Pharmacology 41: Pancreatic Hormones And Anti-Diabetic Drugs

Front 1

Insulin dependent diabetes is type ...

Back 1

1

Front 2

Insulin in-dependent diabetes is type ...

Back 2

2

Front 3

What is type 3 diabetes?

Back 3

diabetes due to removal of pancreas or pancreatic disease

Front 4

What is type 4 diabetes?

Back 4

diabetes during first pregnancy and last trimester

Front 5

Proinsulin is cleaved into ...

Back 5

insulin and C-peptide

Front 6

How is insulin released from the beta cell?

Back 6

glucose enters the cell via GLUT-2> ATP is formed > ATP closes the K channel > depolarization > calcium channel opens > exocytosis of insulin vesicles

Front 7

Activation of IRS by the insulin receptor will lead to which pathways being activated?

Back 7

MAPK and AKT/PI3K

Front 8

Insulin uses what receptor?

Back 8

tyrosine kinase

Front 9

Where is GLUT1 found?

Back 9

all cells (esp RBC and brain)

Front 10

Where is GLUT2 found?

Back 10

pancreas mainly

Front 11

Where is GLUT3 found?

Back 11

brain, kidney, placenta

Front 12

Where is GLUT4 found?

Back 12

adipose tissue and muscle; insulin dependent

Front 13

Where is GLUT5 found?

Back 13

gut, kidney

Front 14

Which GLUT is insulin dependent?

Back 14

GLUT4 (via insulin activation of AKT/PI3K pathway)

Front 15

Which GLUT takes in fructose?

Back 15

GLUT5

Front 16

Which insulins are fastest acting?

Back 16

lispro

Front 17

What are the main categories of insulin preparations? In order from fastest to longest acting?

Back 17

Lispro, regular, NPH, detemir, glargine

Front 18

What is insulin lispro?

Back 18

Rapid acting insulin with the proline and lysine positions switched to increase half-life

Front 19

What is NPH insulin?

Back 19

neutral protamine insulin; has a protamine group attached to it so it dissociates and releases the insulin more slowly

Front 20

What is insulin glargine?

Back 20

long acting insulin; once daily;

Front 21

What is insulin detemir?

Back 21

long acting insulin; less hypoglycemia risk than NPH

Front 22

What is NPL insulin?

Back 22

neutral protamine lispro; acts like regular insulin, but more stable.

Front 23

Most common adverse reaction to insulin therapy?

Back 23

hypoglycemia

Front 24

In a patient with hypoglycemia, when would we not give oral glucose/dextrose treatment?

Back 24

if they are unconscious or semi-conscious

Front 25

B-adrenoreceptor stimulation has what effect on insulin release?

Back 25

increases

Front 26

alpha-adrenoreceptor stimulation has what effect on insulin release?

Back 26

decreases

Front 27

Function of biguanides

Back 27

decrease hepatic glucose production by activating AMPK

Front 28

How does glyburide work?

Back 28

insulin secretagogue; blocks K channels

Front 29

WHich is more likely to induce hypoglycemia? glyburide or glipizide

Back 29

glipizide due to shorter half-life

Front 30

What is Repaglinide?

Back 30

Meglitinide that acts similarly to sulfonylureas, but has extra receptors

Front 31

Why might repaglinide be more likely to cause hypoglycemia than a sulfonylurea?

Back 31

repaglinide is taken before meals, and if the patient skips the meal, then the hypoglycemia can occur easily

Front 32

A patient has a sulfur allergy. Which insulin secretagogue would we give them?

Back 32

repaglinide

Front 33

Which secretagogues has the lowest risk of hypoglycemia and can be used with renal failure?

Back 33

nateglinide

Front 34

What is metformin?

Back 34

biguanide; stimulates AMPK to reduce hepatic gluconeognesis

Front 35

Biguanides are commonly recommended for type ___ diabetes?

Back 35

2

Front 36

A diabetic patient complains of GI problems and has macrocytic anemia. Which drug is he experiencing toxicity to most likely?

Back 36

metformin

Front 37

What class of drugs can lead to the highest risk of hypoglycemia? (besides insulin or its modifications)

Back 37

insulin secretagogues

Front 38

Thiazolidinediones have what major toxicity?

Back 38

increased heart failure risk

Front 39

How do alpha glucosidase inhibitors work?

Back 39

competitively inhibit glucosidase breaking down sugars = less glucose absorbed

Front 40

Which is a stronger alpha glucosidase inhibitor acarbose or miglitol?

Back 40

miglitol is 6x stronger

Front 41

Excess gas is a major side effect of which diabetes treatment plan?

Back 41

alpha glucosidase inhibitors

Front 42

What drug mimics GLP-1 to help sulfonylureas?

Back 42

exenatide

Front 43

Weight loss and pancreatitis are major concerns form which diabetic drug?

Back 43

exenatide (mimics GLP-1)

Front 44

First line therapy for diabetes type 2?

Back 44

metformin

Front 45

Exenatide is commonly coupled with what other class of drugs?

Back 45

biguanides or biguanides + sulfonylureas

Front 46

Glucagon activates what receptor?

Back 46

G-protein (cAMP)