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Pharm 2 Test 2 > Antidiabetic > Flashcards

Antidiabetic Flashcards

1
Q

Rx list

A
  • insulin
  • biguanides (metformin)
  • Sulfonureas (glipizide)
  • Non-sulfonylurea secretagogues (meglitinides)
  • Thiazolidenediones (Pioglitazone)
  • GLP-1 Receptor Ags
  • Dipeptidyl MORE
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2
Q

Insulin replacement

A

Primary Tx Type 1

  • recominant
  • inject SQ
  • new delivery systems, aerosolized nasal
  • No liver 1st pass
  • Individualize Tx
  • REVERSE w/glucose/glucagon
  • S.E. : hypoglycemia, dementia old age
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3
Q

Insulin types

  • ultra short-acting
  • rapid acting
  • Intermediate acting
  • long acting
A
  • ultra short-acting = lispro, aspart, glulisine
  • rapid acting = standard
  • Intermediate acting = NPH
  • long acting= Detemir, Glargine
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4
Q

Individualized dosing

A
  • mixture forms throughout day
  • dawn effect = dose at night
  • blood glucose
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5
Q

Type 2 DM tx

A

*1st line. = wieght exercise
*monotherapy or combo
(Insulin not initially, until progress to beta cell fatigue/degen)

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6
Q

Metformin

A 
BIGUANIDE
1ST LINE TYPE II, also PRE-DM
*only US
*can combo w/ oral
*sensitizer (enhance effect) insulin
*1st line type 2, also prediabetics
*activate AMPK (LIVER+ muscle)
UP FA oxidation,DOWN gluconeogen, DOWN lipogen, UP glucose uptake
*S.E. : NO weight gain (loss maybe), NO hypoglyc, STOP microvascular issues, C/I renal/liver dz/contrast dye, lactic acidosis,
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7
Q

Glipizide

A

Sulfonureas SECRETAGOGUE

  • UP insulin release from pancreas (same as glucose MOA)
  • need functional beta cells
  • NO EFFECT insulin sensitivity
  • S.E. = 2nd gen not much, hypoglyc, weight gain, C/I renal/liver dz,
  • RX-RX = enhance hypoglyc, hyperglyc
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8
Q

Repaglinide

A

NON-SUlFONYLUREA SECRETAGOGUES
*Take Right Before Meal
*UP insulin release pancreas, need functional beta
*rapid absorption, shorter action
S.E.: Less risk hypoglyc, weight gain, rx-rx intxn

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9
Q

Poiglitazone

A 
THIAXOLIDINEDIONES
*UP Insulin Sensitivity in target tissues (PPAR-gamma)
*NOT hypoglycemic
*DOWN liver output glucose
*UP glucose use (muscle, fat)
*DOWN FFA (adipose)
S.E = Fluid retention, weight gain
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10
Q

Sitagliptin

A

INCRETIN-BASED DDP-4 INHIBITOR

  • prolong GLP-1
  • UP glucose mediated insulin
  • weight neutral
  • S.E.: UP hypoglyc risk w/ insulin secretagogues, cleavage not just to incretins, fatal hepatic failure, long term safety unknown
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11
Q

Canagliflozin

A

TYPE II, NOT I

  • SGLT-2 inhibitor
  • stop renal reabsorption glucose, lower blood glucose
  • excretes sodium, facilitates weight loss
  • Metab by UDP-GT inducers RX DOWN blood levels
  • S.E. = mycotic infxns, recurrent UTIs, Long term safety unknown, ketoacidosis
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12
Q

Acarbose

A

Alpha-Glucosidase Blocker

  • DOWN GI glucose absorption
  • Take w/ meal (post-prandial glycemia)
  • S.E. = ab pain, diarrhea, flatulence, alleviated w/ dose titration/continued use, C/I chronic intestinal dz, hypoglyc w/ sulfonylureas/insulin (Tx oral glucose)
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13
Q

DM 2 Rx

A
  • METFORMIN (biguanide, insuline sensitizer)
  • GLIPIZIDE (Sulfonureas)
  • REPAGLINIDE (Katp channel secretagogue)
  • PIOGLITAZONE (Thiazolidinediones)
  • EXANATIDE (GLP-1 Mimetic, incretin)
  • CANAGLIFLOZIN (renal SGLT-2 block)
  • ACARBOSE (A-Glucosidase block)
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14
Q

DM II

Weight gain Rx

A
  • GLIPIZIDE: sulfonureas, meglinitides (classic secretagogues)
  • PIOGLITAZONE: TZDs (insulin sensitizer)
  • REPAGLINIDIDE
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15
Q

DM II Rx targets

  • METFORMIN (biguanide, insuline sensitizer)
  • GLIPIZIDE (Sulfonureas)
  • REPAGLINIDE (Katp channel secretagogue)
  • PIOGLITAZONE (TZDs)
  • EXANATIDE (GLP-1 Mimetic, incretin)
  • CANAGLIFLOZIN (SGLT-2 block)
  • ACARBOSE (A-Glucosidase block)
A
  • METFORMIN = Liver, Muscle
  • GLIPIZIDE =
  • REPAGLINIDE (Katp channel secretagogue) = Pancreas
  • PIOGLITAZONE = Fat, Muscle
  • EXANATIDE (GLP-1 Mimetic, incretin)
  • CANAGLIFLOZIN = renal
  • ACARBOSE = Intestine carbs
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16
Q

Exanatide

A 
DM II - GLP-1 MIMETIC- INCRETIN
*up cAMP
*INJECT
*UP glucose dependent INSULIN SECRETION
*DOWN gastric emptying/UP satiety
*Weight loss
S.E. = N/V/Diarrhea, UP hyploglycemia w/ secretagogues

Pharm 2 Test 2 (5 decks)

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