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diabetes
diabetes drugs nursing pharm
49
Pharmacology
Undergraduate 2
03/10/2011

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Cards

Term
where is insulin synthesized?
Definition
the beta islet cells in the pancreas
Term
what does the release of insulin normally depend on?
Definition
glucose
Term
what are the glucose transporters called?
Definition
GLUT2
Term
because glucose is taken up into the beta cell there is an increase in_____
Definition
ATP
Term
What does high ATP do to the ATP-sensitive potassium channel?
Definition
closes it
Term
increase in intracellular _____ cause insulin to be released
Definition
Calcium
Term
Actions of insulin:
Definition
decrease blood glucose by inhibiting liver glucose production
increase glucose uptake by skeletal muscle and adipose
increase glucose uptake by the liver
Term
why did animal insulin cause a lot of problems when it was used to treat humans?
Definition
immunologic problems
Term
what sort of insulin is used to treat humans today?
Definition
human recomibinant
Term
what do insulin receptors do when activitated?
Definition
they can control gene expresion, growth regulation, glucose utilization, glycogen/lipid/protein synthesis.
Term
what transporter takes glucose into cells?
Definition
GLUT4
Term
Insulin dependent diabetes mellitus
Definition
type 1
Term
non-insulin dependent diabetes mellitus
Definition
type2
Term
how does type 1 usually develop?
Definition
an autoantibody attacks the beta cells of the pancreas and kills them (usually)
Term
do type 2 diabetics make insulin?
Definition
yes- it may be the wrong type, their receptors may not work. many variables. They don't respond to what they have.
Term
diabetes that occurs in pregnancy
Definition
gestational diabetes
Term
for a diagnosis of diabetes
random glucose > ______
fasting glucose >_______
plasma glucose > ______
Definition
200mg/dl
126 mg/dl
200 mg/dl after oral glucose load
Term
what is the usual cutoff age for developing type1
Definition
40 ish
Term
children as young as ___ are now developing type 2
Definition
8
Term
major risk factor for type 2 diabetes
Definition
obesity
Term
regular (humulin, Novolin =human)
lispro (humalog)
aspart (novolog)
glulysine
Definition
short onset/ short duration insulin
Term
neutral protamine hagedorn (NPH)
Definition
intermediate duration insulin
Term
glargine (lantus)
Definition
long duration insulin
Term
what is the side effect of insulin?
Definition
hypoglycemia
Term
how long do short duration insulins take to work? how long do they last?
Definition
10-15 min; 2-3 hrs
Term
acute consequences of diabetes
Definition
hyperglycemia, ketoacidosis, diabetic coma (caused by hypo or hyperglycemia)
Term
most common cause of blindness in people of working age
Definition
diabetic retinopathy
Term
this effects up to 50% of men with long-standing diabetes
Definition
erectile dysfunction
Term
first choice of treatment for type 2
Definition
diet, exercise
Term
Name the Sulfonylureas
Definition
Glipizide/ Glyburide
Term
these work to increase insulin release by blocking the K+ channels in islet cells and increase sensitivity to insulin
Definition
Sulfonylureas: glipizide/glyburide MOA
Term
these drugs close K+ channels in islet cells --> increase release of insulin
Definition
Repaglinide/ Nateglinide MOA
Term
this decreases glucose production by the liver and does not cause insulin release/ no hypoglycemia
Definition
metformin
Term
what shouldn't you give metformin with?
Definition
renal, liver, or heart failure
Term
what is the biggest side effect of the sulfonylureas?
Definition
hypoglycemia
Term
these inhibit alpha-glucosidase in the gut and decrease intestinal absorption of starch, dextrin and disaccharides
Definition
acarbose/miglitol
Term
how are repaglinide/ nateglinide administered?
Definition
they are very short acting and taken with meals
Term
these are agonists for nuclear peroxisome proliferator-activated receptor gamma and leads to upregulation of genes that regulate carb and lipid metabolism
*horrendous side effects, may cause CHF
Definition
Pioglitazone/ Rosiglitazone (avandia)
Term
the new class of hypoglycemics are based upon this peptide that is secreted from the alpha cell
Definition
amylin
Term
what does amylin do?
Definition
inhibits glucagon secretion; liver doesn't secrete glucose
Term
modified amylin peptide used with insulin to prevent postparandial hyperglycemia. must be injected can be used for type 1 or type 2
Definition
pramlintide
Term
glucagon-like peptide (GLP-1) released from the gut to augment glucose-dependant insulin secretion from pancreas
-same effects as amylin plus increases the beta cell number
Definition
incretin
Term
what is incretin broken down by?
Definition
dipeptidyl peptidase-4 enzyme (DPP-4)
Term
incretin mimetic (injected); first one made
Definition
exenatide
Term
this incretin mimetic is brand new may cause thyroid cancer
Definition
liraglutide (victoza)
Term
these are new DPP-4 inhibitors and are admistered orally
Definition
Sitagliptin
vildagliptin
Term
decreased gastric insuli, increased insulin release, increased insulin sensitivity
Definition
GLP-1 MOA
Term
treatment for SEVERE hypoglycemia- IM injection
Definition
glucagon
Term
treatment for hypoglycemia
-opens K+ channels or prolongs open state
-decreases insulin secretion
Definition
Diazoxide
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