Pharmacology Final

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Author:
Rx2013
ID:
82013
Filename:
Pharmacology Final
Updated:
2011-04-26 17:45:34
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Insulin
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Insulin 1
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  1. Alpha cells secrete
    glucagon
  2. beta cells secrete
    • insulin
    • amylin
  3. delta cells secrete
    somatostatin
  4. F (PP) cells secrete
    pancreatic polypeptide
  5. the pancreas has both
    endocrine and exocrine functions
  6. primary glucose sensor
    beta cell
  7. Principle stimulus to insulin secretion in humans
    glucose
  8. action of insulin
    • lower blood glucose
    • affects both utilization and production
  9. Diabetes Mellitus
    a group of symptoms characterized by hyperglycemia
  10. Virtually all forms of DM are due to
    • decrease in insulin
    • increase in peripheral insulin resistance
  11. 2 major forms of DM
    • type 1
    • type 2
  12. Juvenile Diabetes
    • Type 1 DM
    • Insulin dependant
    • autoimmune disease
  13. Maturity onset DM
    • type 2 DM
    • non-insulin dependent
    • characterized by insulin resistance
  14. % of diabetics with type 2 DM
    90-95%
  15. Mainstay treatment for both type 1 and type 2 DM
    insulin
  16. Insulin may be administered
    IV, IM or SQ
  17. Classifications of insulin preparations
    • ultra short acting
    • short acting
    • intermediate acting
    • long acting
  18. All commercial insulin preparations are a concentration of ____
    100 units/mL
  19. Insulin absorption is most rapid from ____ to least rapid.
    abdominal wall > arm > butt > thigh
  20. ADE with insulin
    hypoglycemia
  21. Ultra short acting insulin
    • insulin lispro
    • onset 5 min
    • duration 3-4 hr
  22. Short acting insulin
    • all the "R"s
    • Onset around 30 min
    • Duration around 6 to 8 hours
  23. Intermediate Acting insulin
    • all of the "N"s
    • Onset 1-4 hours
    • Duration 24 hours
  24. Premixed insulins
    • Humulin 70/30 or 50/50
    • Novolin 70/30
    • Onset 30-60 min
    • Duration 24 hours
  25. Long acting insulin
    • glargine (onset 2-5 hr duration 18-24)
    • humulin U (onset 4-8 duration 36hr)
  26. Oral agents acting in the pancreas
    • sulfonylureas
    • repaglinide
  27. Oral agents acting in the gut
    • acarbose
    • miglitol
  28. Oral agents acting in the muscles
    • rosiglitazone
    • pioglitazone
  29. Oral agents acting in the liver
    metformin
  30. Sulfonylureas
    • sulfonamide derivatives
    • 2nd generation more potent
    • only effective in pt with functioning Beta cells
  31. MoA Sulfonylureas
    stimulate release of insulin by blocking ATP dependent K+ current in pancreatic beta cells.
  32. Therapeutic use of sulfonylureas
    control hyperglycemia in type 2 DM who cannot control BG with diet and exercise alone
  33. 1st generation sulfonylureas
    • acetohexamide
    • chlorpropamide
    • Tolazamide
    • Tolbutamide
  34. 2nd Generation sulfonylureas
    • glimiperide
    • glipizide
    • glyburide
  35. ADEs with sulfonylureas
    • hypoglycemia
    • sulfonamide structure can cause allergic reaction in pt allergic to sulfa
    • n/v - disulfiram like effects w/ alcohol
    • weight gain
  36. Contraindications for sulfonylureas
    • hypersensitivity to sulfa
    • pregnancy
    • reduced renal/hepatic function
    • ketoacidosis

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