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Pharm U5 > 4) Diabetes - U5 > Flashcards

4) Diabetes - U5 Flashcards

1
Q

What is the class for Metformin (Glucophage; others)

A

Biguanide

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2
Q

What is the mechanism for Metformin (Glucophage; others)

A

Activates AMP-kinase and inhibits mitochondrial isoform of glycerophosphate dehydrogenase => decreases hepatic glucose production

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3
Q

What are the therapeutics for Metformin (Glucophage; others)

A

First-line therapy in diabetes due to no weight gain or hypoglycemia, reduction in cardiovascular events and mortality

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4
Q

What are the important side effects for Metformin (Glucophage; others)

A

Lactic acidosis (rare)

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5
Q

What are the other side effects for Metformin (Glucophage; others)

A

GI (diarrhea, abdominal discomfort, N & V), B12 deficiency

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6
Q

What are the miscellaneous for Metformin (Glucophage; others)

A

Contraindicated in renal impairment; low cost

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7
Q

What is the class for Glipizide (Glucotrol)

A

Sulfonylurea

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8
Q

What is the mechanism for Glipizide (Glucotrol)

A

Closure of ATP-sensitive K+ channels on ?-cell plasma membrane –> stimulation of insulin release

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9
Q

What are the therapeutics for Glipizide (Glucotrol)

A

Reduction in cardiovascular events and mortality

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10
Q

What are the important side effects for Glipizide (Glucotrol)

A

Weight gain; hypoglycemia

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11
Q

What are the miscellaneous for Glipizide (Glucotrol)

A

low cost

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12
Q

What is the class for Glyburide (Micronase)

A

Sulfonylurea

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13
Q

What is the mechanism for Glyburide (Micronase)

A

Closure of ATP-sensitive K+ channels on ?-cell plasma membrane –> stimulation of insulin release

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14
Q

What are the therapeutics for Glyburide (Micronase)

A

Reduction in cardiovascular events and mortality

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15
Q

What are the important side effects for Glyburide (Micronase)

A

Weight gain; hypoglycemia

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16
Q

What are the miscellaneous for Glyburide (Micronase)

A

low cost

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17
Q

What is the class for Glimepiride (Amaryl)

A

Sulfonylurea

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18
Q

What is the mechanism for Glimepiride (Amaryl)

A

Closure of ATP-sensitive K+ channels on ?-cell plasma membrane –> stimulation of insulin release

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19
Q

What are the therapeutics for Glimepiride (Amaryl)

A

Reduction in cardiovascular events and mortality

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20
Q

What are the important side effects for Glimepiride (Amaryl)

A

Weight gain; hypoglycemia

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21
Q

What are the miscellaneous for Glimepiride (Amaryl)

A

low cost

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22
Q

What is the class for Repaglinide (Prandin); Nateglinide (Starlix)

A

Meglitinide

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23
Q

What is the mechanism for Repaglinide (Prandin); Nateglinide (Starlix)

A

Closure of ATP-sensitive K+ channels on ?-cell plasma membrane –> stimulation of insulin release

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24
Q

What are the therapeutics for Repaglinide (Prandin); Nateglinide (Starlix)

A

Used with meals

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25
Q

What are the important side effects for Repaglinide (Prandin); Nateglinide (Starlix)

A

Weight gain; hypoglycemia (less than sulfonylureas)

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26
Q

What are the miscellaneous for Repaglinide (Prandin); Nateglinide (Starlix)

A

Short acting

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27
Q

What is the class for Pioglitazone (Actos)

A

Thiazolidinedione

28
Q

What is the mechanism for Pioglitazone (Actos)

A

Binds PPAR-?, a nuclear transcription factor; increases peripheral insulin sensitivity

29
Q

What are the therapeutics for Pioglitazone (Actos)

A

No hypoglycemia; increase HDL cholesterol while decreasing triglycerides

30
Q

What are the important side effects for Pioglitazone (Actos)

A

Weight gain; edema; heart failure; bone fractures; macular edema

31
Q

What are the other side effects for Pioglitazone (Actos)

A

Increased risk of bladder cancer

32
Q

What are the miscellaneous for Pioglitazone (Actos)

A

Expensive

33
Q

What is the class for Rosiglitazone (Avandia)

A

Thiazolidinedione

34
Q

What is the mechanism for Rosiglitazone (Avandia)

A

Binds PPAR-?, a nuclear transcription factor; increases peripheral insulin sensitivity

35
Q

What are the therapeutics for Rosiglitazone (Avandia)

A

No hypoglycemia

36
Q

What are the important side effects for Rosiglitazone (Avandia)

A

Weight gain; edema; heart failure; bone fractures; increased cardiovascular events

37
Q

What are the other side effects for Rosiglitazone (Avandia)

A

Increased LDL cholesterol

38
Q

What are the miscellaneous for Rosiglitazone (Avandia)

A

Expensive; contraindicated in heart disease

39
Q

What is the class for Acarbose (Precose); Miglitol (Glyset)

