NGR 6172 pharm exam 2 || || || ||
Study ||online ||at ||https://quizlet.com/_gnjgds
1. pancreatic beta cells: cells responsible for insulin synthesis and release into || || | || || || || || || ||
bloodstream
||
2. primary defect in type 1 DM: destruction of pancreatic beta cells
|| || || || || || || || || ||
3. causes of insulin resistance in type 2 DM: - reduced binding of insulin to
|| || || || || || || || || || || || ||
receptors
||
- reduced receptor numbers || ||
- reduced receptor responsiveness || ||
4. symptoms of type 2 DM are caused by: - insulin resistance || || || || || || || || || ||
- impaired insulin secretion || ||
5. target tissues of insulin: - liver || || || || ||
- muscle
- adipose tissue ||
6. what makes managing diabetes during pregnancy difficult?: - the placenta
|| || || || || || || || ||
produces hormones that antagonize insulin
|| || || || ||
- production of cortisol (which promotes hyperglycemia) increases threefold
|| || || || || || ||
- hyperglycemia in the mother will lead to hyperinsulinemia in the fetus || || || || || || || || || ||
7. DM drug management in pregnancy: d/c oral drug and switch to insulin for
|| || || || || || || || || || || ||
pregnancy
||
oral metformin is okay for managing T2DM in pregnancy
|| || || || || | || ||
8. diagnosis of DM: - fasting plasma glucose >126 || || || || || || ||
- random plasma glucos >200 + symptpms || || || || ||
- oral glucose tolerance test 2-h plasma glucose >200
|| || || || || || ||
- hgA1C 6.5 or higher || || ||
9. preferred anti-htn meds for diabetic htn: - ACE inhibitor (lisinopril) || || || || || || || || ||
- ARB (losartan) ||
reduce the risk of diabetic nephropathy
|| || || || ||
10. statins (atorvastatin): ||
11. 4 step approach to treating DM: 1. at diagnosis, initiate lifestyle changes plus
|| || || || || | | || || || || ||
metformin
||
2. continue, and add a 2nd drug || || || || ||
3. add a 3rd drug|| || ||
4. begin insulin ||
12. beta2 receptors in the pancreas: promotes secretion of insulin
|| || || || || || || ||
13. alpha receptors in the pancreas: inhibits insulin release
|| || || || || || ||
1 ||/ ||24
, NGR 6172 pharm exam 2 || || || ||
Study ||online ||at ||https://quizlet.com/_gnjgds
14. insulin acts to promote anabolic effects by: - stimulating cellular transport
|| || || || || || || || || ||
(uptake) of glucose, amino acids, nucleotides, potassium
|| || || || || || ||
- promotes synthesis of complex organic molecules || || || || ||
(glucose is converted into glycogen, amino acids are assembled into proteins, fatty
|| || || || || || || || || || ||
acids are incorporated into triglycerides)
|| || || || ||
15. insulin deficiency puts the body into: a catabolic mode || || || || || || || ||
16. insulin deficiency promotes hyperglycemia by: - increasing glycogenolysis
|| || || || || || ||
- increasing gluconeogenesis ||
- reduced glucose utilization || ||
17. insulin lispro, insulin aspart, insulin glulisine: short duration, rapid acting
|| || || || || || || || ||
18. regular insulin: short duration, slower acting || || || || ||
19. NPH insulin: intermediate duration, slow acting
|| || || || ||
20. insulin glargine, insulin detemir: long duration, slowest acting
|| || || || || || ||
21. insulin lispro (humalog): rapid acting analog of regular insulin
|| || || || || || || ||
effects begin within 15-30 min, persist for 3 to 6 hours
|| || || || || || || || || ||
22. insulin aspart (novolog): analog of human insulin with rapid onset (10-20min)
|| || | || || || || || || ||
with short duration (3-5 hours)
|| || || || ||
23. insulin glulisine (apidra): rapid onset (10-15 min) and short duration (3-5
|| || || || || || || || || ||
hours)
||
24. regular insulin (humulin R, novolin R): effects begin 30-60min, peak in 1-5
|| || || | || | || || || || ||
hours, last 10 hours
|| || || ||
also available in pump for basal control
|| || || || || ||
25. neutral protamine Hgedorn (NPH) insulin (humulin N, novolin N): prepared
|| || || || || || | || |
by conjugating regular insulin with protamine (large protein)
|| || || || || || || ||
injected 2-3x daily to provide control between meals and nighttime
|| || || || || || || || ||
can be mixed with short-acting
|| || || ||
26. insulin glargine u-100 (lantus, basaglar): modified human insulin with pro-
