Pharmacology Ch 38

Front 1

Function of the Pancreas Gland

Back 1

Endocrine gland
Produces hormones in the islets of Langerhans
Exocrine gland

Front 2

Insulin
Definition

Back 2

Hormone produced by the beta cells of the islets of Langerhans

Front 3

Insulin:
Action

Back 3

Released into circulation when the levels of glucose around these cells rise
Acts like a key that allows glucose to enter the cells for utilization by the body
Stimulates the synthesis of glycogen, the conversion of lipids into fat stored in the form of adipose tissue, and the synthesis of needed proteins from amino acids

Front 4

List 8 Metabolic Changes Occurring When Insufficient Insulin is Released

Back 4

Hyperglycemia
Glycosuria
Polyuria
Polyphagia
Polydipsia
Lipolysis
Ketosis
Acidosis

Front 5

Hyperglycemia:

Back 5

Hyperglycemia: Increased blood sugar

Front 6

Glycosuria:

Back 6

Glycosuria: Sugar is spilled into the urine

Front 7

Polyuria:

Back 7

Polyuria: Glucose attracts water

Front 8

Polyphagia:

Back 8

Polyphagia: Increased hunger

Front 9

Polydipsia:

Back 9

Polydipsia: Increased thirst

Front 10

Lipolysis:

Back 10

Lipolysis: Fat breakdown

Front 11

Ketosis:

Back 11

Ketosis: Ketones cannot be removed effectively

Front 12

Acidosis:

Back 12

Acidosis: Liver cannot remove all of the waste products

Front 13

Clinical Signs and Symptoms of Hyperglycemia

Back 13

Fatigue
Lethargy
Irritation
Glycosuria
Polyuria
Polyphagia
Polydipsia
Itchy skin

Front 14

Clinical Signs and Symptoms of Hypoglycemia

Back 14

Nervousness
Sweating
Intense hunger
Trembling
Weakness
Palpitations
May have trouble speaking
Can progress to confusion, drowsiness, changes in behavior, coma, seizures

Front 15

Insulin Administration

Back 15

Consistency in timing is key for all
Most should be timed in relation to food intake to coincide with onset, peak, and duration of specific insulin.
Time of administration can be from 60 minutes before, during, or up to 20 minutes after a meal
Some longer acting ones need to have no relationship to meal time

Front 16

Sulfonylureas :

Back 16

Sulfonylureas : Stimulate beta cells to make more insulin

Front 17

Meglitinides:

Back 17

Meglitinides: Stimulate beta cells to make more insulin

Front 18

Thiazolidinediones (TZDs):

Back 18

Thiazolidinediones (TZDs): Decrease glucose production in liver and increase insulin sensitivity

Front 19

Biguanides:

Back 19

Biguanides: Decrease glucose production in liver and increase insulin sensitivity

Front 20

Alpha-glucosidase inhibitors:

Back 20

Alpha-glucosidase inhibitors: slow absorption of starches in gut by blocking an enzyme so reduced amount of glucose enters bloodstream

Front 21

Sites of Action of Drugs Used to Treat Diabetes

Back 21

Front 22

Regular Insulin

Back 22

Humulin R - short acting
Onset: 30-60 min
Peak: 2-4 hr
Duration: 8-12 hr

Front 23

Semilente NPH

Back 23

Humulin N - intermediate
Onset: 1-1.5 hr & 60-90 min
Peak: 5-10 hr & 4-12 hr
Duration: 12-16 hr & 24 hr
Appearance: Cloudy

Front 24

Lispro

Back 24

Humulog - Rapid
Onset: <15 min
Peak: 30-90 min
Duration: 2-5 hr

Front 25

Aspart

Back 25

Novolog - rapid
Onset: 15 min
Peak: 1-3 hr
Duration: 3-5 hr

Front 26

Glulisine

Back 26

Apidra - rapid
Onset: 2-5 min
Peak: 30-90 min
Duration: 1-2.5 hr
***CANNOT BE MIXED WITH ANY OTHER DRUG IN SOLUTION***

Front 27

Glargine

Back 27

Lantus - long
Onset: 60-70 min
Duration: 24 hrs
***CANNOT BE MIXED WITH ANY OTHER DRUG IN SOLUTION***

Front 28

Detemir

Back 28

Levemir - long
Onset: 1-2 hours
Peak: 6-8 hr
Duration: 24 hr

Front 29

Lente

*might not need to know for test*

Back 29

Humulin L
Onset: 1-25 min
Peak: 7-15 hr
Duration: 24 hr

Front 30

PZI

Back 30

Humulin U
Onset: 4-8 hr
Peak: 14-24 hr
Duration: 36 hr

Front 31

Ultralente

*might not need to know for test*

Back 31

Humulin U Ultralente
Onset: 4-8 hr
Peak: 10-30 hr
Duration: 20-36 hr

Front 32

Inhalational Insulin

*may not need to know for exam*

Back 32

Exubera
Onset: 10-20 min
Peak: 2 hr
Duration: 6 hr

Front 33

NPH and Regular

Humulin 70/30
Novolin 70/30
Humulin 50/50
Humalog 75/25

Back 33

Onset: 30-60 min then 1-2 hr
Peak: 2-4 hr then 6-12 hr
Duration: 6-8 hr then 18-24 hr

Front 34

Metformin

Type:

Back 34

non-sulfonylureas

Front 35

Metformin

Brand Name:

Back 35

Glucophage

Front 36

Metformin

Indications:

Back 36

Adjunct to diet and exercise for treatment of type 2 diabetics over 10 years old; extended release form for 17 and up

Front 37

Metformin

Therapeutic actions

Back 37

May increase periferal use of glucose, increase production of insulin, decrease hepatic glucose production, alter intestinal absorption of glucose

Front 38

Metformin
Route:
Onset:
Peak:
Duration:

Back 38

Route: Oral
Onset: slow
Peak: 2 - 2.5 hrs
Duration:10-16 hrs

Front 39

Metformin
T 1/2:
metabolized:
excreted:

Back 39

T 1/2: 6.2 & then 17 hrs
metabolized: liver
excreted: urine

Front 40

Metformin

Adverse effects

Back 40

hypoglycemia, lactic acidosis, GI upseat, nausia, anorexia, diarrhea, heartburn, allergic skin reaction

Front 41

chlorpropamide &
glyburide

Type

Back 41

chlorpropamide: 1st generation sulfonylureas

glyburide: 2nd generation sulfonylureas

Front 42

chlorpropamide &
glyburide

Brand Name(s)

Back 42

chlorpropamide: Diabenese

glyburide: DiaBeta, Micronase, Glynase PresTab

Front 43

chlorpropamide &
glyburide

Indications

Back 43

Adjunct to diet and exercise to lower blood gluccose leves in type 2 diabetics

Front 44

chlorpropamide &
glyburide

Therapeutic actions

Back 44

stimulates the realse of insulin from functioning cells in the pancreas; may improve binding (or increase # of) insulin receptor sites.

Front 45

chlorpropamide &
glyburide

Route:
Onset:
Peak:
Duration:

Back 45

Route: Oral
Onset: 1 hr
Peak: 3-4 hrs
Duration: 60 hrs

Front 46

chlorpropamide &
glyburide

T 1/2:
metabolized:
excreted:

Back 46

T 1/2: 36 hrs
metabolized: liver
excreted: urine & bile

Front 47

chlorpropamide &
glyburide

Adverse effects:

Back 47

GI discomfort, anorexia, heartburn, vomiting, nausia, hypoglycemia