T4 Pharmacology Insulin Spring 2011

Front 1

Glucose important because?

Back 1

precursor for synthesis or lipids, amino acids, nucleic acids

Front 2

Body requires how much glucose?

Back 2

190 mg glucose/day

Front 3

Metabolic syndrome can lead to?

Back 3

CV disease
Neuropathy
Nephropathy
Retinopathy
Hyperlipidemias
Peripheral vascular disease

Front 4

Diagnosis of DM?

Back 4

Polyuria
Polydipsia
Weight loss

Front 5

Blood glucose levels for DM?

Back 5

Random blood glucose > 200mg/dL

Fasting glucose >126 mg/dL

Front 6

How many types of diabetes?

Back 6

4

Front 7

Percentages of 1 vs 2?

Back 7

10% 1
90% 2

Front 8

Type 3 due to?

Back 8

secondary factors, decrease insulin in CNS in AD

Front 9

Type 4 DM?

Back 9

Gestational diabetes

Front 10

Risk factors for DM1?

Back 10

genetic
viruses

Front 11

Risk factors for DM2?

Back 11

Ethnicity
Obesity
Life style

Front 12

Cell types in pancreas?

Back 12

Alpha, Beta, Delta, PP

Front 13

Alpha cell percentage? function?

Back 13

20%, mobilizes feul via gluconeogenesis, glycogenolysis

Front 14

Alpha cell products?

Back 14

Glucagon

Front 15

Beta cell percentage? function?

Back 15

75%
Promotes feul storage and growth

Front 16

Beta cell products?

Back 16

Insulin
C-peptide
Amylin

Front 17

Delta cell percentage? function?

Back 17

3-5%
Inhibits secretory cells

Front 18

Delta cell products?

Back 18

Somatostatin

Front 19

Somatostatin does what?

Back 19

inhibitory

Front 20

F cell (PP) function?

Back 20

factilitate digestive processes

Front 21

DM1 is a __ disease causing loss of?

Back 21

autoimmune disease causing loss of beta cells

Front 22

_% of DM1 have antibodies to?

Back 22

80% have antibodies to islet cell antigens

Front 23

Proinsulin converted to what? where?

Back 23

To Insulin and C-peptide in golgi

Front 24

Insulin stored in? as?

Back 24

Stored in beta cells as 6 insulines with 2 zinc

Front 25

C-peptide is?

Back 25

used as an index of insulin secretion, no known function

Front 26

Degradation of insulin via?

Back 26

Hydrolysis of disulfide bonds and then proteolusis

Front 27

Mechanism of insulin release?

Back 27

pancreas exposed to increased glucose which binds Glut-2 and then internalized to ATP, which will close ATP-dependent K channels, decreasing the K flow outward to depolarize the cell, opening Ca channels. Increased Calcium stimulates exocytosis or insulin

Front 28

Mechanism of insulin Action?

Back 28

Stimulates glucose uptake into target tissues to initiates phosphorylation cascade and translocates glucose transporters to cell surface

Front 29

Glucose enters cell via?

Back 29

Facilitated diffusion

Front 30

How many GLUT transporters?

Back 30

5

Front 31

GLUT 1 transporter located?

Back 31

in all tissues

Front 32

GLUT 1 function?

Back 32

basal uptake of glucose, transport across BBB

Front 33

GLUT 2 located?

Back 33

Beta cells of pancreas

Front 34

GLUT 2 function?

Back 34

regulation of insulin release

Front 35

GLUT 3 located?

Back 35

Brain, kidney

Front 36

GLUT 3 function?

Back 36

uptake into neurons

Front 37

GLUT 4 located?

Back 37

Muscle, adipose

Front 38

GLUT 4 function?

Back 38

insulin mediated glucose uptake

Front 39

GLUT 5 located?

Back 39

gut, kidney

Front 40

GLUT 5 function?

Back 40

absorption of fructose

Front 41

Effect of insulin in liver?

Back 41

Stimulates: storage as glycogen, conversion to fatty acids, VLDL and adipose

Inhibits: Glycogenolysis, Gluconeogenesis

Front 42

Effect of insulin on skeletal muscle?

Back 42

Stimulates: storage of glycogen and amino acids

Inhibits: Protein degradation

Front 43

Effect of insulin on adipose tissue?

Back 43

Stimulates: Storage of fatty acids

Inhibits: conversion of TGs to fatty acids

Front 44

Kinetic profile of NPH altered by?

Back 44

Adding protamine

Front 45

Insulin origin?

Back 45

Beef, pork

Human, recombinant in E.Coli or yeast

Front 46

E. Coli:
Yeast:

Back 46

E Coli - Humulin
Yeast - Novolin

Front 47

Types of insulin:

Back 47

Ultra short acting
Short acting
Intermediate
Ultra long acting

Front 48

Ultra short acting insulins:

Back 48

Lispro
Aspart
Glulisine

Front 49

Ultra short acting insulins onset? duration?

Back 49

onset 15 mins, lasts 4 hours

Front 50

Short acting insulins?

Back 50

Regular

Front 51

Short acting insulin onset? duration?

Back 51

onset in .5 to 1 hour
duration 5 to 7 hours

Front 52

Intermediate insulin?

Back 52

NPH

Front 53

Intermediate insulin onset? duration?

Back 53

onset 1 to 3 hours
duration 18 to 24 hours

Front 54

Long acting insulin

Back 54

Glargine
Detemir

Front 55

Long acting onset? duration?

Back 55

onset 2 to 4 or 5 to 6 hours
duration ~24 hours

Front 56

insulin delivery options

Back 56

injection
portable pen
subcutaneous infusion
inhaled
aerosolized
sublingual

Front 57

Indications for insulin:

Back 57

All type 1
Pregnant diabetics, gestational DM
DM2 not controlled
Hyperkalemia

Front 58

Drugs that decrease effect of insulin?

Back 58

Oral contraceptives
Corticosteroids
Dobutamine
Epinephrine
Naicin
Smoking
Thiazides
Thyroid hormone

Front 59

Drugs that increase effect of insulin?

Back 59

Alcohol
Alpha-blockers
Anabolic steroids
Beta-blockers
MAOI

Front 60

Complications of insulin?

Back 60

Hypoglycemia
Immunopathology
Lipodystrophy

Front 61

Goals of insulin therapy

Back 61

Maintain blood glucose in acceptable range

Prevent microvascular complications

Front 62

ADAs Goals:
Fasting
Postprandial
A1C

Back 62

Fasting 80-120
Postprandial 100-140
A1C <7