A

?-glucosidase inhibitor

40
Q

What is the mechanism for Acarbose (Precose); Miglitol (Glyset)

A

Competitively inhibit enzymes that break down carbohydrates into simple sugars, delaying GI carbohydrate absorption & reduces postprandial glucose levels

41
Q

What are the therapeutics for Acarbose (Precose); Miglitol (Glyset)

A

Nonsystemic medication that decreases postprandial glucose

42
Q

What are the important side effects for Acarbose (Precose); Miglitol (Glyset)

A

GI (gas, flatulence, diarrhea)

43
Q

What are the other side effects for Acarbose (Precose); Miglitol (Glyset)

A

Modest reduction in A1c

44
Q

What are the miscellaneous for Acarbose (Precose); Miglitol (Glyset)

A

Taken with each carbohydrate containing meal

45
Q

What is the class for Exenatide (Byetta); Liraglutide (Victoza); Albiglutide (Tanzeum); Dulaglutide (Trulicity)

A

GLP-1 receptor agonist

46
Q

What is the mechanism for Exenatide (Byetta); Liraglutide (Victoza); Albiglutide (Tanzeum); Dulaglutide (Trulicity)

A

Activates GLP-1 receptor in ?-cells, endocrine pancreas, and brain; increases insulin secretion and decreases glucagon secretion in a glucose-dependent fashion; slows gastric emptying, increases satiety

47
Q

What are the therapeutics for Exenatide (Byetta); Liraglutide (Victoza); Albiglutide (Tanzeum); Dulaglutide (Trulicity)

A

Leads to weight reduction

48
Q

What are the important side effects for Exenatide (Byetta); Liraglutide (Victoza); Albiglutide (Tanzeum); Dulaglutide (Trulicity)

A

Acute pancreatitis; GI (nausea, vomiting, diarrhea)

49
Q

What are the other side effects for Exenatide (Byetta); Liraglutide (Victoza); Albiglutide (Tanzeum); Dulaglutide (Trulicity)

A

hypoglycemia (less than sulfonylureas

50
Q

What are the miscellaneous for Exenatide (Byetta); Liraglutide (Victoza); Albiglutide (Tanzeum); Dulaglutide (Trulicity)

A

Injection only (exenatide twice daily, liraglutide once daily, others once weekly; expensive

51
Q

What is the class for Sitagliptin (Januvia); Alogliptin (Nesina); Saxagliptin (Onglyza); Linagliptin (Tradjenta)

A

DPP-4 inhibitor

52
Q

What is the mechanism for Sitagliptin (Januvia); Alogliptin (Nesina); Saxagliptin (Onglyza); Linagliptin (Tradjenta)

A

Inhibition of GLP-1 metabolism; increases insulin and glucagon secretion

53
Q

What are the therapeutics for Sitagliptin (Januvia); Alogliptin (Nesina); Saxagliptin (Onglyza); Linagliptin (Tradjenta)

A

No hypoglycemia, weight neutrality

54
Q

What are the important side effects for Sitagliptin (Januvia); Alogliptin (Nesina); Saxagliptin (Onglyza); Linagliptin (Tradjenta)

A

Well tolerated; rarely urticaria/angioedema & pancreatitis

55
Q

What are the miscellaneous for Sitagliptin (Januvia); Alogliptin (Nesina); Saxagliptin (Onglyza); Linagliptin (Tradjenta)

A

Expensive

56
Q

What is the class for Canagliflozin (Invokana); Dapaglifloxin (Farxiga); Empaglifloxin (Jardiance)

A

SGLT2 inhibitor

57
Q

What is the mechanism for Canagliflozin (Invokana); Dapaglifloxin (Farxiga); Empaglifloxin (Jardiance)

A

Redfuces glucose resorption in the kidney; increases urinary glucose excretion

58
Q

What are the therapeutics for Canagliflozin (Invokana); Dapaglifloxin (Farxiga); Empaglifloxin (Jardiance)

A

No hypoglycemia; weight loss possible

59
Q

What are the important side effects for Canagliflozin (Invokana); Dapaglifloxin (Farxiga); Empaglifloxin (Jardiance)

A

UTIs; genital mycotic infections; volume depletion; hyperkalemia; hypersensitivity

60
Q

What are the miscellaneous for Canagliflozin (Invokana); Dapaglifloxin (Farxiga); Empaglifloxin (Jardiance)

A

Expensive

61
Q

What is the class for Colesevelam (Welchol)

A

Bile acid sequestrant

62
Q

What is the mechanism for Colesevelam (Welchol)

A

Binds bile acids/cholesterol

63
Q

What are the therapeutics for Colesevelam (Welchol)

A

No hypoglycemia; decreased LDL cholesterol

64
Q

What are the important side effects for Colesevelam (Welchol)

A

Increase in triglycerides

65
Q

What are the other side effects for Colesevelam (Welchol)

A

Constipation; may interfere with absorption of other medications

Pharm U5 (5 decks)

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