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40 Cards in this Set
- Front
- Back
Alpha cells in the pancreas |
Produce glucagon
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Beta cells in the pancreas
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Produce insulin
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Beta cells are found
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Islets of Langerhans
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Delta cells in the pancreas
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Produce Somatostatin
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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 duration of action
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Lispro (Humalog)
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Rapid 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 duration of action
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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 (AGI)
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Acarbose, miglitol
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MOA of AGI's
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Act on intestine, delay digestion and absorption of glucose formed from digestion of starch and disacchrides
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SE of AGI's
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Flatulence (do not use beano to tx), diarrhea, abdominal cramps
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Alpha-glucosidase inhibitor associated with elevation of LFT's
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Acarbose
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Amino acid derivative
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Nateglinide
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MOA of nateglinide
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Insulin secretagogue - closes ATP-sensitive K+ channel
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Biguanide
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Metformin
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Drugs available in combination with metformin
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Glyburide, glipizide, and rosiglitazone
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MOA of metformin
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Decreases 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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First generation sulfonylurea
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Chlorpropamide, tolbutamide, tolazamide, etc.
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Second generation sulfonylurea
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Glyburide, glipizide, glimepiride, etc.
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MOA of both generations
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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 because of very long half life
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Chlorpropamide
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Thiazolidinediones
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Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)
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Reason troglitazone was withdrawn from market
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Hepatic toxicity
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MOA of thiazolindinediones
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Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
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SE of Thiazolindinediones
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Edema, mild anemia; interaction with drugs that undergo CYP 450 3A4 metabolism
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Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation
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Glucagon
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Vascular effects of metformin
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Decreased micro and macro vascular disease
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Incidence of hyoglycemia with metformin
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None
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Rapid acting insulins that do not self-aggregate
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lispro insulin, aspart insulin, glulisine insulin
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Peakless ling acting insulin
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Insulin glargine
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