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nurp 502 - ex 3 > 8: DM Meds > Flashcards

8: DM Meds Flashcards

1
Q

Which med is contraindicated in treated CHF?

A

Metformin

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2
Q

This incretin mimetic is administered orally and can be used as monotherapy or added to metformin, thiazolidendione, or sulfonylurea. It raises both endogenous incretins.

A

DPP-4 Inhibitors (-gliptins)

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3
Q

Which drug class?

  • Restores GLP-1 levels
  • Promotes satiety
  • Decreases glucagon release, stimulates insulin release
  • Delays gastric emptying
  • Used with caution in patients with impaired renal and hepatic function
  • Major side effect is diarrhea
A
  • DPP-4 Inhibitors:
    • Sitagliptin (Januvia)
    • Saxogliptin (Onglyza)
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4
Q

Which drug class?

Incretins and incretin mimetics.

A
  • DPP-4 Inhibitors (-gliptins like Januvia)
  • GLP-1 receptor analogue (-natides and -glutides like Byetta, Victoza, Trulicity)
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5
Q

Which drug class?

Contraindicated in class 3 and 4 CHF?

A

Thiazolidinediones (-glitazones)

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6
Q

Which drug?

Injectible that increases satiety.

A

Amlin analogue: Pramlintide (Symlin)

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7
Q

Which drug?

  • Used to improve glycemic control in patients with type 2 DM taking oral agents
  • Once daily dosing
  • Not recommended in patients with end-stage renal disease, severe renal impairment or severe GI disease
  • Nausea most common side effect
  • Contraindicated in patients with gastroparesis
A

Exenatide (Byetta)

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8
Q

T/F Monotherapy of DM is associated with hypoglycemia.

A

False. Not associated.

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9
Q

Where does this oral med work?

Rosiglitazone

A

Muscle

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10
Q

What are advantages and disadvantages to this treatment?

Lifestyle modifications

A
  • Advantages:
    • Low cost
    • Additional health benefits
  • Disadvantages:
    • Fails for most within a year
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11
Q

Which drug class?

  • Most effective
  • No maximum dose
  • Can be combined with oral agents in DMT2
A

Insulin

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12
Q

What are advantages and disadvantages to this treatment?

Exenatide (Byetta)

A
  • Advantages:
    • Weight loss
  • Disadvantages:
    • Injections
    • GI side effects
    • Expensive
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13
Q

What are advantages and disadvantages to this treatment?

Sulfonylureas

A
  • Advantages:
    • Inexpensive
  • Disadvantages:
    • Weight gain
    • Hypoglycemia
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14
Q

What are advantages and disadvantages to this treatment?

Metformin

A
  • Advantages:
    • Weight neutral
    • Inexpensive
  • Disadvantages:
    • GI side effects
    • Lactic acidosis risk (rare)
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15
Q

Which drug classes?

Slows absorption of glucose by the gut.

A
  • Alpha glucosidase inhibitors (Miglitol and Acarbose)
  • Pramlintide (Symlin)
  • GLP-1 receptor analogs (-natides and -glutides like Byetta, Victoza, and Trulicity)
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16
Q

What medication should be prescribed for all DM patients at risk of severe hypoglycemia?

A

Glucagon

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17
Q

Which drug class?

Decrease glucagon levels.

A
  • DPP-4 Inhibitors (-gliptins like Januvia)
  • Pramlintide (Symlin)
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18
Q

What 2 health conditions cause increased risk of hypoglycemia?

A
  1. Active cardiac disease
  2. Neurological disease
19
Q

Which med is contraindicated in binge alcohol drinking?

A

Metformin

20
Q

This incretin mimetic is administered subQ and can be added to metformin, thiazolidendione, and/or sulfonylurea (singly or in combination).

A

GLP-1 Receptor Analogues (-natides and -glutides like Byetta, Victoza, and Trulicity)

21
Q

What is the treatment for hypoglycemia?

A
  • 15-20 g glucose
  • Repeat if hypoglycemia remains
  • Eat meal or snack after blood sugar returns to normal
22
Q

Which drug class?

