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Pharmacology Final
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Alpha cells secrete
glucagon
beta cells secrete
insulin
amylin
delta cells secrete
somatostatin
F (PP) cells secrete
pancreatic polypeptide
the pancreas has both
endocrine and exocrine functions
primary glucose sensor
beta cell
Principle stimulus to insulin secretion in humans
glucose
action of insulin
lower blood glucose
affects both utilization and production
Diabetes Mellitus
a group of symptoms characterized by hyperglycemia
Virtually all forms of DM are due to
decrease in insulin
increase in peripheral insulin resistance
2 major forms of DM
type 1
type 2
Juvenile Diabetes
Type 1 DM
Insulin dependant
autoimmune disease
Maturity onset DM
type 2 DM
non-insulin dependent
characterized by insulin resistance
% of diabetics with type 2 DM
90-95%
Mainstay treatment for both type 1 and type 2 DM
insulin
Insulin may be administered
IV, IM or SQ
Classifications of insulin preparations
ultra short acting
short acting
intermediate acting
long acting
All commercial insulin preparations are a concentration of ____
100 units/mL
Insulin absorption is most rapid from ____ to least rapid.
abdominal wall > arm > butt > thigh
ADE with insulin
hypoglycemia
Ultra short acting insulin
insulin lispro
onset 5 min
duration 3-4 hr
Short acting insulin
all the "R"s
Onset around 30 min
Duration around 6 to 8 hours
Intermediate Acting insulin
all of the "N"s
Onset 1-4 hours
Duration 24 hours
Premixed insulins
Humulin 70/30 or 50/50
Novolin 70/30
Onset 30-60 min
Duration 24 hours
Long acting insulin
glargine (onset 2-5 hr duration 18-24)
humulin U (onset 4-8 duration 36hr)
Oral agents acting in the pancreas
sulfonylureas
repaglinide
Oral agents acting in the gut
acarbose
miglitol
Oral agents acting in the muscles
rosiglitazone
pioglitazone
Oral agents acting in the liver
metformin
Sulfonylureas
sulfonamide derivatives
2nd generation more potent
only effective in pt with functioning Beta cells
MoA Sulfonylureas
stimulate release of insulin by blocking ATP dependent K+ current in pancreatic beta cells.
Therapeutic use of sulfonylureas
control hyperglycemia in type 2 DM who cannot control BG with diet and exercise alone
1st generation sulfonylureas
acetohexamide
chlorpropamide
Tolazamide
Tolbutamide
2nd Generation sulfonylureas
glimiperide
glipizide
glyburide
ADEs with sulfonylureas
hypoglycemia
sulfonamide structure can cause allergic reaction in pt allergic to sulfa
n/v - disulfiram like effects w/ alcohol
weight gain
Contraindications for sulfonylureas
hypersensitivity to sulfa
pregnancy
reduced renal/hepatic function
ketoacidosis
Author
Rx2013
ID
82013
Card Set
Pharmacology Final
Description
Insulin 1
Updated
2011-04-26T21:45:34Z
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