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Pharm II Exam DM

Diabetes Drugs

QuestionAnswer
What Rx is the first line drug for Type 2 diabetes? Metformin
What sub-class does Metformin belong to? Biguanide
What does Metformin originate from? French lilac
What is Metformin's major mechanism of action? Decreases hepatic gluconeogenesis
What is another MOA of Metformin? Increased peripheral utilization of glucose
Is Metformin metabolized? Nope
How is Metformin excreted? Via urine
What is Metformin's t1/2? 6.2 hrs.
What are adverse effects of Metformin? lactic acidosis
Who is affected with lactic acidosis while on Metformin? Those w/ impaired kidney or liver fxn
When should Metformin be discontinued? Before a radiographic study req'ing iodine contrast
How can GI distress with Metformin be avoided? Low dose and titrate up slowly
What are the two Sulfonylurea Rx's? Glipzide & Glimepiride
Which Sulfonylurea is the second generation Sulfonylurea? Glipzide
What generation is Glimpiride considered? Third
What is a side-effect of Sulfonylurea Rx's? Hypoglycemia
Does Metformin (a Biguanide drug) cause hypoglycemia? No
What is the mechanism of action of sulfonylurea Rx's? Increases insulin release from pancreatic Beta cells by binding to ATP dependent K+ channels thus inhibiting the hyperpolarizing outflux of potassium (so continued depolarization leads to increase in insulin secretion)
What are the Meglitinide drugs? Repaglinide & Nateglinide
Are Meglitinide Drugs long or short-acting? Meglitinide drugs are short-acting
When are Meglitinide Drugs taken? Repaglinide and Nateglinide are to be taken before meals and skipped if meal skipped
What drugs cause less hypoglycemia, Sulfonylurea or Meglitinide drugs? Meglitinide drugs - Repaglinide or Nateglinide
What is the MOA of Meglitinides? Same as Sulfonylureas - bind at a K(ATP) Channel (diff't site) that causes the hyperpolarization to not occur and thus, a long depolarizaiton allowing for extended insulin secretion.
What are the Thiazolidenediones drugs? Two drugs: Rosiglitazone & Pioglitazone
What is the MOA of Thiazolidenediones drugs? They act by binding to PPAR gamma R. & activating em - these regulate production of proteins involv in glucose & lipid homeostasis; aid in dec. insulin resistance, Inhib VEGF-induced angiogenesis; Dec. Leptin & some IL's
What are some side-effects of Thiazolidenediones? H2O retention - thus inc. edema, wt. & pot. Heart failure; Osteoporosis
Which of the Thiazolidenediones can increase risk of CAD? Rosiglitazone
What are the alpha-glucosidase Inhibitors? Acarbose & Miglitol
What is the MOA of Alpha-glucosidase inhibitors? They are saccharides that competitively inhibit the enzyme that digest carbs - spec. alpha glucosidase found in the brush border of sm. intestines
What other enzymes does Acarbose inhibit? Pancreatic alpha-amylase
What are side-effects of alpha-glucosidase inhibitors? Flatulence, diarrhea, hypoglycemia
How is hypoglycemia induced by alpha-glucosidase inhibitors corrected? by monosaccharide tablets
Do alpha-glucosidase drugs (Acarbose and Miglitol) normally cause hypoglycemia Nope
Do alpha-glucosidase inhibitors cause weight gain? Nope
What else besides Meglitinides are short-acting agents? Lispro (Humalog)
What is a long-acting insulin analog? Glargine
What diabetes drug is considered an intermediate-acting insulin? Insulin zinc suspension
Created by: doggiekylesmom
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