Contraindicated if transaminase is 2.5x the upper normal limit at baseline.

A

Thiazolidinediones (-glitazones)

23
Q

Which drug?

Contraindicated in renal insufficiency.

A

Metformin

24
Q

Which drug classes?

Insulin sensitizers.

A
  • Biguanides (Metformin)
  • Thiazolididnediones (-glitazones)
  • GLP-1 receptor analogues (-natides and -glutides such as Byetta, Victoza, and Trulicity)
25
Q

Where does this oral med work?

Metformin

A

Liver

26
Q

What are advantages and disadvantages to this treatment?

Insulin

A
  • Advantages:
    • No dose limit
    • Inexpensive
    • Improved lipid profile
  • Disadvantages:
    • Injections
    • Monitoring
    • Hypoglycemia
    • Weight gain
27
Q

Which 4 drugs or classes specifically target postprandial hyperglycemia?

A
  1. Meglitinides (Prandin/Repaglinide and Starlix/Nateglinide)
  2. Acarbose (Alpha Glucosidase Inhibitor)
  3. GLP-1 Analogs (-natides and -glutides such as Byetta, Victoza, and Trulicity)
  4. DPP-4 Inhibitors (-gliptins such as Januvia)
28
Q

Which drug?

  • Once daily dosing
  • Increased risk of pancreatitis
  • Contraindicated with medullary thyroid carcinoma
A

Liraglutide (Victoza, a GLP-1 Analogue)

29
Q

What is the leading limiting factor in glycemic management of DM?

A

Hypoglycemia

30
Q

What are advantages and disadvantages to this treatment?

Alpha Glucosidase Inhibitors (Acarbose/Precose and Miglitol/Glyset)

A
  • Advantages:
    • Weight neutral
  • Disadvantages:
    • GI side effects
    • TID dosing
    • Expensive
31
Q

What are advantages and disadvantages to this treatment?

TZDs (-glitazones)

A
  • Advantages:
    • Improved lipid profile
  • Disadvantages:
    • Fluid retention
    • Weight gain
    • Expensive
32
Q

Where does this oral med work?

Acarbose (Alpha Glucosidase Inhibitor)

A

Gut (carb metabolism)

33
Q

Which drug class?

Contraindicated in pancreatitis?

A

GLP-1 Analogs (-natides and -glutides such as Byetta, Victoza, and Trulicity)

34
Q

What are advantages and disadvantages to this treatment?

Glinides (Meglitinides such as Prandin/Repaglinide and Starlix/Nateglinide)

A
  • Advantages:
    • Short duration
  • Disadvantages:
    • TID dosing
    • Expensive
35
Q

Where does this oral med work?

Pioglitazone

A

Muscle

36
Q

Where does this oral med work?

Repaglinide

A

Pancreas

37
Q

Which 3 drug classes cause weight gain?

A
  1. Sulfonylureas (Glimepiride, Glipizide, Glyburide)
  2. Thiazolidinediones (-glitazones)
  3. Insulin
38
Q

Which drug class?

Contraindicated in active liver disease.

A

Thiazolidinediones (-glitazones)

39
Q

Which drug class?

Contraindicated in gastroparesis.

A

GLP-1 Analogs (-natides and -glutides such as Byetta, Victoza, and Trulicity)

40
Q

Where does this oral med work?

Miglitol (Alpha Glucosidase Inhibitor)

A

Gut (carb metabolism)

41
Q

What are advantages and disadvantages to this treatment?

Pramlintide (Symlin)

A
  • Advantages:
    • Weight loss
  • Disadvantages:
    • Injections
    • TID dosing
    • GI side effects
    • Expensive
42
Q

Where does this oral med work?

Sulfonylureas (Glimepiride, Glipizide, and Glyburide)

A

Pancreas

43
Q

Where does this oral med work?

Nateglinide (-glinides)

A

Pancreas

44
Q

Which drug class?

Increase insulin secretion.

A
  • Secretagogues
    • Sulfonylureas: Glimepiride, Glipizide, Glyburide.
    • Meglitinides: Repaglinide, Nateglinide.

nurp 502 - ex 3 (37 decks)

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