Pharmacology Ch. 41: Diabetic Drugs And Glucagon

Front 1

Glucose transport receptor of muscle and adipose tissue

Back 1

GLUT4

Front 2

Glucose transport receptor of the liver

Back 2

GLUT2

Front 3

Do rapid acting insulins affect their receptors

Back 3

NO

Front 4

Preferred insulin for subq devices

Back 4

Rapid acting insulin

Front 5

Rapid acting insulins

Back 5

Insulin Lispro, aspart, glulsine

Front 6

Used in emergent txmt of diabetic ketoacidosis

Back 6

Rapid acting insulin

Front 7

When are rapid-acing insulin normally given? What is the goal?

Back 7

Before Eating
To prevent post-prandial hyperglycemia

Front 8

NPL

Back 8

Rapid acing Lispro that is combined with a protamine to lengthen its onset and duration of action.
Often given in combination with regular or rapid-acting insulin as part of a tight control regime

Front 9

Long acting insulin. Why is it used?

Back 9

Glargine and detremir:
Controls basal glucose levels without producing hypoglycemia because its peakless

Front 10

Combo of regular insulin and protamine

Back 10

NPH

Front 11

Mechanism of action of sulfonylureas

Back 11

Stimulate release of endogenous insulin release by promoting closure of K channels in the pancreatic B-cell. This causes depolarization of the cell and the entry of Ca, leading to insulin release.

Front 12

2nd generation sulfonylureas

Back 12

Glyburide, glipizide, and glimepiride

Front 13

New generation insulin secretagogue that has a rapid onset and short duration of action. What makes these useful?

Back 13

Repaglinide and nateglinide:
Duration of action is 4-5 hrs. Used to control post-prandial glucose levels

Front 14

Insulin secretagogues increase the risk of?

Back 14

Hypoglycemia, which causes increased weight gain.

Front 15

Duration of action of 2nd generation sulfonylureas

Back 15

10-24 hrs

Front 16

How does metformin decrease blood glucose levels?

Back 16

Inhibit hepatic and renal gluconeogenesis. Also stimulates glucose uptake and glycolysis in peripheral tissues. Reduces both post-prandial and fasting blood glucose levels

Front 17

Meformin is what class of drug. What are its affects on insulin? Why is this important?

Back 17

Biguanide
It reduces insulin secretion by increasing insulin sensitivity. Because of the insulin sparing affects, it does not lead to hypoglycemia.
It does not increase appetite and lead to subsequent weight gain.

Front 18

First line drug of choice for type II diabetics

Back 18

Metformin

Front 19

The use of metformin is contraindicated in what type of patients? Why?

Back 19

Pt's with renal or liver disease, alcoholism, or conditions that predispose to tissue anoxia or lactic acidosis
Lactic acidosis

Front 20

Thiazolidinediones

Back 20

Rosiglitazone and pioglitazone

Front 21

MOA of metformin

Back 21

Increase activation of AMP-stimulated protein kinase

Front 22

MOA of Thiazolidinediones

Back 22

Increase taget tissue sensitivity to insulin by activating P-PAR gamma. This nuclear receptor regulates the transcription of proteins involved in carbohydrate and lipid metabolism

Front 23

Affects of Thiazolidinediones on blood glucose levels

Back 23

Reduces both post prandial and fasting glucose levels.

Front 24

Carbohydrate analogs that act within the intestine to inhibit alpha-glucosidase

Back 24

Acarbose and miglitol

Front 25

What affects do the alpha-glucosidase inhibitors have on blood glucose levels

Back 25

Decrease post prandial glucose but has no affect on fasting glucose levels

Front 26

Primary effect is to to increase glucose uptake in adipose and muscle tissue

Back 26

Thiazolidinediones:
Rosiglitazone and pioglitazone

Front 27

SE's include flatulence, diarrhea, and abdominal resulting from increased fermentation of unabsorbed carbohydrates

Back 27

Alpha-glucosidase inhibitors:
miglitol and acarbose

Front 28

SE may cause fluid retention, which leads to edema, and increase the risk of CHF. May also cause MI.

Back 28

Rosiglitazone:
a thiazolidinedione

Front 29

Does metformin or thiazolidinediones cause hypoglycemia

Back 29

NO

Front 30

Lack an effect on fasting blood glucose

Back 30

alpha-glucosidase inhibitors:
acrabose miglitol

Front 31

Reduces the incidence of vascular complications, including renal and retinal damage

Back 31

Tight control

Front 32

New insulin secretagogues that have rapid onset and short duration of action

Back 32

repaglinide and netaglinide

Front 33

Long acting GLP-1 analong

Back 33

Exenatide

Front 34

SE include GI distrubances, especially during initial therapy and hypoglycemia when combined with insulin secretagogues

Back 34

Exenatide

Front 35

Member of the incretin family of hormones, which are released from endocrine cells in the epi of the bowel? Function?

Back 35

GLP-1:
Exenatide
G-protein receptor that increases cAMP and increases intracellular Ca levels, leading to increased insulin release.

Front 36

Long acting drugs control?

Back 36

Both fasting and post-prandial glucose:
Sulfonylureas, metformin, thiazolidinediones, exenatide, and detemir/glargine

Front 37

Short acting drugs target

Back 37

post-prandial glucose:
alpha-glucosidase inhibitors, repaglinide, rapid-acting insulin

Front 38

Used in the txmt of sever B-blocker overdose

Back 38

Glucagon:
Stimulates cAMP in the heart

Front 39

Tight control of type I diabetes

Back 39

Long acting insulin given in the morning, such as glargine, supplemented with rapid-acting insulin at meal times...lispro.