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Pharm 29 Pancreas

LECOM Pharm Ch 29 endocrine pancrease

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