Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine > Week 1 - Drugs and Insulin Analogs > Flashcards

Week 1 - Drugs and Insulin Analogs Flashcards

(62 cards)

Start Studying
1
Q

What is always the first choice for T2DM treatment after lifestyle changes?

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

For T2DM what time period should you plan to reach your goal for HbA(1c) levels in?

A

3 - 6 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What amino acid is substituted or modified in insulin analogs?

A

B29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Metformin is a(n)?

A

Insulin sensitizer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the three rapid acting insulin analogs?

A

Lispro (Humalog)
Aspart (Novorapid)
Glulisine (Apidra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the two long acting insulin analogs?

A

Detemir and Glargine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the two intermediate acting insulin analogs?

A

Humulin-NPH

Novolin-NPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which type of insulin analogs are cloudy?

A

The intermediate analogs (Humulin-NPH and Novolin-NPH).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some complications of insulin therapy?

A
  • Weight gain
  • Hypoglycemia
  • Lipohypertrophy
  • Insulin allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name two insulin sensitizers.

A

Metformin & the Thiazolidinediones {TZDs} {Pioglitazone}.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some of the properties of Metformin?

A
  • Safe & Cheap
  • Weight loss
  • Can be combined with insulin.
  • Excreted unchanged by the kidney.
  • Reduces hepatic glucose production.
  • Enhances insulin stimulated glucose uptake.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Metformin blocks the conversion of lactate to glucose but allows lactate to be oxidized provided there is?

A

Oxygen; Phenformin blocks both the conversion to glucose and the oxidation of lactate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Metformin may cause CKD (Chronic Kidney Disease). Patients should stop taking metformin if:

A
  • Diarrhea/vomiting/dehydration occurs.
  • Become bed sick.
  • Admitted to hospital.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some properties of Thiazolidinediones (TZDs)?

A
  • Expensive but effective.
  • No hypoglycemia
  • Lower blood pressure
  • Should NOT be combined with insulin.
  • Weight gain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name two types of insulin secretagogues.

A
  • Sulphonylureas

- Meglitnides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do secretagogues act on?

A

Potassium ATP channels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some properties of secretagogues?

A
  • Relatively safe.
  • Prices range from cheap to expensive.
  • Can be combined with insulin.
  • May cause hypoglycemia and weight gain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name four secretagogues.

A

Glyburide, Gliclazide, Glimepiride, and Repaglinide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name an alpha glucosidase inhibitor.

A

Acarbose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List some of the properties of acarbose.

A
  • Slows the digestion of oligosaccharides to monosaccharides.
  • Safe
  • Poorly tolerated and results in gastrointestinal gas.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do incretins do?

A

Incretins are gut hormones which increase insulin secretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name two incretins.

A

GLP-1 (Glucagon like peptide 1)

GIP (Glucose-dependant insulinotropic peptide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What three primary effects does GLP-1 have on the body?

A
  • Lowers glucose levels.
  • Increases insulin secretion.***
  • Lowers glucagon.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Incretin therapies may?

A

Inhibit GLP-1 breakdown or act as GLP-1 mimetics that are resistant to breakdown.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are some of the effects of incretin therapies?
- Reduce blood glucose levels. - Low risk of hypoglycemia. - Weight loss - Increase/preservation of beta cell function. - Nausea and vomiting.
26
What are the effects of an SGLT2 inhibitor?
- Lower blood glucose. - No hypoglycemia. - Weight loss. - Lower blood pressure. - Risk of UTI / Genital infections.
27
What T2DM antihyperglycemic agent causes flatulence?
The Alpha Glucosidase Inhibitor Acarbose.
28
What T2DM antihyperglycemic agent precipitates to form microcrystals after injection?
Glargine (Lantus) - a long lasting insulin analog.
29
What drug has an acylated at B29 to increase self association?
Detemir (Levamir) - a long lasting insulin analog.
30
Which insulins act faster? Rapid analogs or short-acting analogs?
Rapid analogs.
31
What are the only cloudy insulin analogs?
The intermediate analogs: Humulin-NPH & Novolin-NPH.
32
Name the three rapid insulin analogs.
Aspart Lispro Glulisine
33
How long is the onset of the rapid analog insulins?
10 - 15 minutes.
34
After what time do the rapid analog insulins peak?
~1.5 hours.
35
Over what duration do the rapid analog insulins act?
3 - 5 hours.
36
Name two short-acting insulin analogs.
Humulin-R | Novolin Toronto
37
How long is the onset of the short-acting insulin analogs?
30 minutes.
38
After what time do the short-acting insulin analogs peak?
2 - 3 hours.
39
What is the duration of the short-acting insulin analogs?
6 - 7 hours.
40
Name two intermediate insulin analogs.
Humulin-NPH | Novolin-NPH
41
What is the onset of the intermediate insulin analogs?
1 - 3 hours.
42
When do the intermediate insulin analogs peak?
5 - 8 hours.
43
What duration do the intermediate insulin analogs act over?
10 - 18 hours.
44
What is a defining characteristic of the intermediate insulin analogs?
They are cloudy.
45
What would intermediate insulin analogs be used for?
Maintaining basal insulin levels.
46
Name two long-acting insulin analogs.
Detemir | Glargine
47
What is the onset of the long-acting insulin analogs?
90 minutes. | ***Note that this is shorter than the intermediate insulin analogs.
48
When do the long-acting insulin analogs "peak"?
6 - 8 hours; the peak is very small, if present at all.
49
What is the duration of the long-acting insulin analogs?
20 - 24 hours. | {Detemir is 16 - 24 hours}
50
What would the long-acting insulin analogs be used for?
Maintaining basal insulin levels.
51
What would the rapid insulin analogs be used for?
Bolus dose insulin.
52
What would the short-acting insulin analogs be used for?
Bolus dose insulin.
53
At what A(1c) do you give metformin OR give the opportunity for lifestyle changes to lower A(1c)?
A(1c) < 8.5%. | At an A(1c) > 8.5% start metformin and consider combo therapy to lower A(1c) by at least 1.5%.
54
What T2DM drugs were accused (subsequently the accusation were proven false) or causing heart attacks.
TZDs
55
Which drugs result in weight loss?
Metformin {sensitizes the body to insulin resulting in less insulin being released}, alpha-glucoside inhibitors (acarbose) and incretins. P
56
You are ONLY at risk of developing CKD with metformin if?
GFR<15 or Creatine is high (~400).
57
What is a significant possible side effect of Metformin?
Renal disease.
58
What is a possible side effect of TZDs?
CHF {Congestive Heart Failure}.
59
What might the sulphonylureas cause?
Hypoglycemic episodes.
60
What might the Meglitinides cause?
Hypoglycemic episodes {fewer than the sulphonylureas).
61
Which drugs have a higher risk of causing hypoglycemia?
``` Insulin secretagogue (meglitinide and sulfonylurea), and Insulin. Incretins, TZDs, and Orlistat may rarely cause hypoglycemia. ```
62
Which are the only drugs which cannot be used to with insulin to treat T2DM?
TZDs

Endocrine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions