pharm8

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Author:
Neda317
ID:
305728
Filename:
pharm8
Updated:
2015-07-26 14:13:55
Tags:
pharm
Folders:
pharm
Description:
338-339 diabetes
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  1. what are ?
    Aspart,
    Glulisine,
    Lispro
    Insulin, rapid acting
  2. Aspart,
    Glulisine,
    Lispro
    USE
    • Type 1 DM, type 2 DM,
    • GDM (postprandial glucose
    • control).
  3. insulin MOA
    • Binds insulin receptor (tyrosine
    • kinase activity).
    • Liver: inc  glucose stored as glycogen.
    • Muscle: inc glycogen, protein
    • synthesis;
    • inc  K+  uptake.
    • Fat: inc TG storage.
  4. Insulin, short acting
    and USE
    • Regular
    • use:  Type 1 DM, type 2 DM,
    • GDM, DKA (IV),
    • hyperkalemia (+ glucose),
    • stress hyperglycemia.
  5. Insulin, intermediate
    acting
    and USE
    • NPH
    • use  Type 1 DM, type 2 DM,
    • GDM.
  6. Insulin, long acting
    and 
    USE
    Detemir,Glargine

    use: Type 1 DM, type 2 DM,GDM (basal glucosecontrol).
  7. Biguanides
    name
    Metformin
  8. metformin MOA
    • Exact mechanism unknown.
    • dec gluconeogenesis, inc glycolysis,
    • inc peripheral glucose uptake
    • (inc insulin sensitivity).
  9. which one  causes modest
    weight loss?
    metformin
  10. which one is  contraindicated in renal
    insufficiency
    Metformin
  11. Sulfonylureas
    First generation:
    Chlorpropamide,Tolbutamide
  12. sulfonylureas
    Second generation:
    Glimepiride,Glipizide,Glyburide
  13. Sulfonylurese MOA
    • Close K+  channel in β -cell
    • membrane -> cell depolarizes
    • -> insulin release via high Ca2+ influx -> inc insulin secretion
  14. which one  Stimulate release of
    endogenous insulin
    Sulfonylurease
  15. which one has disulfiram-like effect?
    • first generation of sulfonylurease : Chlorpropamide,
    • Tolbutamide
  16. which one has  Weight gain, edema.
    Hepatotoxicity, HF, inc risk of
    fractures.
    • Glitazones/
    • thiazolidinediones: Pioglitazone,
    • Rosiglitazone
  17. Glitazones/
    thiazolidinediones
    Pioglitazone,Rosiglitazone
  18. which one  inc insulin sensitivity in peripheral
    tissue.
    • Glitazones/
    • thiazolidinediones:
    • Pioglitazone,
    • Rosiglitazone
  19. GLP-1 analogs
    name
    Exenatide,Liraglutide
  20. Exenatide,Liraglutide
    MOA
    use 
    tox
    • moa:  inc insulin,  dec glucagon release.
    • use: Type 2 DM.
    • tox: Nausea, vomiting; pancreatitis.
  21. DPP-4 inhibitors
    name
    Linagliptin,Saxagliptin,Sitaglipti
  22. Linagliptin,Saxagliptin,Sitaglipti
    moa 
    use 
    tox
    • moa:  inc insulin,  dec glucagon release. 
    • use: Type 2 DM.
    • tox:  Mild urinary or respiratory infections.
  23. Amylin analogs
    name
    Pramlintide
  24. Pramlintide
    MOA 
    USE
    tox
    • moa: dec gastric emptying,  dec glucagon. use: Type 1 DM, type 2 DM.
    • tox: Hypoglycemia, nausea, diarrhea.
  25. SGLT-2 inhibitors
    name
    • Canagliflozin
    • Dapagliflozin
  26. SGLT-2 inhibitors
    MOA
    USE
    TOX
    • moa:  Block reabsorption of glucose in
    • PCT.
    • use: Type 2 DM.
    • tox: Glucosuria, UTIs, vaginal yeast infections.
  27. which one gives Glucosuria, UTIs, vaginal yeast infections.
    • SGLT-2 inhibitors
    • Canagliflozin, Dapagliflozin
  28. α-glucosidase
    inhibitors
    name
    Acarbose,Miglitol
  29. Acarbose,Miglitol
    MOA 
    use
    tox
    • moa:  Inhibit intestinal brush-border
    • α -glucosidases.
    • Delayed carbohydrate hydrolysis
    • and glucose absorption
    • -> dec  postprandial hyperglycemia.
    • use: Used as monotherapy in type
    • 2 DM or in combination
    • with other agents.
    • tox: GI disturbances.
  30. Glitazones/
    thiazolidinediones
    Pioglitazone,
    Rosiglitazone
    MOA
    • inc insulin sensitivity in peripheral
    • tissue. Binds to PPAR-γ nuclear
    • transcription regulator. 
    • dec blood glucose, TG, C-reactive protein
    • inc HDL, Adeponectin
  31. what is Adeponectin
    • Adeponectin is involved in regulating glucose level as well as Fatty Acid breakdown AKA GBP-28.
    • adeponectin level is low in DM2
  32. before starting SGLT-2 inhibitors what lab should be done?
    Monitor blood urea and creatinine before starting this drug.

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