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old Sophomore cards > Antidiabetic Meds > Flashcards

Antidiabetic Meds Flashcards

0
Q

What predisposes individuals by destroying the beta cells leading to type 1 DM

A

Toxins and viruses

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1
Q

Is a contributing factor to the development of cardiovascular disease, hypertension, renal failure, blindness and stroke.

A

Diabetes Mallory’s

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2
Q

An autoimmune disorder in which beta cells of the pancreas are destroyed in a genetically susceptible person

A

Type 1 DM

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3
Q

NO insulin is produced

A

Type 1 DM

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4
Q

10% of diabetes population, occurs in childhood of adolescence mostly, causes or to be thin and underweight

A

Type 1

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5
Q

What can lead to ketoacidosis?

A

Type 1

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6
Q

A metabolic disease that results from either the loss of receptor sensitivity to insulin, poor control of liver glucose output, and decreased beta cell function

A

Type 2 DM

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7
Q

More frequent among obese, represents 90% of diabetic population, usually in middle age, older adults.

A

Type 2 DM

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8
Q

Insulin resistant: decreased ability to respond to insulin, increased hepatic glucose production

A

Type 2 DM

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9
Q

Glucose intolerance with onset or first recognition during pregnancy.

A

Gestational diabetes mellitus

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10
Q

What is gestational DM diagnoses based on?

A

OGTT/ 100-g oral glucose tolerance test

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11
Q

What population is most affected by diabetes?

A

African American, American Indian, and Hispanic.

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12
Q

Level of glycosylated hemoglobin (HbA1c) to be diabetes

A

> /= 6.5%

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13
Q

Level of fasting plasma glucose to be diabetes

A

> 126mg/dL

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14
Q

2-hr plasma glucose to be diabetes

A

> 200 mg/dL post 75-g oral glucose challenge

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15
Q

Random plasma glucose level for diabetes

A

> 200 mg/dL with symptoms of diabetes (polyuria, polyphagia, and polydipsia)

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16
Q

Biguanide class

A

Glucophage (metformin) and glucophage XR

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17
Q

Glucophage (metformin)

A

2-3 times a day

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18
Q

What lowers A1c by 1-2% and decreases glucose production

A

Metformin (glucophage)

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19
Q

Is weight neutral or weight loss and is FIRST line of therapy after diet and exercise

A

Metformin

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20
Q

Has GI side effects, transient, start slow then increase, take with food to decease GI effects

A

Metformin

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21
Q

What should be discontinued when having general anesthesia or procedure with contrast dye?

A

Glucophage (don’t restart for 48-72 hours until serum creatinine is documented)

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22
Q

1st generation sulfonlyureas

A

Orinase and diabenese

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23
Q

2nd generation sulfonlyureas

A

Glucotrol, glynase, diabeta

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24
Q

Tends to have fewer side effects but are more predictable and expensive

A

2nd generation sulfonlyureas

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25
Q

3rd generation sulfonlyureas

A

Amaryllis

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26
Q

Main site of action for sulfonlyureas

A

Pancreas (stimulates beta cell production by pancreas)

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27
Q

Side effects of sulfonlyureas

A

Hypoglycemia and weight gain

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28
Q

Lowers A1c by 1-2% and stimulates insulin production

A

Sulfonlyureas

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29
Q

Meglitinides

A

Prandin (repaglinide) and starlix

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30
Q

Meglitinides main site if action

A

Pancreas (stimulates pancreas to produce more insulin)

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31
Q

Side effects of meglitinides

A

Hypoglycemia and weight gain

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32
Q

Onset more rapid than sulfonlyureas and duration shorter

A

Meglitinides

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33
Q

Take only with meals!

