Anesthesia Pharmacology: Diabetes Management Practice Questions
Click on the correct answer.
Exendin-4:
Reptilian peptide
(extracted from Gila monster venom)
About 50%
sequence identical to GLP-1
Both
Neither
Extendin-4: this peptide is a glucagon-like peptide 1 receptor agonist that exhibits both pharmacological and physiological actions similar to GLP-1.
True
False
Exendin-4:
Is not a substrate for dipeptidyl peptidase 4
Exhibits longer-term pharmacological activity after injection.
True
False
Exenatide (Byetta and others) is a synthetic exendin-4 molecule that has been approved for use both as monotherapy and along with other agents for type II diabetes management.
True
False
Using exenatide as monotherapy or in combination with metformin, thiozolidinedione or sulfonylurea was associated with:
Better glycemic control
Weight gain
Both
Neither
Exenatide may be used in combination with basal insulin.
True
False
Exenatide pharmacokinetics:
Half-life: about 2.5 hours
Glucose-reducing action is about 6 hours.
Both
Neither
Exenatide administration is not appropriate for patients with eGFR <30 ml/min/1.73m2.
True
False
Exenatide and the immune system.
Exenatide administration may induce relatively low level antibodies (against exenatide) and about 40% of patients. This effect is not impact clinical activity.
Some patients (about 5%) may exhibit high-tighter antibodies following exenatide. about half of these patients may exhibit decreasing glycemic response to exenatide.
Both
Neither
Half-life of administration for exenatide:
Immediate release daily formulation: about 2.5 hours
Extended release formulation (weekly administration): about 2 weeks
Both
Neither
Most of administered dose of exenatide is metabolized by the liver cytochrome P450 drug metabolizing system.
Powers A D'Alessio D Chapters 47:
Endocrine Pancreas and Pharmacotherapy of Diabetes Mellitus and
Hypoglycemia in Goodman & Gilman's: The Pharmcological
Basis of Therapeutics, 13e, (Brunto LL Hilal-Dandan R Knollmann
BC, eds) McGraw-Hill Education, 2018.
Masharani U Diabetes
Mellitus (27-01) in Current Medical Diagnosis & Treatment (Papadakis
MA McPhee SJ Rabow MW McQuaid KR, eds) 61e McGraw Hill 2022.
Masharani U Kroon L
Chapter 41: Pancreatic Hormones & Glucose-Lowering Drugs
in Basic & Clinical Pharmacology (Katzung BG, Editor; Vanderah
TW, Associate editor) 15e McGraw Hill 2021.