TRH's diabetic drugs; 3.18 Flashcards Preview

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Flashcards in TRH's diabetic drugs; 3.18 Deck (26):
1

What are the rapid acting insulin drugs?

Lispro insulin
Aspart insulin
Glulisine insulin

(Think LAG, there is no LAG)

2

What is a short acting insulin drug?

Regular insulin

3

When should rapid/short acting insulin drugs be used?

Bolus/meal time

4

What is an intermediate acting insulin drug?

NPH insulin

5

What are examples of long acting insulin drugs?

Glargine insulin
Detemir insulin

6

What are some side effects of using insulin drugs?

Hypoglycemia
Weight gain (no longer leaking calories)
Allergic reaction
Atrophy/hypertrophy of subcutaneous fat at injection site
Insulin resistance

7

What is the mechanism of biguanides (metformin)?

Inhibit hepatic enzymes and uptake of gluconeogenic substrates (like lactate)

8

Is metformin metabolized?

No...excreted unchanged

9

What are some potential side effects of biguanides?

Diarrhea (with initial high dose)
Lactic acidosis (liver doesn't take up lactate)

10

What drugs increase skeletal muscle uptake of insulin and increase cell responsiveness?

PPAR agonists (thiazolidinedione) (they have glitazone in the name). Sensitize cells to insulin so more GLUT 4 synth and transport

11

What do TZD and glitzazones require to be functional?

The presence of insulin

12

Besides increased muscular uptake of glucose, what is another effect of PPAR agonists?

Activate insulin responsive genes in the liver that regulate carb and lipid metabolism

13

What drugs increase insulin secretion by closing potassium channels?

Sulfonylureas (glimepiride)
Meglitinides (repaglinid, nateglinide)

14

How does glimepiride work?

Binds to SUR1 subunit of the ATP-sensitive K channel

15

Where are sulfonylureas metabolized? Excreted?

Sulfonylureas are metabolized in the liver and excreted by the kidneys (urine)

16

What is a major difference b/w first and second generation sulfonylureas?

Second generation have shorter half lives (more potent & fewer side effects)

17

Besides the typical hypoglycemia and weight gain, what other adverse effects can happen with meglitinides?

Tremor, GI symptoms, dizziness

18

What drugs increase insulin secretion by activating adenylate cyclase?

GLP analogs (exenatide)
Dipeptidase IV inhibitors (increase GLP (end in GLiPtin))

19

Which of the drugs that activates AC is administered SQ? Oral?

Exenatide is given SQ before meals

Dipeptidase IV inhibitors are orally effective

20

What class of drugs slows intestinal digestion/absorption of carbs?

Alpha-glucosidase inhibitors. Delayed sugar hydrolisys and absorption

21

What are examples of alpha-glucosidase inhibitors?

Acarbose (latin for without carbose) and miglitol (no mnemonic, just remember it)

22

What is the normal function of alpha-glucosidase?

Breaks down disaccharides to monosaccharides

23

What drug delays gastric emptying and inhibits glucagon secretion?

Amylin analog (pramlintide [more like prAMYLINtide))

24

What is the effect pramlintide?

Inhibits glucagon synthesis
Inhibits glucose synthesis in liver
Delays gastric emptying
Increases satiety

25

How is pramlintide administered?

Subcutaneous administration before meals

26

What are some side effects of amylin analogs?

GI symptoms
Severe hypoglycemia in combo with insulin