Arcadia Pharmacology Final (Insulin)

Front 1

HBA1C is proportional to average _________ concentration over previous months

Back 1

Blood Glucose

Front 2

What is better PO or injections of glucose?

Back 2

PO b/c has more strong effect on insulin secretions bc stimulates production of digestive hormones which then stimulates insulin secretion by pancreas

Front 3

the _________ effect is the fact that PO glucose has stronger effect on insulin secretions bc it stimulates production of digestive hormones which then stimulates insulin secretion by pancreas

Back 3

incretin

Front 4

How is human insulin created?

Back 4

made by recombinant DNA technology with E. coli (yeast) strains

Front 5

Prior to human insulin what was mainly used?

Back 5

Beef/pork pancreas

Front 6

This insulin has a faster onset but shorter duration of action than regular insulin. there is no aggregation/or complexes that are formed? (3)

Back 6

Lispro, Aspart, Glulisine

Front 7

These 2 types of insulins have a long-acting and prolonged flat levels of hormones after just 1 injection

Back 7

Glargine/Detimir

Front 8

How is insulin usually administered?

Back 8

subQ

Front 9

When is insulin iven IV?

Back 9

In hypoglycemic emergencies

Front 10

What is the most serious/common adverse rxn to insulin overdose?

Back 10

hypoglycemia

Front 11

Why is hypoglycemia such a fear for long term diabetics?

Back 11

Long term diabetics don't produce enough counterregulatory hormones (glucagon/epi/corisol & GH) for defense against hypoglycemia

Front 12

This type of insulin mimics prandial release of insulin and used with longer acting insulin

Back 12

rapid-onset and ultrashort acting insulin preps

Front 13

Can regular insulin be used if you are pregnant?

Back 13

yes

Front 14

This type of insulin is short acting?

Back 14

regular insulin

Front 15

This drug is given 15 mins before meals and is better for external insulin pumps b/c it doesn't form hexamers

Back 15

Lispro

Front 16

This drug is taken 15 mins before meal or within 20 mins after start of meal

Back 16

Glulisine

Front 17

These are the three types of "ultra short acting" drugs

Back 17

Lispro, aspart, glulisine

Front 18

What are the two intermediate-acting insulin preps?

Back 18

Lente & NPH insulin

Front 19

The drug has an onset of action adn peak effect slower than regular insulin but sustained for longer

Back 19

Lente

Front 20

These are the two prolonged acting insulin preps

Back 20

Ultralente inulin and glargine

Front 21

Of the prolonged-acting insulin preps this one has extended zinc insulin

Back 21

ultralente insulin

Front 22

Of the prolonged-acting insulin preps this one has flat, prlonged hypoglycemic effect w/o peaks (similar to insulin)

Back 22

glargine

Front 23

What is the standard tx and goals of care? (including BG and HBA1C)

Back 23

Insulin 2xs daily
Goal: BG: 225-275
HBA1C: 8-9%

Front 24

What is intense tx goals? (including BG and HBA1C)

Back 24

Goal BG: 150
HBA1C 7%

Front 25

If you give too much insulin what can occur other than hypoglycemia?

Back 25

coma & seizures

Front 26

With insulin there is a ________% decrease in long term complications (neuropathy, retinopathy, nephropathy)

Back 26

60

Front 27

This oral hypoglycemic agent is good for type 2 diabetes if it can't be managed with diet. It works by promoting release from pancreatic beta cells. This is not to be administered to Type I diabetes.

Back 27

Insulin secretagogues

Front 28

What are the two types of insulin secretagogues

Back 28

sulfonyureas
metiglinide analogs

Front 29

Tolbutamide is a ________?

Back 29

sulfonyreas

Front 30

Repagtinide and Nateglinide are?

Back 30

metliglinde analogs

Front 31

The MOA of sulfonyureas?

Back 31

decrease serum glucagona dn increases binding of insulin to target tissues and receptors

Front 32

Glypuride, Glipizide, and Glimepride are examples of ????

Back 32

2nd generation sulfonyreas

Front 33

weight gain, hypoglycemia, depleting insulin from fetal pancreas are negative effects of this drug???

Back 33

sulfonyureas

Front 34

Sulfonyuras can or can't be given to a pregnant woman?

Back 34

can't!

Front 35

this drug is sometimes chosen for newly diagnosed type 2 diabetes

Back 35

metformin (a biguanide)

Front 36

what has a higher chance of hypoglycemia: sulfonuyreas or biguanides

Back 36

metformin (a biguanide)

Front 37

this drug works by inhibiting hepatic glucogenesis?

Back 37

metformin (a biguanide)

Front 38

excess glucose produced by ________increases the blood glucose in type 2 diabetes (therefore metformn is important)

Back 38

liver

Front 39

Biguanides and thiazdes are examples of?

Back 39

INsulin sensitizers (oral hypoglycemic agents)

Front 40

This drug improves insulinsa ction by improving target cell reponse to insulin

Back 40

Insulin sensitizers

Front 41

This drug should be used cautiously with hepatic impairment?

Back 41

Metiglinide (repaglinide and nateglinide)

Front 42

This drug is a postprandial glucose regulator?

Back 42

Metiglinide (repaglinide & nateglinide)

Front 43

This drug can cause fatal lactic acidossi?

Back 43

Metformin

Front 44

This drug shouldn't be taken if you are taken HF meds too?

Back 44

Metformin (b/c of its lactic acidsosis)

Front 45

Two exps of thiazolidinedionides?

Back 45

Rosiglitzone and Pioglitazone

Front 46

This drug works by increasing insulin sensitivity in adipose tissue, liver, and skeletal muslce

Back 46

Metformin

Front 47

This drug increases HDL

Back 47

metformin

Front 48

Acarbose and Miglitol are examples of ______?

Back 48

alpha glucosidase inhibitors

Front 49

alpha glucosidase inhibitors (2)

Back 49

Acarbose and Miglitol

Front 50

this type of drug works by delaying carb digestion bc it inhibits membrane bound alpha glucoside in intestine?

Back 50

alpha glucosidase inhibitors

Front 51

this drug shouldn't be taken if you have IBS

Back 51

alpha glucosidase inhibitors (AGIs) b/c it causes flatulence, diarrhea, ab cramping

Front 52

Do the AGIs cause hypoglycemia?

Back 52

No

Front 53

A hypoglycemia patient should be treated with glucose or sucrose when taking an AGI?

Back 53

glucose bc AGIs inhibit sucrose!!!

Front 54

GLIP-1 stands for what and is what?

Back 54

glucagon-peptide 1 and is a gastrointestinal hormone

Front 55

What is an example of a gastrointestinal hormone in addition to GLIP-1?

Back 55

exenatide

Front 56

This drug works by improving insulin secretion, slowing gastric emptying time, increasing glucose supression of glucagon secretion and promoting B cell regeneration and decreasing apoptosis.

Back 56

exenatide

Front 57

exenatide must be administered this way?

Back 57

parentearlly

Front 58

What negatives of exenatide?

Back 58

short DOA and therefore need lot of injections