Shared Flashcard Set

Details

Pharm CH 41
Pancreatic Hormones & Antidiabetic Drugs
22
Pharmacology
Professional
05/31/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
Insulin lispro
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Rapid-acting Insulins

Very fast onset, short duration

Can be taken before meals; duration of action is 4-5 hours

Reduce circulating glucose and promote synthesis of glycogen, lipid, and protein

Used in continuous infusion devices

 
 
 

 

Term
Insulin glulisine
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Rapid-acting Insulins

Very fast onset, short duration

Can be taken before meals; duration of action is 4-5 hours

Reduce circulating glucose and promote synthesis of glycogen, lipid, and protein

Used in continuous infusion devices

 
 
 

 

Term
Insulin aspart
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Rapid-acting Insulins

Very fast onset, short duration

Can be taken before meals; duration of action is 4-5 hours

Reduce circulating glucose and promote synthesis of glycogen, lipid, and protein

Used in continuous infusion devices

 
 
 

 

Term
Regular humulin
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Short-acting Insulins

 

Rapid onset (<30 min) and lasts 5-8 hours; must be taken 30-45 min before meal time to minimize mismatching

 

Reduce circulating glucose and promote synthesis of glycogen, lipid, and protein

Diabetic ketoacidosis; rapidly changing insulin requirement such as after surgery or during acute infections (Only insulin that can be administered IV.)

 
 

 

Term
Crystalline insulin
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Short-acting Insulins

 

Rapid onset (<30 min) and lasts 5-8 hours; must be taken 30-45 min before meal time to minimize mismatching

 

Reduce circulating glucose and promote synthesis of glycogen, lipid, and protein

Diabetic ketoacidosis; rapidly changing insulin requirement such as after surgery or during acute infections (Only insulin that can be administered IV.)

Term
NPH humulin
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Intermediate-acting Insulins

Onset 2-5 hours and duration 4-12 hours.

Usually mixed with regular, lispro, apart, or glulisin insulin.

Highly unpredictable action, variability of absorption >50%, use is waning due to availability of long-acting insulin

 
 

 

Term
Lente insulins
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Intermediate-acting Insulins

Onset 2-5 hours and duration 4-12 hours.

Usually mixed with regular, lispro, apart, or glulisin insulin.

Highly unpredictable action, variability of absorption >50%, use is waning due to availability of long-acting insulin

 
 

 

Term
Insulin glargine
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Long-acting Insulins

 

Slow onset (1-1.5 hours) and duration of > 11-24 hours.

Background insulin replacement

 

Term
Insulin detemir
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Long-acting Insulins

 

Onset 1-2 hours and duration > 24 hours.

Most reproducible effect and is associated with less hypoglycemia.

 

Term
Tolbutamide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Sulfonylureas

Secretagogue: Bind to a sulfonylurea receptor that is associated with the β-cell inward rectifier ATP-sensitive K+ channel. Binding inhibits efflux of K+ ions, causing depolarization and opening of voltage-gated calcium channels. Allows calcium influx & subsequent release of insulin.

Hypoglycemia, weight gain, GI problems, headache, teratogenic

Type 2 diabetes

 

In patients with functioning β-cells, reduce circulating glucose.  Increase glycogen, fat, and protein formation, gene regulation

 
 

 

Term
Chlorpropamide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Sulfonylureas

 

Secretagogue: Bind to a sulfonylurea receptor that is associated with the β-cell inward rectifier ATP-sensitive K+ channel. Binding inhibits efflux of K+ ions, causing depolarization and opening of voltage-gated calcium channels. Allows calcium influx & subsequent release of insulin.

Hypoglycemia, weight gain, GI problems, headache, teratogenic

Type 2 diabetes

 

In patients with functioning β-cells, reduce circulating glucose.Increase glycogen, fat, and protein formation, gene regulation

Term
Glipizide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Sulfonylureas

Secretagogue: Bind to a sulfonylurea receptor that is associated with the β-cell inward rectifier ATP-sensitive K+ channel. Binding inhibits efflux of K+ ions, causing depolarization and opening of voltage-gated calcium channels. Allows calcium influx & subsequent release of insulin.

