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62 Cards in this Set
- Front
- Back
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Produce Glucagon
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Alpha cells in the pancreas
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Produce Insulin
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Beta cells in the pancreas
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Produce Somatostatin
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Delta cells in the pancreas
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Product of proinsulin cleavage used to assess insulin abuse
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C-peptide
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Exogenous insulin
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Little C-peptide
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Endogenous insulin
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Normal C-peptide
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Very rapid acting insulin, having fastest onset and shortest DOA
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Lispro(Humalog)
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Short acting, crystalline zinc insulin used to reverse acute hyperglycemia
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Regular (Humulin R)
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Long acting insulin
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Ultralente(Humulin U)
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Ultra-long acting insulin, has over a day DOA
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Glargine (Lantus)
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Major SE of insulin
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Hypoglycemia
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Important in synthesis of glucose to glycogen in the liver
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Glut-2
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Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation
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Glut-4
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Examples of alpha-glucosidase inhibitors (AGIs)
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Acarbose, miglitol
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MOA of AGIs
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Act on intestine to delay absorption of glucose
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SE of AGIs
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Flatulence (don't tx w/ beano), diarrhea, and abdominal cramps
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AGI assoc w/ elevation of LFTs
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Acarbose
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AA derivative
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Nateglinide
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MOA of Nateglinide
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Insulin secretagogue
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Biguanide
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Metformin
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Drugs available in combo w/ Metformin
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Glyburide, glipizide, and rosiglitazone
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MOA of metformin
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Dec hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
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Most important potential SE of metformin
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Lactic acidosis
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Meglitinide
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Repaglinide
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MOA of repaglinide
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Insulin release from pancreas; faster and shorter acting than sulfonylurea
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1st generation sulfonylureas
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Chlorpropamide, tolbutamide, and tolazamide
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2nd generation sulfonylureas
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Glyburide, glipizide, glimepiride
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MOA of Sulfonylureas
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Insulin release from pancreas by modifying K+ channels
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Common SE of Sulfonylureas, repaglinide, and nateglinide
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Hypoglycemia
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Sulfonylurea NOT recommended for elderly b/c of very long half life
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Chlorpropamide
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Thiazolidinediones
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Pioglitazone, Rosiglitazone, Troglitazone(withdrawn)
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Reason Troglitazone was withdrawn from market
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Hepatic Toxicity
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MOA of thiazolidinediones
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Stimulate PPAR-gamma receptor to regulate carb and lipid metabolism
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SE of thiazolidinediones
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Edema, mild anemia; interaction w/ drugs that undergo CYtP4503A4 metabolism
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Hyperglycemic agent that increase cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe B-blocker overdose and smooth muscle relaxation
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Glucagon
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Glycosylated Hgb that serves as a marker of hyperglycemia
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A1c
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An enzyme in the GI tract that converts complex starches and oligosaccharides to monosaccharides; inhibited by acarbose and miglitol
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Alpha glucosidase
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Insulins effects on the liver
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Inc the storage of glucose as glycogen, inc synthesis of the enzymes pyruvate kinase, phosphofructokinase, and glucokinase; dec protein catabolism
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Insulins action on skeletal muscle
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Glycogen synthesis and protein synthesis
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Insulin's effects on adipose tisse
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Facilitates triglyceride storage by activating plasma protein lipase, inc glucose transport into cells via Glut 4 transporters, and reducing intracellular lipolysis
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Insulin used for emergency treatment of uncomplicated diabetic ketoacidosis
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Rapid acting (lispro, aspart, glulisine)
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Intermediate acting insulin that is a combo of regular insulin and protamine
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NPH insulin
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MOA of insulin secretagogues
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Stimulate the release of endogenous insulin by promoting closure of potassium channels in the pancreatic B cell membrane
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Drug of 1st choice in overweight patients w/ T2DM
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Metformin
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Diabetic drug that doesn't have hypoglycemia as a SE
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Metformin
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Primary effect of thiazolidinediones
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Increasing glucose uptake in muscle and adipose tissue
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Diabetic drugs that are used to restore fertility in anovulatory women w/ PCOD
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Metformin and Thiazolidinediones
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Injectable synthetic analog of amylin
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Pramlintide
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Receptor for amylin
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RANK
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MOA of pramlintide
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Suppresses glucagon release, slows gastric emptying, and works in the CNS to reduce appetite
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Major AEs of Pramlintide
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Hypoglycemia and GI disturbance
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Member of the incretin family of peptide hormones, which are released from endocrine cells in the epithelium of the bowel in response to food
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GLP-1
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Action of incretins
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Augment glucose-stimulated release of insulin from pancreatic B cells, retard gastric emptying, inhibit glucagon secretion, and produce a feeling of satiety
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Long-acting injectable peptide analog of GLP-1, used in combo w/metformin or a sulfonylurea for tx of T2DM
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Exenatide
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Major AEs of Exenatide
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GI disturbances, particularly nausea during initial therapy; hypoglycemia when combined w/ a sulfonylurea
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Oral inhibitor of DPP-4, the enzyme that degrades GLP-1
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Sitagliptin
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MOA of Sitagliptin
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Promotes insulin release, inhibits glucagon secretion, delays gastric emptying, and has an anorexic effect
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Common AEs assoc w/ Sitagliptin
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Headache, nasopharyngitis, and URT infection
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Glucagon's effects on the heart
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Inc HR and force of contraction
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Glucagon's effects on the liver
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Increase glycogenolysis and gluconeogenesis
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Glucagon's effects on smooth muscle
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Relax (marked in the gut)
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Drug that is most effective for stimulating the depressed heart in B-blocker overdose b/c it inc cardiac cAMP w/out requiring access to B-receptors
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Glucagon
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