Antidiabetic Drugs Flashcards
1
Q
Nasal/bolus insulin dose
A
Diabetes mellitus the routine of taking a long acting insulin to keep blood glucose levels stable during fasting periods and shorter acting insulin to prevent rises in blood glucose after meals
2
Q
Diabetes mellitus
A
Disease in which insulin doesn’t help glucose enter the cell
3
Q
Diabetic ketoacidosis (DKA)
A
Life threatening deficiency of insulin, resulting in severe hyperglycemia and excessively high levels of ketones in the blood
4
Q
Glucagon
A
Hormone secreted by the alpha cells of the pancreas that increase the concentration of glucose in the blood
5
Q
Glucometer
A
Device to monitor blood glucose level
6
Q
Glycoslated hemoglobin
A
Blood test that monitors average blood glucose level over a 3-4 month period
7
Q
Incretin hormones
A
Hormones that stimulate an increase of insulin from the beta cells of the pancreas, they slow gastric emptying and inhibit glucagon release
8
Q
Lipodystrophy
A
Atrophy of subcutaneous fat
9
Q
Polydipsia
A
Excessive thirst
10
Q
Polyphagia
A
Eating large amounts of food
11
Q
Polyuria
A
Increased urination
12
Q
Prediabetes
A
A conviction of blood glucose higher than normal, yet not to a diabetic level as evidence by an impaired glucose tolerance/fasting glucose, or metabolic syndrome
13
Q
How does insulin affect blood glucose levels
A
Insulin insufficiency results in elevated blood glucose levels
14
Q
Major symptoms of type 1 and type 2 diabetes
A
Hyperglycemia, polydipsia, polyphagia, polyuria, and weight loss
15
Q
Insulin onset
A
When insulin first begins to act in the body
16
Q
Insulin peak
A
When the insulin is exerting maximum action
17
Q
Insulin duration
A
The length of time the insulin remains in effect
18
Q
Insulin MOA
A
Helps glucose molecules enter the cells of striated muscle and adipose tissue , stimulates the synthesis of glycogen by the liver and promotes protein synthesis and helps the body store fat by preventing its breakdown for energy
19
Q
Insulin analogs ex
A
Lispro, aspart, and glulisine
20
Q
Insulin analogs use
A
Fast onset, slow release, long duration: used for premeal coverage, Constance administration in an insulin pump, or basal insulin administration
21
Q
Glargine MOA
A
Very slow and even release into bloodstream, so it doesn’t have a peak action
22
Q
Insulin products use
A
Replace insulin hormone in type 1 diabetes, supplement insulin production of type 2 diabetes when uncontrolled by TLCs or other antidiabetics, treat severe diabetic ketoacidosis, diabetic coma, hypokalemia in combination with glucose
23
Q
Insulin products side effects
A
Hypoglycemia, and hyperglycemia
24
Q
When does hypoglycemia occur
A
Too much insulin in relation to glucose, can occur when they eat too little food or go too loony between meals, drastically increased demands (activity or illness), too much insulin is given
25
When does hyperglycemia occur
Too little insulin in comparison to glucose, can occur when they eat too much food, too little insulin is given, emotional stress, infection, surgery, pregnancy, or an acute illness
26
How can someone become insulin resistant
When antibodies develop against insulin, these patients have impaired receptor function and require much higher doses
27
Hypoglycemia signs
Sudden onset, blood glucose less than 60 mg/dL, fatigue, weakness, nervousness, agitation, confusion, diplopia, convulsions, dizziness, unconsciousness, rapid and shallow breathing, hunger, nausea, pale, moist and cool skin, numbness, tingling of lips or tongue
28
Hyperglycemia signs
Gradual onset, blood glucose higher than 200 mg/dL, drowsiness, dim vision, deep and rapid breaths, thirst, nausea, vomiting, abdominal pain, loss of appetite, dry, flushed and warm skin, rapid and weak pulse, and acetone breath and excessive urination
29
Insulin products contraindications
Hypoglycemic
30
Insulin precautions
Renal or hepatic impairment, pregnancy (cat B) and lactation
31
Glargine pregnancy cat
C
32
Aspart pregnancy cat
C
33
Insulin pregnancy considerations
Dose decrease in 1st trimester, increases in 2nd and 3rd trimester, and decrease fast after delivery, and pregnant women should have good metabolic control
34
Drugs that decrease the effect of insulin
Acetazolamide, albuterol, antipsychotics (atypical), asparaginase, calcitonin, oral contraceptives, corticosteroids, cyclophosphamide, danazol, dilatásemos, diuretics, dobutamine, epinephrine, estrogens, glucagon, HIV antivirals, isoniazid, lithium, morphine, niacin, nicotine, phenothiazines, phenytoin, progestogens, protease inhibitors, somatropin, terbutaline, thyroid hormones
