Term
| What are the rapid acting short duration insulin drugs? |
|
Definition
| Lispro, Aspart, Glulisine, Semilente |
|
|
Term
| What does semilente and lente contain that make them longer duration medications? |
|
Definition
|
|
Term
| What are the three intermediate acting insulin medications? |
|
Definition
| NPH, aspart protamine, and lente |
|
|
Term
| Why does lispro have a decreased risk for hypoglycemia compared to other insulin mediations? |
|
Definition
| b/c it has a short duration of action (3-5hrs) |
|
|
Term
| How is lispro's amino acid sequence different than insulin? |
|
Definition
| switch B28 and B29 amino acid |
|
|
Term
| How is aspart amino acid sequence different than insulin? |
|
Definition
| puts an aspartate on B28 amino acid |
|
|
Term
| WHat are the two long acting insulin medications? |
|
Definition
|
|
Term
| What is true about the peak of action with the long acting insulin medications? |
|
Definition
|
|
Term
What does determir have in its structure that makes it longer acting? (2)
|
|
Definition
|
|
Term
| What are the three side effects of the insulin-like medications? |
|
Definition
hypoglycemia (longer the action greater the risk)
hypersensitivity
atroph at injection site |
|
|
Term
|
Definition
| Symlin is amylin recombinant it helps to potentiate insulin action |
|
|
Term
| What are the benefits of symlin when used with insulin medication? (4) |
|
Definition
| it decreases the fluctuation, gives better long term control, decreases glucagon secretion and decreases amount of insulin needed |
|
|
Term
| What type of diabetes do you use oral hypoglycemic agents for and why? |
|
Definition
type II diabetes
Cannot use with type I b/c there is no Bcell activity |
|
|
Term
| What are the four first generation sulfonylureas? |
|
Definition
Tolbutamide
Acetohexamide
Tolazamide
Chlorpromide
ALL END IN amide (except chlorpromide) |
|
|
Term
| What are the three second generation sulfonylureas? |
|
Definition
Glipizide
Glyburide
Glymepiride
all end in -ide |
|
|
Term
| What is the MOA of sulfonylureas? |
|
Definition
| bind to the K channel and block it to increase insulin release |
|
|
Term
| What are the adverse effects of the sulfonylureas? (7) |
|
Definition
Cardiovascular risks
antidiruetic
leudopenia
hemolytic anemia
rashes
GI disturbance
hypoglycemia |
|
|
Term
| What does ETOH do to a diabetic individual on sulfonylureas both acutely and chronically? |
|
Definition
ACUTE: decreases gluconeogensis b/c of high carb load-->hypoglycemia
CHRONIC: decreases hypoglycemia b/c it increases metabolism of sulfonylureas in the liver |
|
|
Term
| What four drugs antagonize sulfonylureas? |
|
Definition
thiazides
furosamide
corticosteriods
oral contraceptives |
|
|
Term
| What drug interfers with metabolism of sulfonylureas? |
|
Definition
|
|
Term
| What is the benefit of using a second generation sulfonylurea versus a first generation? (2) |
|
Definition
| less drug drug interaction and increased potency |
|
|
Term
| What are the two meglitinde mediations? |
|
Definition
| rapaglinide and nateglinide |
|
|
Term
| What medications would you use in a pregnant diabetic patient? |
|
Definition
|
|
Term
| What is the MOA of the meglitinides? |
|
Definition
| they bind the K channel and inhance insulin secretion |
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