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Pharm 2 > Anemia, PO DM meds > Flashcards

Anemia, PO DM meds Flashcards

1
Q

first line if A1C is <7.5%

A

metformin

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2
Q

site of action: Alpha Glucosidase Inhibitors

A

intestines

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3
Q

class: Acarbose, miglitol

A

Alpha Glucosidase Inhibitors

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4
Q

site of action: Meglitinides

A

pancreas

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5
Q

class: Repaglinide, nateglinide

A

Meglitinides

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6
Q

main SE of Repaglinide, nateglinide

A

hypoglycemia (severe if also on gemfibrozil)

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7
Q

site of action: Sulfonylureas

A

pancreas

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8
Q

class: Glyburide, glipizide, glimepiride

A

Sulfonylureas

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9
Q

MOA: blocks ATP sensitive K channels – insulin release from functional beta cells, decreased efficacy w/ time
o Increases insulin secretion

A

Sulfonylureas

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10
Q

AEs: **Hypoglycemia
o Weight gain
o Nausea, dyspepsia, diarrhea

A

Sulfonylureas

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11
Q

cautions: Sulfonylureas

A

elderly, renal and hepatic dysfunction

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12
Q

CI: Sulfonylureas

A

pregnancy, sulfa allergy, type 1 DM

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13
Q

site of action: Biguanides

A

liver, muscle

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14
Q

class: metformin

A

Biguanides

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15
Q

initial dosing for metformin

A

IR 500mg Qd or bid / XR 500mg QD

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16
Q

MOA: reduces liver gluconeogenesis and glycogenolysis
o Decreases liver glucose formation/release
o Increase glucose uptake by skeletal muscle and adipose tissue à increases insulin sensitivity

A

metformin

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17
Q

metformin - hypoglycemia risk as monotherapy?

A

no

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18
Q

AEs: ovulation, N/V/**D, flatulence, macrocytic anemia / peripheral neuropathy – must monitor renal function and Vit B12

A

metformin

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19
Q

BBW: metformin

A

LACTIC ACIDOSIS
§ in pts w/ CHF, hepatic or renal dysfunction, elderly, alcohol abuse

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20
Q

stie of action: Thiazolidinediones (Glitazones)

A

liver, muscle, adipose tissue

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21
Q

class: Pioglitazone, rosiglitazone

A

Thiazolidinediones (Glitazones)

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22
Q

MOA: PPARg agonist à increase GLUT-4 transporters, increase insulin sensitivity of tissues. decreases gluconeogenesis

A

Thiazolidinediones (Glitazones)

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23
Q

AEs: Weight gain, URI, HA
o Fluid retention
o ­ Risk of bone fracture
o ­ **Risk of BLADDER CANCER
can induce ovulation

A

Thiazolidinediones (Glitazones)

24
Q

BBW: Thiazolidinediones (Glitazones)

A

fluid retention in CHF

25
Q

which Thiazolidinediones (Glitazones) causes bladder cancer?

A

pioglitazone

26
Q

site of action: Dipeptidyl peptidase-4 Inhibitors (DPP-4)

A

intestines

27
Q

MOA: blocks breakdown of GLP-1 – increases endogenous GLP-1
o “Incretin enhancer”

A

Dipeptidyl peptidase-4 Inhibitors (DPP-4)

28
Q

AEs: **URI, sore throat
o **Hypersensitivity rxn
o **Pancreatitis
o HA, diarrhea, joint pain

A

Dipeptidyl peptidase-4 Inhibitors (DPP-4)

29
Q

class: Sitagliptin, saxagliptin, linagliptin, alogliptin

A

Dipeptidyl peptidase-4 Inhibitors (DPP-4)

30
Q

cautions: Dipeptidyl peptidase-4 Inhibitors (DPP-4)

A

HF, pancreatitis

31
Q

CI: Dipeptidyl peptidase-4 Inhibitors (DPP-4)