|| || || | | || || || ||
longed duration (up to 24 hours)
|| || || || || ||
used for daily dosing, 1-2x same time every day
|| || || || || || || ||
27. insulin detemir (levemir): slow onset, dose dependent duration|| || | || || || ||
|| low dose = up to 12 hours, high dose = up to 24
|| || || || || || || || || || || ||
2 ||/ ||24
, NGR 6172 pharm exam 2 || || || ||
Study ||online ||at ||https://quizlet.com/_gnjgds
28. insulin glargine u-300 (toujeo): similar to u-100 but 3x more concentrated -
|| || || || || || || || || || ||
ideal for daily dosing in pt who don't get 24 hr effect from u-100
|| || || || || || || || || || || || || ||
29. insulin degludec (tresiba): long acting, effects up to 48 hours || || || || || || || || ||
30. drugs that raise blood glucose: thiazides || || || || |
glucocorticoids
||
sympathomimetics
31. beta blockers: mask symptoms of hypoglycemia || || || || ||
impair glycogenolysis ||
32. metformin (glucophage, fortamet, glumetza, riomet): biguanide || | | | |
|| initial drug of choice in most patients with T2DM, started immediately
|| || || || || || || || || ||
|| may be useful for high risk prediabetics
|| || || || || ||
SE: GI disturbances, b12/folic acid deficiency, lactic acidosis (rare)
| || || || || || || ||
33. metformin MOA: lowers BG and improves glucose tolerance by || | || || || || || ||
- inhibiting glucose production in the liver || || || || ||
- reducing glucose absorption in the gut || || || || ||
- sensitizes insulin receptors in target tissues (fat and skeletal muscle) --> increases
| | | | | | | | | | |
glucose uptake
|| ||
does not actively drive BG down, little risk of hypoglycemia
|| || || || || || || || ||
slowly absorbed in the small intestine, excreted unchanged by the kidneys
|| || || || || || || || || ||
(contraindicated w renal impairment and heart failure) || || || || || ||
34. early signs of lactic acidosis: - hyperventilation || || || || || ||
- myalgia
- malaise
- unusual somnolence ||
35. sulfonylureas: promote insulin release by binding/blocking ATP-sensitive | | | | | |
potassium channels
|| ||
for T2DM only
|| ||
|| AE: hypoglycemia
|
3 ||/ ||24
Study ||online ||at ||https://quizlet.com/_gnjgds
1. pancreatic beta cells: cells responsible for insulin synthesis and release into || || | || || || || || || ||
bloodstream
||
2. primary defect in type 1 DM: destruction of pancreatic beta cells
|| || || || || || || || || ||
3. causes of insulin resistance in type 2 DM: - reduced binding of insulin to
|| || || || || || || || || || || || ||
receptors
||
- reduced receptor numbers || ||
- reduced receptor responsiveness || ||
4. symptoms of type 2 DM are caused by: - insulin resistance || || || || || || || || || ||
- impaired insulin secretion || ||
5. target tissues of insulin: - liver || || || || ||
- muscle
- adipose tissue ||
6. what makes managing diabetes during pregnancy difficult?: - the placenta
|| || || || || || || || ||
produces hormones that antagonize insulin
|| || || || ||
- production of cortisol (which promotes hyperglycemia) increases threefold
|| || || || || || ||
- hyperglycemia in the mother will lead to hyperinsulinemia in the fetus || || || || || || || || || ||
7. DM drug management in pregnancy: d/c oral drug and switch to insulin for
|| || || || || || || || || || || ||
pregnancy
||
oral metformin is okay for managing T2DM in pregnancy
|| || || || || | || ||
8. diagnosis of DM: - fasting plasma glucose >126 || || || || || || ||
- random plasma glucos >200 + symptpms || || || || ||
- oral glucose tolerance test 2-h plasma glucose >200
|| || || || || || ||
- hgA1C 6.5 or higher || || ||
9. preferred anti-htn meds for diabetic htn: - ACE inhibitor (lisinopril) || || || || || || || || ||
- ARB (losartan) ||
reduce the risk of diabetic nephropathy
|| || || || ||
10. statins (atorvastatin): ||
11. 4 step approach to treating DM: 1. at diagnosis, initiate lifestyle changes plus
|| || || || || | | || || || || ||
metformin
||
2. continue, and add a 2nd drug || || || || ||
3. add a 3rd drug|| || ||
4. begin insulin ||
12. beta2 receptors in the pancreas: promotes secretion of insulin
|| || || || || || || ||
13. alpha receptors in the pancreas: inhibits insulin release
|| || || || || || ||
1 ||/ ||24
, NGR 6172 pharm exam 2 || || || ||
