Diabetes Pharmacology: Insulin and Drugs
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Questions and Answers

Which of the following is a short-acting insulin example?

  • Insulin aspart (correct)
  • Neutral Protamine Hagedorn (NPH) insulin
  • Insulin glargine
  • Insulin detemir

    • What is the primary mechanism of action of insulin in the body?

  • Promotes uptake of glucose by cells (correct)
  • Increases blood glucose levels
  • Releases glycogen from liver
  • Inhibits glucose transporters

    • Which of the following drugs is classified as a long-acting insulin?

  • Insulin lispro
  • Insulin Lente
  • Insulin ultralente (correct)
  • Insulin aspart

    • What is NOT a function of insulin in the body?

    <p>Enhances gluconeogenesis</p> Signup and view all the answers

    Which insulin form is characterized by the longest duration of action?

    <p>Insulin glargine</p> Signup and view all the answers

    What is a key action of thiazolidinediones in relation to glucose uptake?

    <p>Stimulates glucose uptake specifically in adipose and muscle tissue</p> Signup and view all the answers

    Which of the following is a side effect associated with thiazolidinediones?

    <p>Fractures due to osteoblast impairment</p> Signup and view all the answers

    How do thiazolidinediones affect sodium and glomerular filtration rate?

    <p>They increase sodium reabsorption and reduce GFR</p> Signup and view all the answers

    What hormonal effect does adiponectin have that is mediated by thiazolidinediones?

    <p>Stimulates glucose uptake in muscle</p> Signup and view all the answers

    What is the primary mechanism of action for SGLT2 inhibitors?

    <p>Inhibit glucose reabsorption in the kidney</p> Signup and view all the answers

    Which of the following is considered a potential adverse effect of SGLT2 inhibitors?

    <p>Mycotic genital infections</p> Signup and view all the answers

    Thiazolidinediones are contraindicated in which of the following conditions?

    <p>Heart failure</p> Signup and view all the answers

    What is a characteristic of α-Glucosidase Inhibitors?

    <p>They inhibit carbohydrate breakdown in the gut</p> Signup and view all the answers

    Which of the following statements about Dapagliflozin is accurate?

    <p>It inhibits SGLT2-mediated glucose reabsorption</p> Signup and view all the answers

    How do α-Glucosidase Inhibitors affect post-meal blood sugar levels?

    <p>They delay carbohydrate absorption</p> Signup and view all the answers

    What is a unique feature of the SGLT2 inhibitors compared to some other diabetes medications?

    <p>They lead to urinary glucose excretion</p> Signup and view all the answers

    How do AGIs manage postprandial blood glucose levels?

    <p>By inhibiting digestive enzymes in the gut</p> Signup and view all the answers

    Which of the following diabetes medications carries a risk of increased incidence of certain cancers?

    <p>Dapagliflozin</p> Signup and view all the answers

    What is the primary indication for α-glucosidase inhibitors such as acarbose?

    <p>Management of postprandial hyperglycemia in type 2 diabetes</p> Signup and view all the answers

    What side effect is commonly associated with α-glucosidase inhibitors?

    <p>Flatulence</p> Signup and view all the answers

    Which of the following conditions contraindicates the use of α-glucosidase inhibitors?

    <p>Irritable bowel syndrome</p> Signup and view all the answers

    How does miglitol function pharmacologically?

    <p>Inhibits isomaltase and β-glucosidases</p> Signup and view all the answers

    What is the mechanism of action of GLP-1 in patients with type 2 diabetes?

    <p>Stimulates insulin release from pancreatic beta cells</p> Signup and view all the answers

    What management is recommended for hypoglycemia associated with α-glucosidase inhibitors?

    <p>Glucose</p> Signup and view all the answers

    Which of these drugs is a Dipeptidyl Peptidase (DPP)-4 inhibitor?

    <p>Sitagliptin</p> Signup and view all the answers

    What effect does prolonged use of α-glucosidase inhibitors have on gastrointestinal side effects?

    <p>They are reduced due to enzyme up-regulation</p> Signup and view all the answers

    What is the primary mechanism of action of biguanides like Metformin?

    <p>Reduce blood glucose without stimulating insulin secretion</p> Signup and view all the answers

    What causes lipoatrophy and lipohypertrophy related to insulin use?

    <p>Immune response and fat cell generation</p> Signup and view all the answers

    Which of the following describes the pharmacokinetics of NPH insulin?

    <p>Slow, even absorption due to protamine and zinc</p> Signup and view all the answers

    Which side effect is associated with Metformin use?

    <p>Abdominal pain and diarrhea</p> Signup and view all the answers

    What is the primary action of sulfonylureas in treating diabetes?

    <p>Increase insulin secretion from pancreatic beta cells</p> Signup and view all the answers

    What characterizes the pharmacokinetics of second-generation sulfonylureas?

    <p>Short half-lives of 3 to 5 hours</p> Signup and view all the answers

    What condition is a contraindication for the use of Metformin?

