NU 578 - Unit 4 Questions with 100% Correct
Answers
Insulin use
Insulin is used to treat all patients with type 1 and many with type 2 diabetes. consists of two
amino acid chains (a acidic and b basic) linked by two disulfide bridges. it is synthesized in
the pancreas by b ce;;s within islets of langerhans. insulin is released by rise in blood sugar
(eating a. meal).
Anaolic reaction (insulin promotes conservation of energy and buildup of energy stores)
Insulin metabolic actions
Insulin promotes glucose into glycogen, amino acids assembled into proteins, fatty acids into
triglycerides.
Insulin deficiency promotes glycogen into glucose, proteins into amino acids, and fats into
glycerol.
Metformin use
Biguanide
used for type 2 DM. oral anti diabetic. may be used with other drugs. can be used for
prevention of type 2 diabetes, GDM, PCOS.
Reduces GI absorbance of glucose and hepatic production of glucose. Does not stimulate
insulin release from the pancreas.
Increases HDL, decreases BP, promotes weight loss.
,DPP-4 Inhibitors (gliptins)
go to pancreas and increase insulin release.
Example is Sitaglitpin
Sodium Glucose cotransporter 2 inhibitors (SGLT-2 inhibitors). (gliflozins)
Example: empagliflozin
increases urine excretion of glucose, taken PO, reduces cardiovascular risk of type 2 diabetes.
SE: yeast infections and genital gangrene
Incretin Mimetics ('tides)
injectables that slow gastric emptying, causes weight loss and help an overwhelmed pancreas.
solfonylureas
stimulate pancreas to release more insulin. range in onset, duration, and potency and are only
used for type 2 diabetes. there are first generation and second generation. second are more
potent and doses are lower and drug drug interactions are less common
AE: hypoglycemia
Acarbose
a glucosidase inhibitor
oral anti diabetic agent that inhibits breakdown of oligosaccharides into monosaccharides.
this delays digestion and prolongs absorption of carbs and decreases postprandial
hyperglycemia!!
, ADR: FI upset and flatulence.
take this with first bite of each meal.
Insulin Complications/ Drug Interactions
hypoglycemia caused by overdose.
hypoglycemic agents (sulfonylureas, glinides, and alcohol), hyperglycemia agents, b
adrenergic blocking agents.
Sitagliptin
DP4 inhibitor.
stimulates glucose dependent release of insulin and suppresses postprandial release of
glycogen. both actions help keep BG from climbing to ohhight. used for type 2 dm
AE: URI, headache, inflammation of nasal passages, pancreatitis, hypersensitivity reactions.
Canagliflozin
SGC2 inhibitor
reduces reabsorption of glucose and increases urinary glucose excretion
AE: UTI, yeast infection, increased urination
DDI: uridine 5 diphospho glucuronosyltransferase inducers can decrease effects. when used
with diuretic can cause dehydration
How does insulin deficiency promote hyperglycemia
Answers
Insulin use
Insulin is used to treat all patients with type 1 and many with type 2 diabetes. consists of two
amino acid chains (a acidic and b basic) linked by two disulfide bridges. it is synthesized in
the pancreas by b ce;;s within islets of langerhans. insulin is released by rise in blood sugar
(eating a. meal).
Anaolic reaction (insulin promotes conservation of energy and buildup of energy stores)
Insulin metabolic actions
Insulin promotes glucose into glycogen, amino acids assembled into proteins, fatty acids into
triglycerides.
Insulin deficiency promotes glycogen into glucose, proteins into amino acids, and fats into
glycerol.
Metformin use
Biguanide
used for type 2 DM. oral anti diabetic. may be used with other drugs. can be used for
prevention of type 2 diabetes, GDM, PCOS.
Reduces GI absorbance of glucose and hepatic production of glucose. Does not stimulate
insulin release from the pancreas.
Increases HDL, decreases BP, promotes weight loss.
,DPP-4 Inhibitors (gliptins)
go to pancreas and increase insulin release.
Example is Sitaglitpin
Sodium Glucose cotransporter 2 inhibitors (SGLT-2 inhibitors). (gliflozins)
Example: empagliflozin
increases urine excretion of glucose, taken PO, reduces cardiovascular risk of type 2 diabetes.
SE: yeast infections and genital gangrene
Incretin Mimetics ('tides)
injectables that slow gastric emptying, causes weight loss and help an overwhelmed pancreas.
solfonylureas
stimulate pancreas to release more insulin. range in onset, duration, and potency and are only
used for type 2 diabetes. there are first generation and second generation. second are more
potent and doses are lower and drug drug interactions are less common
AE: hypoglycemia
Acarbose
a glucosidase inhibitor
oral anti diabetic agent that inhibits breakdown of oligosaccharides into monosaccharides.
this delays digestion and prolongs absorption of carbs and decreases postprandial
hyperglycemia!!
, ADR: FI upset and flatulence.
take this with first bite of each meal.
Insulin Complications/ Drug Interactions
hypoglycemia caused by overdose.
hypoglycemic agents (sulfonylureas, glinides, and alcohol), hyperglycemia agents, b
adrenergic blocking agents.
Sitagliptin
DP4 inhibitor.
stimulates glucose dependent release of insulin and suppresses postprandial release of
glycogen. both actions help keep BG from climbing to ohhight. used for type 2 dm
AE: URI, headache, inflammation of nasal passages, pancreatitis, hypersensitivity reactions.
Canagliflozin
SGC2 inhibitor
reduces reabsorption of glucose and increases urinary glucose excretion
AE: UTI, yeast infection, increased urination
DDI: uridine 5 diphospho glucuronosyltransferase inducers can decrease effects. when used
with diuretic can cause dehydration
How does insulin deficiency promote hyperglycemia
