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Flashcards in Review - Agents for Diabetes Mellitus Deck (28):
0

What types of drugs can elevate blood glucose concentrations?

1. Alcohol
2. Beta blockers
3. Combination oral contraceptives
4. Diazoxide
5. Diuretics
6. Corticosteroids
7. Lithium
8. Niacin
9. Phenytoin
10. Sympathomimetics

1

What is the term used to describe a rise in blood glucose usually between 4 and 11am due to release of GH, cortisol, glucagons, and epinephrine?

Dawn phenomenon.

2

What is the term used to describe a rebound rise in morning blood glucose secondary to a low overnight blood glucose?

Somogyi effect.

3

What is the time of onset, peak effect, and duration of insulins?

Aspart --> 0.17-0.33h/ 1-3h/ 3-5h.
Lispo --> 0.25h/ 0.5-1.5h/ 6-8h.
Regular --> 0.5-1h/ 2-3h/ 8-12h.
NPH --> 1-1.5h/ 4-12h/ 24h.
Lente --> 1-2.5h/ 8-12h/ 18-24h.
Ultralente --> 4-8h/ 16-18h/ >36h.
Glargine --> No peak/ duration is 24h.

4

Can insulin glargine be mixed with other insulins?

No.

5

What is the most common side effect of insulin?

Hypoglycemia

6

Which sign/symptom of hypoglycemia is not masked by β blockers?

Diaphoresis

7

What is the name of the incretin mimetic that increases insulin secretion, slows gastric emptying, and decreases food intake?

Exenatide

8

What hypoglycemic agent is not contraindicated in a pregnant woman with DM?

Insulin

9

Other than blood glucose reduction, regular insulin can also be used for what condition?

HYPERKALEMIA.
Causes intracellular shift of K.

10

What is the longest acting sulfonylurea?

Chlorpropamide

11

Which sulfonylurea can cause disulfiram-like reactions?

Chlorpropamide

12

Which sulfonylurea can cause SIADH?

Chlorpropamide

13

The dose of what 2nd gen sulfonylurea should be decreased in patients with renal dysfunction?

Glyburide

14

The dose of what 2nd gen sulfonylurea should be decreased in patients with hepatic dysfunction?

Glipizide

15

Name two concomitant health conditions in which thiazolidinediones may NOT be used in a diabetic patient?

1. CHF
2. Liver failure

16

Based of liver function test results, when should a therapy with a thiazolidinedione be withheld?

When LFTs rise above 2.5 times the upper limit.

17

What oral hypoglycemic should be withheld when the serum creatinine is above 1.5 for males and 1.4 for males?

Metformin

18

What time of day should meglitinides be given?

15-30 minutes before each meal.

19

Would oral sucrose be effective in a hypoglycemic patient who is currently taking an α-glucosidase inhibitor?

NO - sucrose is a disaccharide. Glucose would.

20

The 3 rapid acting insulins are also used in what condition?

For emergency treatment of diabetic ketoacidosis.

21

What patients are particularly susceptible for developing hypoglycemia after insulin use?

1. Renal patients
2. Elderly
3. Children <7yrs

22

What are the 4 well-established groups of oral antidiabetic drugs that are used most commonly to treat type 2 DM?

1. Insulin secretagogues
2. The biguanide metformin
3. Thiazolidinediones
4. Alpha-glucosidase inhibitors

23

Mention 3 novel agents that target endogenous regulators of glucose homeostatis.

1. Pramlintide
2. Exenatide
3. Sitagliptin

24

What is the mechanism of action of biguanides?

Inhibit hepatic and renal gluconeogenesis.

25

What is nowadays increasingly the drug of choice in overweight patients with type 2 DM?

Metformin

26

Besides type II DM, what is another use of metformin?

To restore fertility in anovulatory women with polycystic ovary disease and evidence of insulin resistance.

27

Has pioglitazone and troglitazone any effect on CYP450 activity?

Yes - INDUCERS

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