Insulin Preparations and Antidiabetic Agents
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Questions and Answers

Which type of insulin has the fastest onset of action?

  • Long-acting insulin
  • Rapid-acting insulin (correct)
  • Regular insulin
  • Intermediate-acting insulin

What is the primary use of meglitinide drugs?

  • To treat hypertension in diabetic patients
  • To control fasting blood sugar levels
  • To manage variable meal schedules (correct)
  • As a first-line therapy for diabetes

Which side effect is commonly associated with sulfonylurea drugs?

  • Weight gain
  • Insulin resistance
  • Lactic acidosis
  • Hypoglycemic reactions (correct)

Which insulin preparation has a duration of action of more than 24 hours?

<p>Insulin degludec (D)</p> Signup and view all the answers

What is the main function of metformin in diabetes management?

<p>To increase insulin sensitivity (B)</p> Signup and view all the answers

What distinguishes the first-generation sulfonylureas from second-generation agents?

<p>First-generation agents have a higher risk of hypoglycemia. (B)</p> Signup and view all the answers

Which adverse effect is associated with the use of phenformin, a biguanide?

<p>Lactic acidosis (C)</p> Signup and view all the answers

Which class of antidiabetic agents is known to work as an insulin sensitizer?

<p>Thiazolidinediones (C)</p> Signup and view all the answers

What is a potential adverse effect of rosiglitazone?

<p>Increased risk of heart failure (B)</p> Signup and view all the answers

Which of the following is NOT a recommended use for SGLT-2 inhibitors?

<p>Patients at high risk of urinary tract infections (D)</p> Signup and view all the answers

What is a common adverse effect of alpha-glucosidase inhibitors like acarbose?

<p>Increased flatulence (D)</p> Signup and view all the answers

Which of the following GLP-1 receptor agonists is administered as a sustained-release preparation for weekly injections?

<p>Exenatide (D)</p> Signup and view all the answers

What is one of the main reasons GLP-1 itself is not used therapeutically?

<p>It is rapidly degraded (B)</p> Signup and view all the answers

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Flashcards

Thiazolidinediones (TZDs)

A class of drugs used to treat type 2 diabetes by increasing insulin sensitivity.

Edema

A common side effect of TZDs that can lead to fluid retention and swelling.

DPP-4 Inhibitors

A class of drugs that inhibit the breakdown of GLP-1, a hormone that stimulates insulin release.

Liraglutide

A medication that mimics the effects of GLP-1, promoting insulin release and slowing gastric emptying.

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SGLT-2 Inhibitors

A class of drugs that block the reabsorption of glucose in the kidneys, leading to increased glucose excretion in urine.

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Types of Insulin Preparations

Insulin preparations classified based on their onset, peak, and duration of action.

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Rapid-Acting Insulin

Insulin that starts working quickly (10-20 minutes) and has a short duration of action (3-5 hours).

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Short-Acting Insulin

Insulin that starts working within 30-60 minutes and lasts for 5-8 hours.

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Intermediate-Acting Insulin

Insulin that starts working within 1-2 hours and lasts for 18-24 hours.

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Long-Acting Insulin

Insulin that starts working within 1-1.5 hours and lasts for up to 24 hours or longer.

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Sulfonylurea Drugs

First generation oral antidiabetic agents that stimulate insulin release from the pancreas.

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Meglitinide Drugs

Drugs like Repaglinide and Nateglinide that stimulate insulin release from the pancreas, useful for variable meal schedules.

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Metformin (Biguanide)

A drug that improves insulin sensitivity and reduces glucose production by the liver, often used in combination with other diabetes medications.

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Study Notes

Insulin Preparations

  • Insulin preparations are categorized as short-acting, rapid-acting, intermediate-acting, and long-acting.
  • Rapid-acting insulins:
    • Insulin aspart: onset 10-20 minutes, peak 40-50 minutes, duration 3-5 hours
    • Insulin lispro: onset 15-30 minutes, peak 30-90 minutes, duration 3-5 hours
    • Insulin glulisine: onset 20-30 minutes, peak 30-90 minutes, duration 1-2.5 hours
  • Short-acting insulin:
    • Regular insulin: onset 30-60 minutes, peak 2-5 hours, duration 5-8 hours
  • Intermediate-acting insulin:
    • Isophane (NPH) insulin: onset 1-2 hours, peak 4-12 hours, duration 18-24 hours
  • Long-acting insulins:
    • Insulin glargine: onset 1-1.5 hours, no peak, duration 20-24 hours
    • Insulin detemir: onset 1-2 hours, peak 6-8 hours, duration up to 24 hours
    • Insulin degludec: onset 1-2 hours, no peak, duration >24 hours

Other Antidiabetic Agents

  • Sulfonylureas:
    • First oral antidiabetic agents.
    • Original sulfonylureas include chlorpropamide, acetohexamide, and tolbutamide.
    • Second-generation drugs include glimepiride, glipizide, and glyburide.
    • Meglitinides:
      • Examples are repaglinide and nateglinide.
      • Useful for patients with variable meal schedules.
      • Hypoglycemic reactions are less severe than with sulfonylureas.
    • Biguanides:
      • Metformin is an antihyperglycemic biguanide.
      • Phenformin was removed from the market due to an unacceptable risk of lactic acidosis.
      • Used alone or combined with other antidiabetic medications.
    • Thiazolidinediones (Insulin sensitizers):
      • Examples are pioglitazone and rosiglitazone.
      • Used to manage type 2 diabetes as an adjunct to diet and exercise.
      • Adverse effects include edema, increased plasma volume, increased risk of heart failure, and increased risk of myocardial infarction (MI), particularly with rosiglitazone.

Other Antidiabetic Agents Details

  • alpha-Glucosidase Inhibitors: Acarbose and Miglitol. Adverse effects include increased flatulence and bloating.
  • GLP-1 Receptor Agonists (GLP-1RAs) and DPP-4 Inhibitors: GLP-1 itself is not useful due to quick degradation. Exenatide is now available in a sustained-release formulation for weekly injection. Other medications include Liraglutide, Sitagliptin, Linagliptin, and Saxagliptin.
  • Amylin Analogue: Pramlintide acetate reduces caloric intake and may lead to weight loss. Administered Subcutaneously.
  • SGLT-2 Inhibitors: Canagliflozin, empagliflozin, and dapagliflozin. Adverse effects include urinary tract infections.

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Description

This quiz covers various insulin preparations, including their classifications, types, onset, peak, and duration. Additionally, it includes information on other antidiabetic agents such as sulfonylureas. Test your knowledge on the essential components of diabetes management!

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