35
Drugs that increase the effect of insulin
ACE inhibitors, alcohol, anabolic steroids, oral antidiabetics, beta blockers, calcium, clonidine, disopyramide, fluoxetine, fibrates, lithium, mebendazole, pentamidine, pentoxifylline, pyridoxine, salicylates, somastatin analog, tetracycline
36
Oral antidiabetic drugs use
Used with insulin with type 2 diabetes, and won’t help type 1 diabetes
37
Biguanides MOA
Sensitized the liver to circulating insulin levels, reduces intestinal glucose absorption, and reduces hepatic glucose production
38
Biguanides use
1st choice for initial type 2 diabetes, and usually started alone, they don’t increase insulin levels or cause weight gain
39
Biguanides ex
Metformin
40
Metformin side effects
When taken with insulin, it can cause hypoglycemia, and other side effects include nausea, vomiting, diarrhea, and increased flatulence, (usually taken with food to minimize GI reactions)
41
Metformin contraindications
Poor kidney function, people older than 80, and pregnancy (cat B) and lactation, and temporarily discontinued for surgical procedures
42
Metformin interactions
Contrast medium (in radiologic studies) can cause acute kidney failure, vitamin B12 malabsorption, increased whisk for lactic acidosis with glucocorticoids
43
Lactic acidosis symptoms
Malaise, abdominal pain, rapid respirations, shortness of breath, and muscular pain. Cardiovascular collapse can happen if not treated
44
Glucagon-like peptide 1 Agonists MOA
Injectable, mimic the incretin hormone, GLP-1, which stimulates insulin release when a person eats
45
Glucagon like peptide 1 Agonists ex
Albiglutide, dulaglutide, and exenatide, liraglutide
46
Glucagon like peptide 1 Agonists
Type 2 diabetes
47
Liraglutide use
Chronic weight management of those with a BMI greater than 27, who also have hypertension or dyslipidemia
48
Glucagon like peptide 1 Agonists side effects
Diarrhea, nausea, vomiting, heartburn, local irritation at injection sites
49
Exenatide side effects
Headaches
50
Liraglutide side effects
Headaches
51
GLP-1 contraindications
Personal or family history of thyroid or other endocrine disorders, type 1 diabetes, DKA,
52
GLP-1s interactions
Androgens, insulin’s, pegvisomant can cause blood glucose levels to lower, and elevated blood glucose levels can occur with corticosteroids, danazol, luteinizing hormones, and thiazide diuretics, effectiveness of oral contraceptives is reduced, and bleeding is prolonged with vitamin K
53
Albiglutide pregnancy cat
C, and should be stopped 1 month prior to pregnancy
54
Sodium glucose linked transporter 2 inhibitors MOA
decreases the amount of Glucose that is reabsorbed in the kidney
55
SLGT-2 inhibitors use
Type 2 diabetes,
56
SGLT-2 inhibitors side effects
Drop in the HbA1C weight, and systolic blood pressure, reduction in LDL, yeast infections, hypotension, and Hyperkalemia
57
SGLT-2 inhibitors contraindications
End stage kidney disease, dialysis, pregnancy (cat C)
58
SGLT-2 inhibitors interactions
Canagliflozin and dapagliflozin increase diuresis, and can cause dehydration, ACE inhibitors, ARBs, and potassium sparing diuretics increase risk of Hyperkalemia,
59
Dipeptidyl peptidase-4 inhibitors MOA
Lower the blood glucose of those with type 2 diabetes by enhancing the secretion of incretin hormone, reducing glucagon
60
Dipeptidyl peptidase 4 inhibitors use
Type 2 diabetes
61
Dipeptidyl peptidase 4 inhibitors side effects
Headare, upper respiratory tract infections (nasopharyngitis)
62
Dipeptidyl peptidase 4 inhibitors contraindications
DKA, type 1 diabetes,
63
Dipeptidyl peptidase 4 inhibitors precautions
Chronic kidney disease or in elderly, pregnancy (cat B), and lactation
64
Thiazolidinediones MOA
Inhibit gluconeogenesis (formation of glucose from glycogen), HbA1C lowers
65
TZD use
Type 2 diabetes
66
TZDs side effects
Upper respiratory infections, sinusitis, headache, pharyngitis, myalgia, diarrhea, and back pain. Weight gain and hypoglycemia occur with combination therapy
67
TZDs contraindications
Symptomatic heart failure, type 1 diabetes,
68
Rosiglitazone contraindications
Shouldnt be used in combination therapy with insulin,
69
TZDs precautions
Edema, cardiovascular disease, liver or kidney disease, pregnancy (cat C)
70
What to monitor with TZDs
