 and GIP? 3. DDP-4 inhibitors have what effect on blood sugar?

1. Decrease 2. Inhibits 3. Decrease Good job team.

Is hypoglycemia seen clinically with metformin?

Nope

What do we have to do with someone's Metformin if they need to use IV iodinated contrast agent?

hold that puppy for 48 hours.

What is our TZD?

Pioglitzone (Actos)

MoA for Pioglitazone?

Decrease insulin resistance by activating of nuclear PPAR-gamma in myocytes, hepatocytes, and adipocytes. Basically look for PPAR-gamma

What is our Alpha-glucosidase inhibitor?

Acarbose (Precose)

What is our SGLT2 inhibitor and how does it work?

Canaglifloxin (Invokana) inhibits glucose reabsorption in proximal renal tubule

What drug do we initially prescribe for hypothyroidism and thyroid cancer?

Levothyroxine

What is the MoA of Levothyroxine?

Replacement T4 converted to T3 in peripheral tissues

When would we prescribe Liothyronine?

When hypothyroidism is not responsive to T4 therapy.

Besides hypothyroidism, when else would we use Liothyronine?

Myxedema coma

What do we put people at risk for if we over-treat thyroid supplement?

A fib, depression, post-menopausal osteoporosis

When do we use Radioactive Iodine?

To ablate the thyroid -can be an exacerbation of Grave's opthalmology

How do we treat hyperthyroidism?

Methimazole and Propylthiouracil PTU for pregnant women

How does prednisone affect adrenal function?

Suppresses

What drug is also a glucocorticoid but is much more potent than prednisone?

Dexamethasone

What drug do we prescribe for resistant orthostatic hypotension?

Fludrocortisone

What else is Fludrocortisone prescribed for?

Addison's

What type of calcium supplementation should be used with PPI's?

Calcium citrate

What drug is our Selective Estrogen Receptor Modulators?

Raloxifene (Evista)

Dx-Dx interaction with Raloxifene?

Thyroid supplementations

So Fosamax decreases rate bone resorption, how does Zolidronic acid (Reclast) work?

Inhibits osteoclast activity and skeletal calcium release

How is Denosumab (Prolia) administered?

Injection every 6 months

How is Calcitonin administered?

IM or nasal spray formulation

What is Teriparatide (Forteo)?

Recombinant Human Parathyroid Hormone

What is the longest amount of time someone can be on Teriparatide?

2 years

Can you use Teriparatide with bisphosphonates?

Pharmy pharm pharm Flashcards

(84 cards)