A

type 1 DM, use w/ GLP1 receptor agonists

32
Q

site of action: Selective Sodium-Dependent Glucose Cotransporter-2 Inhibitor (SGLT2 Inhibitors)

A

kidneys

33
Q

class: Canaglifozin, dapaglifozin, empaglifozin, ertuglifozin

A

Selective Sodium-Dependent Glucose Cotransporter-2 Inhibitor (SGLT2 Inhibitors)

34
Q

MOA: Inhibits glucose reabsorption in proximal tubule of kidneys à excess glucose excreted in urine

A

Selective Sodium-Dependent Glucose Cotransporter-2 Inhibitor (SGLT2 Inhibitors)

35
Q

AEs: **hyperK
Polyuria, constipation, hypotension
o Increased risk of UTI and genital fungal infections
o Increased risk of bone fracture and pancreatitis

A

Selective Sodium-Dependent Glucose Cotransporter-2 Inhibitor (SGLT2 Inhibitors)

36
Q

BBW: Selective Sodium-Dependent Glucose Cotransporter-2 Inhibitor (SGLT2 Inhibitors)

A

lower limb amputation risk

37
Q

cautions: Selective Sodium-Dependent Glucose Cotransporter-2 Inhibitor (SGLT2 Inhibitors)

A

bladder / breast cancer hx

38
Q

dopamine agonist indicated for DM

A

bromocriptine

39
Q

class: Colesevelam

A

bile acid sequestrant

40
Q

AEs: GI disturbances – constipation, bloating, gas
o Impaired absorption of lipid soluble vitamins and drugs

A

Colesevelam

41
Q

iron deficiency causes ____ anemia

A

microcytic

42
Q

Vit B12 and folate defic cause ____ anemia

A

macrocytic

43
Q

anemia of chronic dz causes ____ anemia

A

normocytic

44
Q

Low ferritin means ___ iron

A

low

45
Q

High transferrin means ___ iron

A

low

46
Q

High TIBC means __ iron

A

low

47
Q

1st line for iron defic anemia

A

PO iron

48
Q

counseling for PO iron

A

counseling: Take on an empty stomach but if you
have GI upset you can take with food
except dairy or caffeine. You may experience
dark stools or constipation
take w/ orange juice or vitamin C

49
Q

Take separately from calcium-containing foods/beverages/supplements, cereals, dietary fiber, tea, coffee,
eggs

A

PO iron

50
Q

4 meds iron impairs absoprtion of:

A

Levothyroxine
§ Levodopa/methyldopa
§ Fluroquinolones
§ Tetracycline and doxycycline

51
Q

AEs: GI side effects common: metallic taste, nausea, flatulence, constipation, N/V/D, epigastric discomfort
o Black/green or tarry stools staining clothing or cause anxiety about bleeding

A

PO iron

52
Q

tx for iron toxicity

A

IV fluids
o Whole bowel irritation w/ polyethylene glycol
o Deferoxamine (Desferal)

53
Q

AEs: flushing, rash, abdominal pain, hypotension

A

IV irons: Ferric carboxylmaltose (Injectafer), iron sucrose (Venofer)

54
Q

long term metformin use can cause vitamin ___ defic

A

B12

55
Q

folate DIs

A

Phenytoin – reduces absorption of folic acid, may lead to deficiency. Folic acid may decrease serum concentration of phenytoin
* DNA synthesis inhibitors: Azathioprine, 6-MP, 5-FU, hydroxyurea, zidovudine. May cause folate deficiency
* Folate antagonists: methotrexate, trimethoprim, pentamidine, triamterene. Leucovorin (folinic acid) used to circumvent action of methotrexate – reduces toxicity of high dose methotrexate

56
Q

class: Epoetin, darbepoetin

A

Erythropoiesis-Stimulating Agents (ESAs) – ALL IV

Pharm 2 (29 decks)

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