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Flashcards in Endocrine - Pharmacology Deck (64)
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1

What is the basis of treatment of diabetes mellitus type 1?

Low-sugar diet and insulin replacement

2

What is the basis of treatment for diabetes mellitus type 2?

Dietary modification and exercise for weight loss, oral hypoglycemics, insulin replacement (late)

3

Name three short-acting insulins.

Lispro, aspart, regular

4

Is neutral protamine Hagedorn (NPH) insulin considered a short-, intermediate-, or long-acting insulin?

Intermediate-acting insulin

5

Name two long-acting insulins.

Glargine, detemir

6

Insulin binds insulin receptors which have ______ _____ signaling pathways.

Tyrosine kinase

7

For what electrolyte disturbance can insulin be used as a treatment?

Hyperkalemia

8

A patient is in the intensive care unit and noted to have a blood glucose of 225 mg/dL; what medication is appropriate for this condition?

Insulin is effective in treating stress-induced hyperglycemia

9

What is the most common adverse effect of insulin treatment?

Hypoglycemia; very rarely, one may see a hypersensitivity reaction

10

Name two first generation sulfonylureas.

Tolbutamide, chlorpropamide

11

Name three second generation sulfonylureas.

Glyburide, glimepiride, glipizide

12

Which diabetes drugs can cause a disulfiram-like reaction?

First-generation sulfonylureas

13

To which class of diabetes drugs does metformin belong?

Biguanides

14

To which class of diabetes drugs do pioglitazone and rosiglitazone belong?

Glitazones

15

Name two -glucosidase inhibitors.

Acarbose, miglitol

16

Describe the mechanism of action of sulfonylureas.

Sulfonylureas close the K+ channel on the -cell membrane leading to cell depolarization and causing insulin release by increased calcium influx

17

Will sulfonylureas work in type 1 diabetes mellitus?

No; these drugs require islet cell function and the ability to secrete endogenous insulin (defective in type 1 diabetes)

18

What is an adverse effect of second-generation sulfonylureas?

Hypoglycemia

19

What is the mechanism of action of metformin?

Unknown; may decrease gluconeogenesis, increase glycolysis, thereby decreasing serum glucose levels; overall, it acts as an insulin sensitizer

20

True or False: Metformin can be used in patients without islet function.

True

21

Before prescribing metformin, it is important to assess the function of what organ?

Kidney; if metformin cannot be excreted it may build up leading to lactic acidosis

22

How do glitazones work?

They increase target cell response to insulin via the peroxisome proliferator-activated receptor-γ pathway

23

What are the side effects of glitazones?

Glitazones can cause weight gain, edema, hepatotoxicity, and cardiovascular toxicity

24

Acarbose and miglitol work by inhibiting what enzyme?

-Glucosidase, an intestinal brush border enzyme; this results in decreased postprandial hyperglycemia

25

What is the principal toxicity of -glucosidase inhibitors?

Gastrointestinal disturbances

26

What is the mechanism of action of pramlintide?

Pramlintide is a mimetic of an endogenous hormone and acts by inhibiting glucagon

27

What are some toxicities of pramlintide?

Hypoglycemia, nausea, diarrhea

28

Give an example of a glucagon-like peptide-1 mimetic drug.

Exenatide; this drug was discovered in the saliva of the gila monster

29

What is the mechanism of action of the GLP-1 mimetics?

Increases insulin and decreases glucagon

30

What are toxicities of exenatide use?

Nausea, vomiting and possibly pancreatitis