Pharmacology Diabetes

Front 1

T/F

Diabetes can be acquired with extreme weight gain even without a genetic predisposition

Back 1

F

Genetic Metab Disorder

Front 2

organ least affected by diabetes

a) LV
b) KD
c) HT
d) Brain

Back 2

LV

80% diabetes die due to ischemia of KD, HT, Brain

Front 3

Diabetics rely on _____ for energy needs

Back 3

lipid metab

Front 4

what is the difference between juvenile and adult diabetes

Back 4

juvenile= absolute xu of insulin secretion (beta cells don't work thus insulin dependent)

adult= relative lack of insulin function (beta cells intact but overstimulated and cannot be used properly)

Front 5

general secondary disease characteristic of genetic diabetes

Back 5

cardio vascular disease due to accelerated atherosclerosis (due to xs acetyl CoA creating xs cholesterol)

Front 6

xs amounts of Acetyl CoA causes

a) ketosis
b) acidosis
c) cholesterol synth

Back 6

ALL

Front 7

T/F

Most px that manifest diabetes over the age of 16 are typically adult onset

Back 7

F

before 25= juvenile
(think rob robol)

Front 8

list the stages of diabetes

Back 8

pre
latent
chemical
overt

Front 9

why is it safer to have a slightly higher blood sugar level than a low one in diabetic px

Back 9

Lo Blood Sugar >50 causes seizure, brain damage in minutes

Hi BS- takes 5 days to cause coma

Front 10

stage of diabetes that must have a genetic predisposition and apply only to children of 2 diabetic parents

Back 10

pre-diabetes

Front 11

Latent Diabetes glucose tolerance tests are normal except under which conditions?

Back 11

emotional stress
pregnancy
infection
trauma

Front 12

3 most important components to maintaining blood sugar

Back 12

diet
exercise (walk)
insulin

Front 13

stage of diabets when px is asymptomatic and has normal fasting glucose levels, but abnormal postprandial hyperglycemia

Back 13

chemical diabetes- symptomatic and has normal fasting glucose levels, but abnormal postprandial hyperglycemia

may be transformed into overt disease during times of stress or xs weight gain

Front 14

T/F

Stress can transform chemical diabetes to overt disease

Back 14

T

Front 15

_____% never reach overt disease from chemical diabetes

Back 15

50%

Front 16

Symptoms of overt diabetes

Back 16

increased hunger, thirst, diuresis
"Wasting Thirsting"

Front 17

in Overt Diabetes fasting BS levels are ________ and postprandial levels are ______

Back 17

hyperglycemia both fasting and postprandial

Front 18

T/F

Insulin increases Blood Glucose levels

Back 18

F-
reduce BS levels
promote glucose to glycogen (storage form)
AA uptake
protein to muscle cells
inhibit protein degradation
stim triglyceride formation
inhibit release of FA from adipose
stim lipoprotein lipase activity
convert lipoprotein to FA

Front 19

T/F

insulin promotes conversion of glucose to glucagon

Back 19

F

glycogen (storage form of sugar)

Front 20

insulin _____ glucose transport across muscle and fat cell membranes

Back 20

increases

Front 21

form of insulin that can be given both parenterally and sub q

a) insulin lispro (humalog)
b) beef regular iletin
c) beef lente iletin

Back 21

Regular Insulin (beef regular iletin)

Front 22

which type of insulin medication can be used for type II diabetes only

a) insulin secretagogues
b) Glucosidase Inhibitors
c) thiazolidinediones

Back 22

all

(work on beta cells)

Front 23

diabetes medication that works by stim release of insulin from pancreatic beta cells

a) insulin secretagogues
b) Glucosidase Inhibitors
c) thiazolidineiones
d) biguanide

Back 23

insulin secretagogues
2 types: sulfonylureas, glinides

Front 24

list the 2 types of insulin secretagogues

Back 24

sulfonylureas- only useful when pancreas continues to produce sufficient insulin

glinides- taken w meals

Front 25

staple therapy for type 2 diabetes w/o obesity

a) glyburide (diabeta)
b) acarbose (precose)
c) metformin (glucophage)

