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Insulin and Sulfonylureas
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1
Question
Which three tissues are the primary targets of insulin's metabolic actions?
Page 7
Answer
Adipose tissue; Striated (skeletal) muscle; Liver.
2
Question
What effect does insulin have on glucose uptake in adipose tissue?
Page 7
Answer
Insulin increases glucose uptake in adipose tissue.
3
Question
How does insulin affect lipogenesis in adipose tissue?
Page 7
Answer
Insulin increases (stimulates) lipogenesis in adipose tissue.
4
Question
What effect does insulin have on lipolysis in adipose tissue?
Page 7
Answer
Insulin decreases (inhibits) lipolysis in adipose tissue.
5
Question
Name three metabolic effects of insulin on striated (skeletal) muscle.
Page 7
Answer
• Increases glucose uptake • Increases glycogen synthesis • Increases protein synthesis
6
Question
What is the effect of insulin on hepatic gluconeogenesis?
Page 7
Answer
Insulin decreases (inhibits) gluconeogenesis in the liver.
7
Question
How does insulin affect glycogen metabolism in the liver?
Page 7
Answer
Insulin increases glycogen synthesis in the liver (promotes glycogen formation).
8
Question
What effect does insulin have on hepatic lipogenesis?
Page 7
Answer
Insulin increases (stimulates) lipogenesis in the liver.
9
Question
How does insulin affect glycogen synthase activity and glycogen formation?
Page 9
Answer
Insulin increases glycogen synthase activity and thereby increases glycogen formation.
10
Question
What are insulin's effects on protein synthesis, lipolysis, and lipogenesis (general statement)?
Page 9
Answer
Insulin has multiple effects: it increases protein synthesis, inhibits lipolysis, and stimulates lipogenesis.
11
Question
How does insulin influence gene transcription related to growth?
Page 9
Answer
Insulin activates transcription factors that enhance DNA synthesis and cell growth and division.
12
Question
What is the composition of Humulin M3?
Page 28
Answer
Humulin M3 is a mixture of \$30\%\$ soluble (rapid‑acting) insulin and \$70\%\$ isophane (intermediate‑acting) insulin.
13
Question
Which strengths (percent mixes) are available for Insulin Mixtard as shown on the slide?
Page 28
Answer
Insulin Mixtard is available in mixes denoted 10, 20, and 30 (e.g., Mixtard 30 corresponds to a \$30\%\$ rapid component).
14
Question
How frequently are premixed insulins like Humulin M3 or Mixtard typically administered and why?
Page 28
Answer
They are typically given twice daily (2‑daily administration); the rapid/soluble component in each dose covers the mealtime (prandial) insulin requirements.
15
Question
What is the composition of Novomix 30?
Page 28
Answer
Novomix 30 contains insulin aspart plus protamine‑complexed insulin aspart in a \$30:70\$ ratio (\$30\%\$ rapid aspart : \$70\%\$ protamine/aspart intermediate).
16
Question
What are the Humalog Mix formulations shown and which insulin do they contain?
Page 28
Answer
Humalog Mix formulations include Mix 25 and Mix 50; they contain insulin lispro in premixed proportions (e.g., Mix 25 has \$25\%\$ rapid lispro).
17
Question
What is the primary and most serious acute adverse drug reaction (ADR) associated with insulin therapy?
Page 29
Answer
Hypoglycemia (which can include severe cases progressing to coma).
18
Question
List the sympathetic nervous system signs of hypoglycemia described on the slide.
Page 29
Answer
Sympathetic signs of hypoglycemia include tachycardia, palpitations, sweating, and tremulousness.
19
Question
What parasympathetic (PS) symptoms of hypoglycemia are listed on the slide?
Page 29
Answer
Parasympathetic symptoms include nausea and hunger.
20
Question
What central nervous system (brain) manifestations of hypoglycemia does the slide list?
Page 29
Answer
Brain hypoglycemia manifestations include headache, visual disturbances, and loss of consciousness.
21
Question
According to the slide, what is the immediate treatment for hypoglycemia?
Page 29
Answer
Give glucose orally if possible, or intravenously — for IV use 20–50 mL of 50% glucose solution.
22
Question
Which electrolyte disturbance is listed as an ADR of insulin therapy?
Page 29
Answer
Hypokalemia is listed as an adverse effect of insulin therapy.
23
Question
What local adverse effect can occur from repeated insulin injections and how is it prevented?
Page 29
Answer
Local injection‑site reactions and lipodystrophy can occur; prevention is by rotating injection sites.
24
Question
What form of insulin resistance is mentioned on the slide?
Page 29
Answer
Insulin resistance due to IgG antibodies against insulin is mentioned.
25
Question
Name the six main classes of oral antidiabetic agents listed on the slide.
Page 30
Answer
1) Sulfonylureas (SU) 2) Glinides 3) Biguanides 4) Thiazolidinediones 5) α‑Glucosidase inhibitors 6) GLP‑1 receptor agonists and DPP‑4 inhibitors
26
Question
Match the sulfonylurea drug glibenclamide to its trade name shown on the slide.
Page 31
Answer
Glibenclamide — Maninil®.
27
Question
Match the sulfonylurea drug glipizide to its trade name shown on the slide.
Page 31
Answer
Glipizide — Minidiab®.
28
Question
Match the sulfonylurea drug gliclazide to its trade name shown on the slide.
Page 31
Answer
Gliclazide — Diaprel®.
29
Question
Match the sulfonylurea drug glimepiride to its trade name shown on the slide.
Page 31
Answer
Glimepiride — Amaryl®.
30
Question
What is the primary mechanism of action of sulfonylureas on pancreatic β‑cells as stated on the slide?
Page 31
Answer
Sulfonylureas increase the release of insulin from pancreatic β‑cells.