Anti-Diabetic Meds

Question 1

Biguanide med:

Answer 1

Metformin- decr gluc production, incr intestinal absorption of gluc, incr insulin receptor sensitivity, decr triglycerides
Does NOT cause hypoglycemia
RADIOLOGIC CONTRAST DYE- DC 48hrs before/ after
AE: weight LOSS, n/v, cramping, feeling full, bloating, metallic taste, vitamin b12 deficiency

Question 2

Sulfonylurea Med:

Answer 2

Glipizide- incr release of insulin, incr sensitivity, decr glucagon release
Cross-sensivity w other sulfa containing drugs
ONCE INSULIN STARTED-> DC THIS
AE: HYPOGLYCEMIA, weight gain

Question 3

Thiazolidinedione med:

Answer 3

Pioglitazone (-glitazones)- incr insulin receptor sensitivity, incr peripheral glu uptake & storage, decr gluc & triglyceride production

Slow onset of actions, may take several weeks to take effect
BLACK BOX WARNING: can cause HF
AE: weight gain, edema, hepatotoxic, decr bone mineral density

Question 4

Alpha-Glucosidase Inhibitor med:

Answer 4

Acarbose- delays glu absorption in small intestine by blocking enzyme
MUST take w food
ONLY decr post-pyramidal glucose
Does NOT cause hypoglycemia 
AE: flatulence, diarrhea, abd pain

Question 5

Dipeptidyl Peptidase IV Inhibitor med:

Answer 5

Sitaglipitin (-glipitins): inhibits DDP-IV -> incr active incretins
AE: upper respiratory infections, h/a, diarrhea

Question 6

Incretin Mimetic Med:

Answer 6

Liraglutide- mimics incretin hormone
SQ
CANNOT be used w insulin
BLACK BOX WARNING: risk of developing thyroid C-Cell tumors
AE: Weight loss, pancreatitis, n/v/d

Question 7

Amylin Agonist Med:

Answer 7

Pramlintide- improves postprandial glucose control
SQ
Can be used in both types of DM
Helps decr insulin requirements
Contraindicated in pts w/ gastroparesis (bc slows gastric emptying)

Question 8

Rapid Acting Insulin

Answer 8

Lispro
Onset 15 mins
Peak 1-2 hrs
Duration 3-5 hrs
*most like natural insulin
*take w/in 15 mins of eating

Question 9

Short Acting Insulin

Answer 9

Regular
Onset 30-60 mins
Peak 2-5 hrs
Duration 6-10 hrs
*only insulin that can be given IV
*clear

Question 10

Intermediate Acting Insulin

Answer 10

NPH
Onset 1-2hrs
Peak 4-8 hrs
Duration 10-18 hrs
*appears cloudy, needs mixing

Question 11

Long Acting Insulin(s)

Answer 11

Glargine- onset 1-2hrs, no peak, duration 24. DON’T GIVE IF BREASTFEEDING

Detemir- onset 3-4hrs, peak unknown, duration 6-24 hrs

Question 12

Drugs that INCREASE blood sugar:

Answer 12

Glucocorticoids, thiazides diuretics, estrogen, thyroid agents (levothyroxine), octreotide, Mycophenolate

Question 13

Drugs that DECREASE blood sugar:

Answer 13

Tricyclics antidepressants, MAOIs, aspirin, metoprolol (?), ARBs

Question 14

Drugs that mask s/s of hypoglycemia & hyperglycemia:

Answer 14

(Dual acting) Beta Blockers

Question 15

This drug, if used long term, can lead to DM:

Answer 15

Somatropin/ somatrem