Men and women for bone fractures, especially in the upper limbs
71
TZD interactions
Decreased effectiveness of oral contraceptives
72
Alpha glucosidase inhibitors ex
Acarbose, miglitol
73
Alpha glucosidase inhibitors use
Prevent after meal surge in blood glucose levels
74
Alpha glucosidase inhibitors MOA
Delaying the digestion absorption of carbs in the intestine
75
Alpha glucosidase inhibtors side effects
Bloating, flatulence, diarrhea (increasing dose should be done slowly)
76
Alpha glucosidase inhibitors side effects nature
Unpleasant and not well tolerated (use in the US is limited)
77
Alpha glucosidase inhibitors contraindications
Pre existing GI problems, DKA, cirrhosis,
78
Alpha glucosidase inhibitors precautions
Pregnancy (cat B), lactation
79
Acarbose precautions
Renal impairment
80
Miglitol precautions
Renal impairment
81
Miglitol interactions
Digestive enzymes reduce miglitol effect
82
Amylinomimetic MOA
Mimics the endogenous mauling effects by delaying gastric emptying, decreasing glucagon release, and decreasing appetite
83
Amylinomimetc use
Reduce blood glucose levels and reduce weight (type 2 diabetes)
84
Amylinomimetics side effects
Nausea, vomiting, decreased appetite, abdominal pain, headache, injection site irritation, and hypoglycemia
85
Amylinomimetics contraindications
```
Problems with stomach emptying, shouldn’t be taken with drugs that slow
GI motility (alpha glucosidase inhibitors)
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86
Amylinomimetics precautions
Pregnancy (cat C), and lactation
87
Pramlintide interactions
Will delay onset of action when taken with an oral antidiabetic, and can cause severe hypoglycemic reactions in people with type 1 diabetes when taken with insulin
88
Sulfonylureas use
Lower blood glucose
89
Sulfonylureas MOA
Stimulate the beta cells of the pancreas to release insulin
90
Sulfonylureas side effects
Hypoglycemia, anorexia, nausea, vomiting, epigastric discomfort, weight gain, heartburn, weakness, numbness of the extremity
91
Sulfonylureas: what is most commonly used
2nd and 3rd generation
92
1st generation sulfonylureas contraindications
Coronary artery disease, liver or renal dysfunction
93
First generation sulfonylureas ex
Chlorpropamide, tolazamide, tolbutamide
94
Sulfonylureas precautions
Impaired liver function, renal impairment and severe cardiovascular disease, risk for cross sensitivity with sulfonamides
95
Sulfonylureas interactions
Increased hypoglycemic effect with anticoagulants, clofibrate, fluconazole, histamine H2 antagonists, MAOIs, NSAIDs, salicylates, sulfonamides, and TCAs. Hypoglycemic effect will decrease with beta blockers, CCBs, cholestyramine, corticosteroids, estrogens, hydantoins, isoniazid, oral contraceptives, phenothiazines, rifampin, thiazide diuretics, and thyroid agents
96
Meglitinides Use
Lower blood glucose levels
97
Meglitinides MOA
Stimulate the release of insulin form the pancreas, have very rapid action and short duration, so must be taken 3 times a day
98
Meglitinides side effects
Upper respiratory tract infection, headache, rhinitis, bronchitis, headache, back pain, hypoglycemia
99
Meglitinides interactions
Corticosteroids, carbamazepine, and rifampin decrease hypoglycemic effect, and debilitated, malnourished and elderly are more sensitive to hypoglycemic effects
100
Meglitinides precautions
Pregnancy (cat C) And lactation
101
Colesevelam use
Adjunctive therapy to improve glycemic control in adults with type 2 diabetes
102
Bromocriptine
| use
Normalize blood glucose patients with insulin resistance
103
Bromocriptine MOA
Acts on circadian neuronal activities and may help regulate the hypothalamus
104
Rapid acting insulin ex
Regular insulin, aspart, glulisine, lispro
105
Intermediate acting insulin ex
Isophane insulin suspension
106
Long acting insulin’s ex
Insulin degludec, insulin detemir, insulin glargine
107
Biguanides ex
Metformin
108
GLP-1 Agonists ex
Albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide
109
SLGT-2 inhibitors ex
Canagliflozin, dapagliflozin, empagliflozin,
110
Dipeptidyl peptidase 4 inhibitors ex
Alogliptin, sitagliptin, linagliptin, saxagliptin,
111
TZD ex
Pioglitazone, rosiglitazone
112
Alpha glucosidase inhibitors ex
Acarbose, miglitol
113
Amylinomimetics ex
Pramlintide
114
3rd generation sulfonylureas ex
Glimepiride
115
2nd generation sulfonylureas ex
Glipizide. Glyburide
116
Meglitinides ex
Nateglinide, repaglinide
117
Glucose elevating agents ex
Diazoxide. Glucagon
