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  1. What is insulin
    released by the beta cells in the pancreatic islets of Langerhans in response to blood glucose levels. 

    Effect- lower blood glucose concentration
  2. what is amylin
    secreted with insulin from the beta cells in the pancreatic islets of langerhans in response to meals

    Effect- lower blood glucose concentration
  3. what is Glucagon?
    released from the alpha cells in the islets of Langerhans in response to blood glucose levels. 

    Effect- raise blood glucose concentration
  4. What are incretins?
    two hormones that are secreted from cells located in the epithelium of the small intestine. Glucose dependent isulinotropic peptide (GIP) and Glucagon like peptide (GLP-1). 

    Effect- lower blood glucose.
  5. What does insulin do?
    • 1. Binds to plamsa membrane receptors on skeletal, heart muscle and adipose tissue. Causes the movement of a carrier protein from inside the cell to the plasma membrane where it acts as a channel to allow glucose into a cell. Result: as glucose moves into cells- the blood glucose concentration decreases. 
    • 2) Stimulates gluconeogenesis in the liver to store glucose for use between meals or during a fast. 
    • 3) Inhibits the liver from releaseing more glucose into the bloodstream and inhibits the breakdown of protein and fat for energy 
    • 4) Facilitates entry of amino acids into cell for protein synthesis.
  6. What does Glucagon do
    1)Raises blood glucose through action at the liver (activates enzymes that break down glucogen) 

    2) Stimulates formation of glucose from amino acids

    3) stimulates breakdown of triglycerides to fatty acids to use for fuel
  7. Characteristics of Type 1 Diabetes
    • "Juvenille"
    • sudden onset
    • can occur after viral infection
    • stops forming insulin 
    • 10% of diabetes cases
  8. What is the treatment of type 1 diabetes
    insulin injection
  9. What are the characteristics of Type 2 Diabetes?
    • older onset
    • insulin resistance
    • overweight
    • hereditary
    • slower onset
    • 90% of diabetes cases
  10. 3 classic symptoms of diabetes
    • Polyurea- urine
    • Polydipsia- hunger
    • Polyphasia- thirst
  11. Complications of Diabetes
    • Retinopathy
    • Neuropathy
    • Nephropathy 
    • CVD/Artherosclerosis
  12. Fasting blood sugar greater than _______ = diabetes
    126 mg/dl
  13. Random blood sugar > _________ = diabetes
  14. Hgb ALC tests what?
    blood test of blood sugar over 3 months

  15. Treatment of Diabetes
    All individals with diabetes are treated with diet and exercise. Most individuals also require the use of medicine
  16. Symptoms of Hyperglycemia
    • Sweating
    • Urine glucose -
    • Sudden onset
    • Rapid shallow respiration 
    • Hyperactive reflex
    • Normal to high BP
  17. Symptoms of Hypoglycemia
    • Gradual onset
    • Hypotension 
    • Rapid deep respiration 
    • Hyperactive reflex 
    • Urine glucose +
  18. MOA of Insulin
    facilitates rate of glucose uptake into cels and stimulates gluconeogenesis
  19. Insulin comes in _____ units/ml
  20. glargene
    • 24 hour/long acting 
    • no peak
  21. lyspro
    • pre meal insulin
    • fast acting
    • 2-5 hours
    • peak 30-90 min
  22. Regular insulin
    no peak
  23. Glyburdide MOA
    "big stick"

    Cause the release of insulin. bind to receptors in beta cell membrane which closes potassium channels. Cell depolaries, influc of calcium, and insulin release from cell. 

    Adverse effect: can cause hypoglycemia
  24. Metformin MOA and Adverse effects
    MOA: decreases liver glucose production and intestinal glucose absorption. Also increases glucose utilization by other tissues. Does not affect insulin secretion. Does not cause hypoglycemia when used alone. 

    Adverse effects: Diahrea, upset stomach. 

  25. Key facts about Lactic acidosis
    • fatal 50% of the time
    • as an adverse effect of therapy with metformin it is extremely rare 
    • The onset of lactic acidosis is sublte with malaise, myalgias (muscle pain), respiratory changes, sleepiness, and gastrointestinal issues.
Card Set
pharmacology exam 2
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