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Flashcards in Pharmy pharm pharm Deck (84)
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1

L cells release?

Glucagon-like peptide-1 (GLP-1)

2

K cells release?

Glucose-dependent insulinotropic polypeptide (GIP)

3

DPP-4 inactivates what two hormones?

GLP-1 and GIP

4

Residual carbohydrates in the bowel leads to?

Flatulence and diarrhea

5

Alpha cells secrete?

Glucagon

6

Beta cells secrete?

Insulin and amylin

7

Delta cells release?

Somatostatin

8

What does somatostatin do?

Acts locally to decrease beta cell release

9

Insulin is cleared via the _______

kidneys

10

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

6-8 units

11

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

Insulin

12

What maintains blood glucose between meals and in fasting state?

Glucagon

13

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

Amylin

14

Growth hormone will have what effect on glucose levels?

Increases glucose levels

15

"Hypoglycemia begets hyperglycemia" refers to what?

Somogyi effect

16

What could you do before bed to reduce Somogyi effect?

Eat protein

17

How is Dawn phenomena different from Somogyi effect?

Dawn phenomena

18

What is our rapid acting insulin?

Lispro

19

What is our short acting insulin?

Regular insulin (Humulin-R)

20

What is our intermediate acting insulin?

Neutral Protamine Insulin (Humulin-N)

21

What is our long acting insulin?

Long-acting Glargine Insulin (Lantus)

22

What type of insulin can be given IV?

Regular Insulin

23

Where does Invokana work?

It inhibits glucose reabsorption in proximal renal tubule

24

T4 accounts for what percentage of thyroid hormone produced?

80-90%

25

T3 accounts for what percentage of total thyroid hormone produced?

10-20%

26

Calcitonin is released from??

Parafollicular C cells

27

What is Fludrocortisone prescribed for?

Addison's disease and resistant orthostatic hypotension

28

Deficient mineralization of bone is called?

Osteomalacia

29

Early or mild bone thinning is called?

Osteopenia

30

Significant bone thinning with or without fracture is called?

Osteoporosis

31

How long does bone resorption take?

2 weeks

32

How long does bone formation take?

3 months

33

Parathyroid stimulates?

Bone resorption

34

Estrogen controls?

Osteoclast activation

35

Calcitonin inhibits?

Osteoclast activity

36

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

Osteoporosis

37

Epinephrine _____ blood glucose levels secondary to stress, hypoglycemia

raises

38

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

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

39

What drug stimulates pancreatic beta-cell release of insulin?

Glipizide

40

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

Repaglinide

41

Is insulin released in a continuous or pulsatile fashion?

Pulsatile

42

What is the half life of insulin in the periphery?

15 minutes

43

GLUT-1 transporters go where in the body?

All tissues including nervous system

44

GLUT-2 transporters go where in the body?

Pancreatic beta-cells and liver cells

45

GLUT-4 transporters go where in the body?

Skeletal muscle and adipose tissue

46

What are macrovascular complications of diabetes?

CAD, CVA, and PVD

47

What are microvascular complications of diabetes?

Retinopathy, Nephropathy, Neuropathy

48

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

ACE-inhibitors, statins, and aspirin

49

What classes of drugs decrease insulin resistance?

Biguanides, TZD's

50

What classes of drugs decrease hepatic gluconeogenesis?

Biguanides, amylin analogue

51

What classes of drugs decrease glucose absorption?

Alpha-glucosidase inhibitors and bile acid sequestrants

52

True or False

Sulfonylureas can cause weight gain and hypoglycemia concerns

TRUE

53

Is Glipizide a first or second generation sulfonylurea?

Second

54

What is our amylin analogue?

Pramlintide (Symlin)

55

What are our GLP-1 agonists?

Exenatide (Byetta) and Liraglutide (Victoza)

56

What is the difference between Exenatide and Liraglutide?

Not much...

Exenatide can increase warfarin effect

57

What is our DDP-4 inhibitor?

Sitagliptin (Januvia)

58

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.

59

Is hypoglycemia seen clinically with metformin?

Nope

60

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.



61

What is our TZD?

Pioglitzone (Actos)

62

MoA for Pioglitazone?

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

Basically look for PPAR-gamma

63

What is our Alpha-glucosidase inhibitor?

Acarbose (Precose)

64

What is our SGLT2 inhibitor and how does it work?

Canaglifloxin (Invokana)

inhibits glucose reabsorption in proximal renal tubule

65

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

Levothyroxine

66

What is the MoA of Levothyroxine?

Replacement T4 converted to T3 in peripheral tissues

67

When would we prescribe Liothyronine?

When hypothyroidism is not responsive to T4 therapy.

68

Besides hypothyroidism, when else would we use Liothyronine?

Myxedema coma

69

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

A fib, depression, post-menopausal osteoporosis

70

When do we use Radioactive Iodine?

To ablate the thyroid

-can be an exacerbation of Grave's opthalmology

71

How do we treat hyperthyroidism?

Methimazole and Propylthiouracil

PTU for pregnant women

72

How does prednisone affect adrenal function?

Suppresses

73

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

Dexamethasone

74

What drug do we prescribe for resistant orthostatic hypotension?

Fludrocortisone

75

What else is Fludrocortisone prescribed for?

Addison's

76

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

Calcium citrate

77

What drug is our Selective Estrogen Receptor Modulators?

Raloxifene (Evista)

78

Dx-Dx interaction with Raloxifene?

Thyroid supplementations

79

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

Inhibits osteoclast activity and skeletal calcium release

80

How is Denosumab (Prolia) administered?

Injection every 6 months

81

How is Calcitonin administered?

IM or nasal spray formulation

82

What is Teriparatide (Forteo)?

Recombinant Human Parathyroid Hormone

83

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

2 years

84

Can you use Teriparatide with bisphosphonates?

No