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Pharmocology > DM > Flashcards

DM Flashcards

1
Q

primary defect in T1DM

A

pancreatic beta cells due to autoimmune process

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2
Q

defects in T2DM

A
  • Insulin resistance and impaired insulin secretion
  • Hyperinsulinemia- relatively new T2DM bc pancreas is releasing insulin but cells are resistant
  • Insulin resistance
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3
Q

insulin lispro

A

onset- 15-30 minutes
peak 30 minutes - 2- 2.5 hrs
duration 3-6 hrs

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4
Q

insulin lispro peak

A

30 minutes- 2.5 hrs

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5
Q

insulin lispro duration

A

3-6 hours

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6
Q

insulin aspart (novolog) onset

A

10-20 minutes
peak 1-3 hrs
duration 3-5 hrs

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7
Q

insulin aspart - novolog- peak

A

1-3hours

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8
Q

insulin aspart-novolog- duration

A

3-5 hrs

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9
Q

insulin glulisine-aprida onset

A

10-15 minutes
peak 1 - 1.5 hrs
duration 3-5 hrs

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10
Q

insulin glulisine aprida peak

A

1 - 1.5 hrs

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11
Q

insulin glulisine - aprida- duration

A

3-5 hrs

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12
Q

regular insulin onset, peak, duration

A

onset- 30 - 60 mins
peak 1 -5 hrs
duration 6-10 hrs

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13
Q

NPH

A

onset 60-120 minutes
peak 6-14 hrs
duration 18-24 hrs

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14
Q

insulin glargine

A

onset 70 min
peak none
duration 18-24 hrs

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15
Q

insulin detemir

A

onset 60 - 120 min
peak 12 - 24 hrs
duration varies

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16
Q

insulin degludec

A

onset 60 min
peak none
duration 42 hrs

17
Q

metformin MOA

A

lowers BG and improves glucose tolerance in 3 ways
1- Inhibits glucose production in the liver
2- Reduces (slightly) glucose absorption in gut
3- Sensitizes insulin receptors in target tissues (fat and muscle) and thereby increases glucose uptake in response to whatever insulin may be available

18
Q

Metformin metabolized where

A

none, absorbed in small intestine

19
Q

metformin excretion

A

kidneys

20
Q

metformin AE

A

• most common GI- decreased appetite, nausea, diarrhea (subside w/time)
• does not cause wt gain, wt neutral drug
• BLACK BOX- lactic acidosis
o Avoid in ppl w/ liver disease, severe infection, hx of lactic acidosis, renal insufficiency, etoh excess, show and conditions that can result in hypoxemia, HF (predisposes)

21
Q

sulfonylurea MOA

A

stimulating release of insulin and increasing cell sensitivity

22
Q

sulfonylurea AE

A

hypoglycemia

wt gain

23
Q

metaglindines aka glidines

A

nateglidine, repaglinide

  • Same MOA of sulfonylureas- stimulation of pancreatic insulin release
  • Difference between sulfonylureas and glinides is that glinides are shorter acting and taken w/ each meal
  • AE- hypoglycemia
24
Q

Thiazolidinediones (glitazones)

A
  • Reduce glucose levels primarily by decreasing insulin resistance
  • Rosiglitazone [Avandia]: Restricted use
  • Pioglitazone [Actos
25
Q

Pioglitazone [Actos] black box

A

associated with HF d/t renal retention of fluid. If HF dx, drug should be dc or dose reduced

26
Q

Alpha-glucosidase inhibitors acarbose

A

• Act in intestine to delay the absorption of carbohydrates and thereby reduces rise in post prandial rise in BGL

27
Q

Alpha-glucosidase inhibitors acarbose AE

A

Frequently causes flatulence, cramps, abdominal distention, borborygmus, diarrhea, and liver dysfunction

28
Q

[dipeptidyl peptidase-4 inhibitor] gliptin moa

A

• Promote glycemic control by enhancing the actions of incretin hormones
1- Stimulate glucose-dependent release of insulin
2- Suppress postprandial release of glucagon (hormone that decreases glucose production in liver)

29
Q

dipeptidyl peptidase-4 inhibitor] gliptin excretion

A

kidneys

renal dosing

30
Q

Sodium-glucose cotransporter 2 (SGLT-2) inhibitors MOA

A
  • Block reabsorption of filtered glucose in the kidney, leading to glucosuria
  • Work by lowering threshold for glucose excretion from kidney, excretes glucose out of urine
31
Q

Sodium-glucose cotransporter 2 (SGLT-2) inhibitors AE

A

• Side effects: Genital fungal infections in female patients, urinary tract infections, increased urination

32
Q

Glucon-Like Peptide -1 (GLP-1 mimetics)

A

• Incretin mimetics, augments effects of incretin hormone GLP1

33
Q

Glucon-Like Peptide -1 (GLP-1 mimetics) MOA

A

• Slow gastric emptying, stimulate glucose-dependent release of insulin, inhibit postprandial release of glucagon, and suppress appetite

34
Q

Amylin mimetics

A

 Pramlintide [Symlin]
 Reduces postprandial bgl by delaying gastric emptying and suppressing glucagon secretion
 Adverse effects: Hypoglycemia and nausea, injection site reactions

35
Q

Glucon-Like Peptide -1 (GLP-1 mimetics)

A

• Exenatide [Byetta]
o Adverse effects: Hypoglycemia and gastrointestinal effects, including pancreatitis
• Liraglutide [Victoza]
o May cause medullary thyroid carcinoma (MTC)

Pharmocology (15 decks)

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