Study ||online ||at ||https://quizlet.com/_gnjgds
14. insulin acts to promote anabolic effects by: - stimulating cellular transport
|| || || || || || || || || ||
(uptake) of glucose, amino acids, nucleotides, potassium
|| || || || || || ||
- promotes synthesis of complex organic molecules || || || || ||
(glucose is converted into glycogen, amino acids are assembled into proteins, fatty
|| || || || || || || || || || ||
acids are incorporated into triglycerides)
|| || || || ||
15. insulin deficiency puts the body into: a catabolic mode || || || || || || || ||
16. insulin deficiency promotes hyperglycemia by: - increasing glycogenolysis
|| || || || || || ||
- increasing gluconeogenesis ||
- reduced glucose utilization || ||
17. insulin lispro, insulin aspart, insulin glulisine: short duration, rapid acting
|| || || || || || || || ||
18. regular insulin: short duration, slower acting || || || || ||
19. NPH insulin: intermediate duration, slow acting
|| || || || ||
20. insulin glargine, insulin detemir: long duration, slowest acting
|| || || || || || ||
21. insulin lispro (humalog): rapid acting analog of regular insulin
|| || || || || || || ||
effects begin within 15-30 min, persist for 3 to 6 hours
|| || || || || || || || || ||
22. insulin aspart (novolog): analog of human insulin with rapid onset (10-20min)
|| || | || || || || || || ||
with short duration (3-5 hours)
|| || || || ||
23. insulin glulisine (apidra): rapid onset (10-15 min) and short duration (3-5
|| || || || || || || || || ||
hours)
||
24. regular insulin (humulin R, novolin R): effects begin 30-60min, peak in 1-5
|| || || | || | || || || || ||
hours, last 10 hours
|| || || ||
also available in pump for basal control
|| || || || || ||
25. neutral protamine Hgedorn (NPH) insulin (humulin N, novolin N): prepared
|| || || || || || | || |
by conjugating regular insulin with protamine (large protein)
|| || || || || || || ||
injected 2-3x daily to provide control between meals and nighttime
|| || || || || || || || ||
can be mixed with short-acting
|| || || ||
26. insulin glargine u-100 (lantus, basaglar): modified human insulin with pro-
|| || || | | || || || ||
longed duration (up to 24 hours)
|| || || || || ||
used for daily dosing, 1-2x same time every day
|| || || || || || || ||
27. insulin detemir (levemir): slow onset, dose dependent duration|| || | || || || ||
|| low dose = up to 12 hours, high dose = up to 24
|| || || || || || || || || || || ||
2 ||/ ||24
, NGR 6172 pharm exam 2 || || || ||
Study ||online ||at ||https://quizlet.com/_gnjgds
28. insulin glargine u-300 (toujeo): similar to u-100 but 3x more concentrated -
|| || || || || || || || || || ||
ideal for daily dosing in pt who don't get 24 hr effect from u-100
|| || || || || || || || || || || || || ||
29. insulin degludec (tresiba): long acting, effects up to 48 hours || || || || || || || || ||
30. drugs that raise blood glucose: thiazides || || || || |
glucocorticoids
||
sympathomimetics
31. beta blockers: mask symptoms of hypoglycemia || || || || ||
impair glycogenolysis ||
32. metformin (glucophage, fortamet, glumetza, riomet): biguanide || | | | |
|| initial drug of choice in most patients with T2DM, started immediately
|| || || || || || || || || ||
|| may be useful for high risk prediabetics
|| || || || || ||
SE: GI disturbances, b12/folic acid deficiency, lactic acidosis (rare)
| || || || || || || ||
33. metformin MOA: lowers BG and improves glucose tolerance by || | || || || || || ||
- inhibiting glucose production in the liver || || || || ||
- reducing glucose absorption in the gut || || || || ||
- sensitizes insulin receptors in target tissues (fat and skeletal muscle) --> increases
| | | | | | | | | | |
glucose uptake
|| ||
does not actively drive BG down, little risk of hypoglycemia
|| || || || || || || || ||
slowly absorbed in the small intestine, excreted unchanged by the kidneys
|| || || || || || || || || ||
(contraindicated w renal impairment and heart failure) || || || || || ||
34. early signs of lactic acidosis: - hyperventilation || || || || || ||
- myalgia
- malaise
- unusual somnolence ||
35. sulfonylureas: promote insulin release by binding/blocking ATP-sensitive | | | | | |
potassium channels
|| ||
for T2DM only
|| ||
|| AE: hypoglycemia
|
3 ||/ ||24