    <p>Renal impairment</p> Signup and view all the answers

    What aspect of SGLT2 inhibitors contributes to their mechanism of action?

    <p>Blocking glucose reabsorption in the proximal tubules</p> Signup and view all the answers

    Which of the following side effects is less common with second-generation sulfonylureas compared to first-generation agents?

    <p>Weight gain</p> Signup and view all the answers

    Which of the following agents is a first-generation sulfonylurea?

    <p>Tolbutamide</p> Signup and view all the answers

    What is the role of adenosine monophosphate (AMP) kinase in the action of Metformin?

    <p>Inhibits gluconeogenesis</p> Signup and view all the answers

    What effect does glucagon have on blood glucose levels?

    <p>Increases blood glucose levels by breaking down glycogen</p> Signup and view all the answers

    What is the risk associated with the use of first-generation sulfonylureas that is less prominent with second-generation drugs?

    <p>Hematologic toxicities</p> Signup and view all the answers

    What is the outcome of crystals varying in size on lente insulins?

    <p>Slower absorption and prolonged duration</p> Signup and view all the answers

    Study Notes

    Drugs Used in Diabetes

    • Various drug classes are used in diabetes management, each with specific mechanisms of action.

    Insulin

    • Forms include Regular insulin, NPH (Intermediate-acting), and Long-acting insulins like Insulin glargine and detemir.
    • Insulin promotes glucose uptake in cells by mobilizing glucose transporters (GLUT-4).
    • Increases glycogen storage in liver and muscle; inhibits gluconeogenesis.
    • Insulin also promotes protein synthesis and fat storage, and interacts with IGF-1 receptors for growth effects.

    Pharmacokinetics of Insulin

    • Delivered mostly subcutaneously, with some formulations available for inhalation.
    • Variability exists among individuals regarding the peak hypoglycemic effect.
    • Lente insulins are absorbed slowly due to larger crystal sizes.

    Indications and Side Effects of Insulin

    • Indicated for both Type 1 and Type 2 diabetes.
    • Common side effects include hypoglycemia, lipodystrophy (lipoatrophy and lipohypertrophy), and edema.

    NPH Insulin

    • NPH is regular insulin modified with protamine and zinc to slow absorption.
    • Used in diabetes management for its steady effect.

    Biguanides

    • Prototype: Metformin, which reduces blood glucose without stimulating insulin secretion.
    • Acts by reducing gluconeogenesis and enhancing insulin action through AMP kinase activation.
    • Helps delay glucose absorption from the gastrointestinal tract.

    Pharmacology of Metformin

    • Excreted unchanged in urine; contraindicated in cases of metabolic acidosis.
    • Side effects include abdominal discomfort, nausea, diarrhea, and rare instances of lactic acidosis.

    Sulfonylureas (SUs)

    • Oral agents that stimulate insulin secretion from pancreatic beta cells.
    • First-generation prototype: Tolbutamide; Second-generation prototype: Glyburide.

    Mechanism of Action for SUs

    • Bind to cellular receptors on beta cells, leading to calcium influx and increased insulin release.
    • Reduce glucagon levels to lower glucose production.

    Pharmacokinetics of SUs

    • Varying half-lives, with first-generation agents generally longer.
    • All are metabolized by the liver and excreted in urine; dosage adjustment may be necessary in liver impairment.

    Indications and Side Effects of SUs

    • Indicated for Type 2 diabetes; potential hypoglycemia if taken with other agents.
    • Other side effects may include flushing (older agents), weight gain, and hematologic toxicities.

    SGLT2 Inhibitors

    • Prototypes include Dapagliflozin, working by reducing glucose reabsorption in kidneys.
    • Actions lead to increased urinary glucose excretion without stimulating insulin secretion.

    Adverse Effects of SGLT2 Inhibitors

    • Fatigue, increased urination, risk of genital/urinary infections, and rare hypoglycemia.

    Alpha-Glucosidase Inhibitors (AGIs)

    • Prototype: Acarbose; reduce blood glucose by delaying carbohydrate absorption in the gut.
    • They competitively inhibit glucosidases, leading to lower post-meal glucose spikes.

    Side Effects and Contraindications of AGIs

    • Side effects include flatulence, bloating, and diarrhea; contraindicated in IBS and inflammatory bowel disease.

    Incretins

    • Prototypes: DPP-4 inhibitors like sitagliptin and incretin mimetics like exenatide.
    • Incretin hormones lower blood glucose by stimulating insulin and reducing glucagon.

    Thiazolidinediones

    • Examples include rosiglitazone and pioglitazone; indicated for type 2 diabetes.
    • Contraindicated in cases of heart failure, with side effects including weight gain, edema, and potential heart issues.

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    Drugs Used in Diabetes PDF

    Description

    Explore the various drug classes used in diabetes management with a focus on insulin. Learn about the mechanisms of action, pharmacokinetics, and indications for both Type 1 and Type 2 diabetes. This quiz covers essential concepts for understanding diabetes pharmacology.

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