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36 Cards in this Set

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rapid-acting insulin
lispro

aspart
short-acting insulin
regular
intermediate-acting insulin
NPH
long-acting insulin
glargine

detemir
what does insulin do?
binds to the TK insulin receptor

affects which organs?
liver: increase glucose uptake

mucle: increase glycogen and protein production

fat: store TG
what do you give for life-threatening hyperkal?
insulin
toxicities of insulin?
hypoglycemia

hypersens rxn
which insulin do you give for DKA?
regular
tolbutamide
1st line sulfonyurea

name another:
chlorpropamide
second gen sulfonyureas
glyburide
glipizide
gllimepiride

MOA
bind to Katp recepotr and close K+ channels in b-cells so that cell depolarizes and releases insulin via Ca influx
what type of receptor do sulfonyureas work on?
membrane ion channel
sulfonyureas cant be used for what type of patient
DM1

what can you use regardless of islet function?
metformin
ADE of first-gen and second gen sulfonyureas:
disulfuram-like rxn

hypoglycemia
metformin is what type of drug?
biguanide

MOA?
decrease gluconeogen
increase glycolysis
increased periph insulin sensitivity
what type of ezyme does metformin affect?
intracellular enzymes

what is metformin first-line therapy for?
DM2
ade of metformin?
lactic acidosis

who can't get metformin?
renal failure
pioglitazone and rosiglitazone are what type of drug?
glitazones/thazolidinediones

used as monotherapy for?
DM2
moa of glitizones?
increase insulin sens of periph tissues (inc Glut-4 on adipocytes) increase adiponectin

binds to what?
PPAR-gamma
where is PPAR-gamma located?
in the nucleus

what is it
transcription regulator
ADE of glitizones?
weight gain
edema
hepatotox
HF

one side effect you wont see?
hypoglycemia
acarbose is
alpha-glucosidase

another is?
miglitol
MOA of alpha-glucosidase:
inhibit intestinal brush-border alpha-glucosidase [prevents disaccharide breakdown to delay absorption of carbs]

leading to:
decreased postprandial hyperglycemia
ADE of alpha-glucosidase?
flatulence
bloating

how can you prevent ADE?
take with foods
who can't take acarbose/miglitol?
people with malabsoprtion issues
pramlintide is a:
mimetic

MOA? in who?
decreases glucagon

DM2
ade of mimetics?
hypogly
nausea
diarrhea
exenatide is a?
GLP-1 analog

MOA? how given?
incretin analog , increases insulin and decreases glucagon release [increases satiety]

subcut, 60 minutes after first and last meal of day
ADE of exenatide?
NV
pancreatitis
PPAR-gamma codes for:
adioponectin

what is adiopenctin?
cytokine secreted by fat cells
how does adiponectin help treat DM2
this is how glitazones decrease insulin resistance
incretin is excreted by... in response to...
small intestine
in response to food intake
how do GLP-1 decrease glucose
induce satiety and decreasing gastic emptying
where are GLP-1 receptors located?
cell surface

associated with which second messanger?
cGMP
who you give GLP-1 drugs to?
patients with suboptimal blood glucose control
which drugs do enzyme activation?
metformin
alpha-glucosidase inhib
what do sulfonyureas do to beta cells?
bind to Katp channels to force them to close, depolarize the cell and release insulin!