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Pharm 29 Pancreas
LECOM Pharm Ch 29 endocrine pancrease
| Question | Answer |
|---|---|
| 3 drugs that bind and inhibit brush border α-glucosidase | acarbose, miglitol, voglibose |
| 3 drug classes that do not induce hypoglycemia | α-glucosidase inhibitors, TZDs and biguanides (insulin sensitizers) |
| Acarbose, miglitol and voglibose are good drugs for what Pt’s ? | Type II DM with post prandial or mild hyperglycemia |
| What to monitor with patients on α-glucosidase inhibitors | ALT and AST |
| Speed of action: lispro | ultra rapid |
| Speed of action: NPH | intermediate |
| Speed of action: Ultra-lente | long acting |
| Exogenous insulin that mimics basal insulin secretion best | Glargine isulin |
| MOA of sulfonylureas and meglitinides | inhibit pancreatic beta cell K+ ATP channel at SUR1, stimulating insulin release |
| 1st gen vs 2nd gen sulfonylureas: name hints | All 1st gen end in –amide and don’t start with G |
| Which generation of sulfonylureas must be given in higher doses ? | 1st generation |
| Sulfonylureas are good drugs of choice for what Pt population ? | non-obese DM type II |
| 2 names and MOA of TZDs | pioglitazone, rosiglitazone; bind/stimulate PPARγ increasing insulin sensitivity |
| 4 serious SE of TZDs | heart failure, cholestatic hepatitis, hepatotoxicity, diabetic macular edema |
| Name and MOA of biguanide | metformin; activates AMPPK blocking breakdown of FA and inhibits liver gluconeogenesis and glycogenolysis and increases insulin receptor activity and responsiveness |
| 2 positive SE of metformin | lowers serum lipids and decreases weight |
| Serious SE of metformin | lactic acidosis |
| GLP-1 receptor agonist | exenatide |
| DPP-IV inhibitor | sitagliptin |
| GLP-1 does what 4 things? | enhances glucose dependent insulin secretion, inhibits glucagon secretion, delays gastric emptying, decreases appetite |
| DPP-IV does what? | breaks down GLP-1 |
| Exanatide is usually used with what other drugs | metformin or a sulfonylurea |
| What other drug needs to be monitored with sitagliptin? | digoxin |
| Can be used in hypoglycemia due to hyperinsulinism also in emergent HTN crisis | diazoxide |
| MOA of diazoxide | opposite of sulfonylurea; stabilized beta cell K+ ATP channel in SUR1 and SUR2 in cardiac and SM decreasing blood pressure |
| 9 Serious side effects of diazoxide | heart failure, fluid retention, DM ketoacidosis, hypernatremia, bowel obstruction, pancreatitis, neuto/thrombocytopenia, EPS |
| Octreotide is used for what? | to block insulin release from insulinomas |
Created by:
csheck
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