Back 25

glyburide (diabeta) -
2nd generation sulfonylurea
first line choice of drug esp for non-obese px
hypoglycemia episodes common

Front 26

Chlorpropamide is a 1st generation _______ infrequently used to to the high risk of _____

Back 26

1st generation sulfonylurea (insulin secretagogue)
high risk of MI/Cardiac death

Front 27

primary potential side affect of Glinide drugs such as repaglinide (prandin)

a) MI
b) hyperglycemia
c) hypoglycemia

Back 27

hypoglycemia

note: cleared thru the KD and CI in px w renal failure

Front 28

CI in px w renal failure

a) repaglinide (prandin)
b) arcarbose (precose)
c) pioglitazone (actos)

Back 28

repaglinide (prandin) -glinide insulin secretagogue cleared thru the KD

ALSO- Sulfonylureas s/a glyburide also use w extreme caution in px w LV/Renal disease

Front 29

what is the major difference between 1st and 2nd generation sulfonylureas

Back 29

1st generation has longer half life w longer hypoglycemic effects

Front 30

work in the SI to delay the absorption of carboohydrates

a) insulin secretagogues
b) glucosidase inhibitors
c) thazolidineiones
d) biguanide

Back 30

glucosidase inhibitors
s/a acarbose (precose)

allow for better utilization of second phase insulin

Front 31

reduce insulin resistance in muscle and fat tissue

a) insulin secretagogues
b) glucosidase inhibitors
c) thazolidineiones
d) biguanide

Back 31

thazolidineiones (glitazones)
s/a rosiglitazone (avandia)

biguanides- also limit LV Glucose output
s/a metformin

Front 32

1st choice drug for type 2 diabetes w obesity

a) Rosiglitazone (avandia)
b) acarbose (precose)
c) metformin (glucophage)

Back 32

metformin (glucophage)

Front 33

diabetes medication not useful for acute hyperglycemia

a) Rosiglitazone (avandia)
b) acarbose (precose)
c) metformin (glucophage)

Back 33

rosiglitazone (avandia) - takes up to 3 months for optimal results

Front 34

delay post- meal absorption of carbs to allow for better utilization of 2nd phase insulin

a) repaglinide (prandin)
b) metformin (glucophage)
c) acarbose (precose)

Back 34

acarbose (precose)

Type of Alpha Glucosidase Inhibitor

Front 35

T/F

Glitazones are not suitable for acute hypoglycemia

Back 35

T- takes up to 3 months to get optimal results

Front 36

popular for type 2 diabetes because it promotes weight loss however it can have severe side effects such as lactic acidosis, megaloblastic anemia, and diarrhea

a) rosiglitazone (avandia)
b) metformin (riomet)
c) tolbutamide (molbenol)

Back 36

metformin (riomet)

Front 37

can improve insulin sensitivity in fat and muscle cells

a) acarbose (precose)
b) glyburide (diabeta)
c) metformin (fortamet)

Back 37

metformin

type of biguanide
acts in the LV to limit hepatic glucose levels and improve insulin sensitivity in muscle and fat cells and inhibit intestinal absorption of glucose

Front 38

________ determines the onset and duration of effect of the various forms of insulin

Back 38

rate of release of insulin

Front 39

which is the fastest and shortest acting form of insulin

a) Regular insulin (beef iletin)
b) insulin lispro (humalog)
c) prompt insulin zinc suspension (ilentin semilente)

Back 39

insulin lispro (humalog) - can only be given sub q

Front 40

diabetes med that decreases chances of hypoglycemia but makes it more difficult to tx

Back 40

alpha glucosidase inhibitors
acarbose (precose)

tx of hypoglycemia requires special gel/tablet. cadies will NOT suffice therefore dangerous. if a px rarely gets hypoglycemic attacks they are not likely to carry the gel w them at all times -> death w/in minutes