Flashcards in Pharmy pharm pharm Deck (84)
L cells release?
Glucagon-like peptide-1 (GLP-1)
K cells release?
Glucose-dependent insulinotropic polypeptide (GIP)
DPP-4 inactivates what two hormones?
GLP-1 and GIP
Residual carbohydrates in the bowel leads to?
Flatulence and diarrhea
Alpha cells secrete?
Beta cells secrete?
Insulin and amylin
Delta cells release?
What does somatostatin do?
Acts locally to decrease beta cell release
Insulin is cleared via the _______
How many units of insulin are degraded by the kidney every 24 hours?
What promotes glucose uptake by tissue cells, promotes protein synthesis, and provides for glucose storage?
What maintains blood glucose between meals and in fasting state?
What is released in response to increased blood glucose (besides insulin)?
Growth hormone will have what effect on glucose levels?
Increases glucose levels
"Hypoglycemia begets hyperglycemia" refers to what?
What could you do before bed to reduce Somogyi effect?
How is Dawn phenomena different from Somogyi effect?
What is our rapid acting insulin?
What is our short acting insulin?
Regular insulin (Humulin-R)
What is our intermediate acting insulin?
Neutral Protamine Insulin (Humulin-N)
What is our long acting insulin?
Long-acting Glargine Insulin (Lantus)
What type of insulin can be given IV?
Where does Invokana work?
It inhibits glucose reabsorption in proximal renal tubule
T4 accounts for what percentage of thyroid hormone produced?
T3 accounts for what percentage of total thyroid hormone produced?
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?
Early or mild bone thinning is called?
Significant bone thinning with or without fracture is called?
How long does bone resorption take?
How long does bone formation take?
BMD > 2.5 SD below mean for same sex young adult on DEXA means what?
Epinephrine _____ blood glucose levels secondary to stress, hypoglycemia
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?
This drug is a Meglitinide and is used in replacement of Glipizide when people have a sulfa allergy
Is insulin released in a continuous or pulsatile fashion?
What is the half life of insulin in the periphery?
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?
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
Is Glipizide a first or second generation sulfonylurea?
What is our amylin analogue?
What are our GLP-1 agonists?
Exenatide (Byetta) and Liraglutide (Victoza)
What is the difference between Exenatide and Liraglutide?
Exenatide can increase warfarin effect
What is our DDP-4 inhibitor?
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?
Good job team.
Is hypoglycemia seen clinically with metformin?
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?
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?
What is our SGLT2 inhibitor and how does it work?
inhibits glucose reabsorption in proximal renal tubule
What drug do we initially prescribe for hypothyroidism and thyroid cancer?
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?
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?
What drug is also a glucocorticoid but is much more potent than prednisone?
What drug do we prescribe for resistant orthostatic hypotension?
What else is Fludrocortisone prescribed for?
What type of calcium supplementation should be used with PPI's?
What drug is our Selective Estrogen Receptor Modulators?
Dx-Dx interaction with Raloxifene?
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?