Hypoglycemia, weight gain, GI problems, headache, teratogenic

Type 2 diabetes

 

In patients with functioning β-cells, reduce circulating glucose.  Increase glycogen, fat, and protein formation, gene regulation

 
 

 

Term
Repaglinide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Glitinides

 

Secretagogue: Modulate β-cell insulin release by regulating K+ efflux through K+ channels; similar to sulfonylureas with some overlap in binding sites

 

hypoglycemia

Type 2 diabetes

 
 

 

Term
Nateglinide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Glitinides

 

Secretagogue: Modulate β-cell insulin release by regulating K+ efflux through K+ channels; similar to sulfonylureas with some overlap in binding sites

 

hypoglycemia

Type 2 diabetes

 
 

 

Term
Metformin
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Biguanides

 

Obscure - Reduce hepatic glucose production through activation of AMP-activated protein kinase (AMPK). Also:

·         Impair renal gluconeogenesis

·         Slow glucose absorption from GI

·         ↑ glucose→lactate conversion

·         Stimulate glycolysis

·         ↑ glucose removal from blood

·         ↓ plasma glucagon levels

 

GI effects (anorexia, nausea, vomiting, diarrhea) in 20%, reduced vitamin B12 absorption, lactic acidosis is rare

 

CI: renal/hepatic disease, alcoholism, CHF or hypoxic/acidotic states due to ↑risk of lactic acidosis

Type 2 diabetes – 1st line therapy

 

Does NOT increase weight or provoke hypoglycemia

 

Term
Acarbose
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Alpha-Glucosidase Inhibitors

Inhibit intestinal α-glucosidases.  Reduce conversion of starch and disaccharides to monosaccharides.  Reduce postprandial hyperglycemia.

GI symptoms

 

CI: impaired renal/hepatic function, intestinal disorders

Type 2 diabetes

 
 

 

Term
Miglitol
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Alpha-Glucosidase Inhibitors

Inhibit intestinal α-glucosidases.  Reduce conversion of starch and disaccharides to monosaccharides.  Reduce postprandial hyperglycemia.

GI symptoms

 

CI: impaired renal/hepatic function, intestinal disorders

Type 2 diabetes

 
 

 

Term
Rosaglitazone
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Thiazolidinediones

 

Regulates gene expression by binding to PPAR-γ.  Reduces insulin resistance.

Fluid retention, edema, anemia, weight gain, macular edema, bone fractures in women

Type 2 diabetes

CI: CHF, hepatic disease, may worsen heart disease

 

Term
Exenatide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Incretin-Based Drugs

 

Binds to glucagon-like-polypeptide 1 (GLP-1) receptors

Nausea, headache, vomiting, anorexia, mild weight loss, pancreatitis

Type 2 diabetes;

 

Reduces post-meal glucose excursions: glucose-mediated insulin release, glucagon levels, slows gastric emptying, appetite

 

Term
Sitagliptin
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Incretin-Based Drugs

 

Inhibitor of dipeptidy peptidase-4 (DPP-4), the enzyme that degrades incretin and other GLP1-like molecules

Raises circulating GLP-1 levels

Rhinitis, upper respiratory infections, rare allergic reactions

Reduces post-meal glucose excursions: glucose-mediated insulin release, glucagon levels, slows gastric emptying, appetite

 

Term
Pramlintide
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Oral Antidiabetic Agents

Amylin Analog

 

Analog of amylin: Binds amylin receptors

Nausea, anorexia, hypoglycemia, headache

Type 2 diabetes; Reduces post-meal glucose excursions: ↑glucose-mediated insulin release, ↓glucagon levels, slows gastric emptying, ↓ appetite

 

Term
Glucagon
Definition

CH 41 Pancreatic Hormones & Antidiabetic Drugs

Glucagon

 

Bind to Gs protein-coupled receptors on liver cells.  This leads to an increase in cAMP, which facilitates catabolism of stored glycogen and ↑gluconeogenesis and ketogenesis.

↑blood glucose

Transient nausea and occasional vomiting

Severe hypoglycemia, endocrine diagnosis, reverse effects of overdose of β-blocking agents (↑cAMP production in heart), radiology of bowel (relaxes intestine)

 

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