Diabetes Drugs 1

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Author:
kyleannkelsey
ID:
266506
Filename:
Diabetes Drugs 1
Updated:
2014-03-15 00:42:50
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Diabetes Drugs
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Diabetes Drugs
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Diabetes Drugs 1
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  1. Which Insulins have a rapid OOA/DOA?
    • Lispro
    • Aspart
    • Glulisine
  2. Which Insulins have a short OOA/DOA?
    Regular insulin
  3. Which Insulins have an intermediate OOA/DOA?
    NPH
  4. Which Insulins have a long OOA/DOA?
    • Glargine
    • Detemir
  5. What additive does NPH have to help create a suspension rather than a solution?
    Protamine
  6. Which Insulin is cloudy?
    NPH
  7. A cloudy vs. a clear Insulin indicates what?
    • Cloudy: Suspension
    • Clear: Solution
  8. What is a rapid OOA/DOA for insulin?
    • OOA: 5-15 minutes
    • DOA: 3-5 hrs
  9. What is a Short OOA/DOA for insulin?
    • OOA: 30-60 minutes
    • DOA: 5-8 hrs
  10. What is an intermediate OOA/DOA for insulin?
    • OOA: 2-4 hours
    • DOA: 10-16 hours
  11. What is a long OOA/DOA for insulin?
    • OOA: 2-6 hours
    • DOA: 8-24 hours
  12. What is the mechanism that gives Detimir its long OOA and DOA?
    • Bound to Myristic acid, which make it highly albumin bound
    • Must remove Myristic acid and be released from albumin to be active = slow process
  13. What is the mechanism that gives Glargine its long OOA and DOA?
    • 2 arginines added to end of B chain
    • Enhances crystal formation at physiological pH, which is slow to dissolve
    • Stored at pH 4
  14. What is the mechanism that gives Insulin Lispro and Aspart their rapid OOA and DOA?
    The amino acids are switched at 29 and 28 on the B chain
  15. Which insulin is sometimes called peakless?
    Glargine
  16. What is the goal fasting glucose for a diabetic?
    70-130 mg/dL
  17. What is the goal for postprandial glucose in a diabetic?
    <180 mg/dL
  18. What is the goal fr Hb A1c for diabetics?
    <7%
  19. What are the Adverse effects of Insulin?
    • Hypoglycemia
    • Weight gain
    • Local reactions – itching, rash, lipohypertrophy
  20. Which hypoglycemic drugs are Insulin sensitizers?
    • Biguanide
    • Thiazolidinediones
  21. Which hypoglycemic drugs are Insulin releasers?
    Sulfonylureas and Meglitinides
  22. Which hypoglycemic drugs are Glucose absorption inhibitors?
    Alpha Glucosidase inhibitors
  23. Which hypoglycemic drugs mimic endogenous incretins?
    Incretin drugs
  24. Which hypoglycemic drugs are Dipeptidyl peptidase – IV inhibitors that prevent the breakdown of endogenous incretins?
    Gliptins
  25. Which hypoglycemic drugs are Amylin analogues?
    Pramlintide
  26. Which hypoglycemic drugs increase glucose excretion?
    Na glucose co-transporter 2 inhibitors
  27. What groups of Hypoglycemic drugs are PO?
    Sulfonylureas and Meglitinides, Biguanide, Thiazolidinediones, Alpha Glucosidase Inhibitors, Gliptins, Na+-glucose co-transporter 2 inhibitors
  28. What groups of Hypoglycemic drugs are IV?
    Incretin drugs and Pramlintide
  29. Sulfonylureas and Meglitinides differ in what way?
    • Pharmacokinetics
    • Sulfonylureas: Given 1 or 2x per day = Fast OOA (1 hr) and very long DOA
    • Meglitinides: Given before meals = Very Rapid OOA (20 min) and short DOA (2-3 hrs)
    • Metabolites: Sulfonylureas have active ones and Meglitinides do not
  30. What is the OOA and DOA of Glipizide?
    • OOA: 1 hr
    • DOA: 10-20 hours
  31. What type of drug is Glipizide?
    Sulfonylurea
  32. What type of drug is Repaglinide?
    Meglitinide
  33. What is the OOA and DOA of Repaglinide?
    • OOA: 20 minutes
    • DOA: 2-3 hours
  34. What are the 2nd Gen Sulfonylureas?
    Glyburide, Glipizide and Glimepiride
  35. What are the Meglitinides?
    Repaglinide and Nateglinide
  36. Does Glipizide have active liver metabolites?
    No
  37. Does Repaglinide have active liver metabolites?
    No
  38. What is the MOA of Sulfonylurea and Meglitinides?
    • Stimulate release of Insulin from B-cells
    • By: Blocking ATP sensitive K+ channels and depolarizing B-cells
    • May increase sensitivity of muscle and fat cells to insulin
  39. Which drug can be used in patients with Sulfa allergies, Sulfonylureas or Meglitinides?
    Meglitinides
  40. Which drug can be used in patients with renal impairment, Sulfonylureas or Meglitinides?
    Meglitinides – not excreted by the kidneys
  41. What are the Adverse effects of Sulfonylureas or Meglitinides?
    • Excessive hypoglycemia
    • Sulfa allergy (Sulfonylureas)
    • Weight gain
    • Loss of effectiveness/secondary failure
    • Sulfonylureas cautioned in renal failure

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