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47 Cards in this Set

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What is glargine?
a long acting insulin, does not produce peak, constant concentration throughout the day
What are the 4 different insulin types?
Ultra Short, Rapid, Intermediate, Long Acting
What are some names of ULTRA-SHORT acting insulin?
Lispro (Humalog), Novolog
What are some names of INTERMEDIATE insulin?
Isophane Insulin Suspension (NPH), Insulin Zinc Supression (Lente)
What are some names of LONG-LASTING insulin?
Extended Insulin Zinc Suspension (Ultralente), Glargine (Lantus)
What are some names of RAPID acting insulin?
Insulin (Regular), Prompt Insulin Zinc Suspension (Semilente)
Generally, what duration of action is Ultra Lente insulin?
Long-acting
What is glyburide (DiaBeta, Micronase)?
a 2nd generation sulfonylurea, oral hypoglycemic agent
What is tolbutamide (Orinase)?
a 1st generation sulfonylurea, oral hypoglycemic agent
What is rosiglitazone (Avandia) and how does it work?
Thiazolindedione, oral hypoglycemic agent

Increases sensitivity of peripheral cells and hepatic cells to insulin
What are Thiazolindinediones?
a drug class that works to lower the resistance to insulin in muscle, liver, and fat cells, resensitizing them to insulin.
What is Metformin (Glucophage)?
an anti-diabetic drug from the biguanide class of oral antihyperglycemic agents
What is the mode of action of Biguanides?
Tendency to reduce gluconeogenesis in the liver, thereby, reducing the level of glucose in the blood

Also tends to make the cells of the body more willing to absorb glucose already present in the blood stream.
What is the prototypical 1st generation sulfonylurea?
Tolbutamide
What is the prototypical 2nd generation sulfonylurea?
Glyburide
What is the method of action of Metformin?
reduction of hepatic gluconeogenesis, decreased absorption of glucose from the gastrointestinal tract, and increased insulin sensitivity.
There are three
What does Glipizide (Glucotrol) treat?
treats Type II diabetes by increasing beta cell production
What does Glyburide (Micronase, DiaBeta) treat?
treats Type II diabetes by increasing beta cell production of insulin

-2nd Generation Sulfonylureas
What is the mode of action of Sulfonylureas?
Stimulates the release of insulin from pancreatic beta-cells
What's the difference between first and second generation sulfonylureas?
Second generation (fewer drug interactions, & side effects, more commonly prescribed)
Notes: in rare cases, ------ may lead to lactic acidosis (it can impair the hepatic metabolism of lactic acid)
Metformin
Pioglitazone (Actos)
oral hypoglycemic, thiazolidinedione derivatives
Rosiglitazone (Avandia)
oral hypoglycemic, thiazolidinedione derivatives
Name two thiazolidinediones (glitazones):
Pioglitazone & Rosiglitazone
-glitazone

Rosi/Pio
Type I diabetes mellitus
An inability to metabolize carbohydrates caused by an overt insulin deficiency that occurs in children and adults
Type II diabetes mellitus
Type of diabetes in which patients are not insulin dependent but they may take insulin to correct the hyperglycemia
What does glucagon initiate?
Glycogenolysis
Action of glycogenolysis?
Opposes the action of insulin (increasing the blood glucose level)
IDDM
Insulin-dependent diabetes, Type I diabetes mellitus, also known as juvenile-onset diabetes.
Signs and symptoms of hyperglycemia?
ed pulse rate, abnormal breathing, and a fruity, acetone odor to their breath.
Signs and symptoms of hypoglycemia?
Weakness, nervousness, cold and clammy skin, sweating, paleness of the skin, and shallow, rapid breathing. Notify physician if any of these symptoms occur.
Which insulin has the longest duration?
a. Regular
b. Lente
c. NPH
d. Ultra Lente
d. Ultra Lente
Which type of insulin can be given intravenously?
a. Regular
b. Lente
c. NPH
d. Ultra Lente
a. Regular
How does Diazoxide (Proglycem) work?
Inhibits the generation of an action potential, by switching off calcium ion channels and activating potassium channels (increasing smooth muscle tissue membrane permeability to potassium ions)
Uses of Diazoxide (Proglycem)
It is used as a vasodilator in the treatment of acute hypertension

It reverses hypoglycemia, raising blood sugar.
What is hypertension?
Chronically elevated high blood pressure

Hypertension has been associated with a higher risk of heart attack or stroke.
What medications are used to treat diabetes mellitus?
anti-diabetic drugs or oral hypoglycemic agents
non-oral antidiabetic drugs:
Insulin, exenatide, and pramlintide.

(Exenatide and pramlintide are new injectable medications approved in 2005 in the U.S. by the FDA to treat Diabetes mellitus type 2)
Sulfonylureas bind strongly to _______.
plasma proteins
Sulfonylureas are only useful in ________, as they work by stimulating the release of insulin.
Type II diabetes
Name three first-generation Sulfonylureas
1. tolbutamide (Orinase)
2. tolazamide (Tolinase)
3. chlorpropamide(Diabinese)
Name three second-generation Sulfonylureas
1. glipizide (Glucotrol)
2. glyburide (Diabeta, Micronase, Glynase)
3. glimepiride (Amaryl)
What does the medication class, thiazolidinedione, treat?
The only approved use of the thiazolidinediones is in diabetes mellitus type 2
What is Glucagon?
Glucagon helps maintain the level of glucose in the blood by binding to glucagon receptors on hepatocytes, causing the liver to release glucose - stored in the form of glycogen - through a process known as glycogenolysis.
What is Acarbose (Precose)?
an anti-diabetic drug used to treat type 2 diabetes mellitus and, in some countries, prediabetes
What is the mechanism of action of Acarbose?
Acarbose inhibits enzymes needed to digest carbohydrates, thereby reducing the rate of digestion of complex carbohydrates.

Less glucose is absorbed because the carbohydrates are not broken down into glucose molecules.
What drug class usually ends in -ide?
Oral hypoglycemics