A

Meglitinides

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34
Q

Lowers A1c by 1-1.5% and targets pp glucose to mimic insulin secretion, must be taken 15- 20 min before each meal

A

Meglitinides

35
Q

Alpha glucosidase inhibitor

A

Precose (acarbose) glyset (migitol)

36
Q

Main site of action of alpha glucosidase inhibitors

A

Small intestine (slows digestion of starchy food in small intestine so absorption of sugar into blood is delayed helping prevent surge of it)

37
Q

Side effects if alpha glucosidase inhibitors

A

Flatulence, diarrhea, abdominal discomfort

38
Q

Thiazolidinediones

A

Actos (pioglitazone) and Avandia (rosiglitazone)

39
Q

Main site of action for thiazolidibediones

A

Peripheral tissues (increases sensitivity of peripheral tissues to insulin, thus improving glucose control)

40
Q

Side effects of thiazolidinediones

A

Weight gain (increase intravascular volume so may not be used in patients with CHF)

41
Q

Lowers A1c 1-1.5%, insulin sensitizer, edema, may have connection to bladder cancer

A

TZDs (actis and Avandia)

42
Q

What function must be monitored for TZDs?

A

Liver

43
Q

DPP4

A

Januvia, onglyza, trajenta –DPP-4 inhibitor

44
Q

Increases insulin made in pancreas and decreases glucose produced by liver

A

DPP4

45
Q

Lowers A1c by 0.5-1.0%, increases glucose-dependent insulin release and suppresses glucagon secretion.

A

DPP4 inhibitor

46
Q

Weight neutral, oral, nausea and pancreatitis reported

A

DPP4

47
Q

Metabolized in liver and excreted thru kidney

A

DPP4

48
Q

Bike acid sequestrant

A

Welch ok

49
Q

Now indicated for treatment of type 2 diabetes, lowers A1c 0.5-1%, clean drug, rare side effects

A

Bike acid sequestrant

50
Q

Also treats cholesterol, take 2 tabs x3 a day, constipation side effect

A

Bile acid sequestrant

51
Q

GLP

A

Byetta, Victoza, pre filled injectable pens

52
Q

Injectable med for type 2 but NOT and insulin, inject twice a day within 60 min of bfast and dinner

A

Byetta

53
Q

Inject once daily

A

Victoza

54
Q

Signals pancreas to make right amount of insulin after eating. Decreases glucose production by liver, reduces appetite

A

GLP - 1

55
Q

Side effects of GLP-1

A

Nausea and vomiting, take within 1 hour of eating

56
Q

Natural hormone released from small intestine, 1-1.5% A1c lowering, inhibits hepatic glucose production

A

GLP1- receptor agonist, Victoza

57
Q

For type 1 and 2 who don’t have good control with insulin

A

Smylin

58
Q

Amylin mimetics

A

Smylin (pramlintide)

59
Q

Hormone secreted by beta cells of pancreas which carry glucose from bloodstream into cells binding to receptors on the cell membrane allowing glucose to make energy

A

Insulin

60
Q

Controls glucose in between meals and suppresses overnight hepatic glucose production, background insulin

A

Basal insulin

61
Q

Controls post- prandial glucose spikes or correct hyperglycemia, covers amount of food eaten

A

Prandial insulin or bolts insulin

62
Q

Rapid acting insulin U-100

A

Humalog, novolog, apidra

63
Q

Short acting insulin U-100

A

Regular

64
Q

Intermediate acting insulin

A

NPH

65
Q

Long acting insulin

A

Lantus and Levemir

66
Q

Combination

A

Human 70/30, novolog mix 70/30, humalog mix 75/25, humalog mix 50/50

67
Q

What can you not mix with other insulin?

A

Lantus and Levemir

68
Q

Basal insulin

A

NPH and glargine (lantus) and detemir (Levemir) daily or BID

69
Q

Prandial or Bolus insulin

A

Rapid acting insulin analogue or regular

70
Q

Onset, peak, and duration of NPH (intermediate)

A

Onset: 1-3 hours
Peak: 4-10 hours
Duration: 10-18 hours (12 mostly)

71
Q

Lantus and Levemir peak, onset and duration

A

Virtually peak less
Onset: 1 hour
Duration: 24 hours

72
Q

Why don’t you mix lantus and Levemir with other insulin?

A

They can crystallize

73
Q

Regular (short acting) onset, peak, and duration

A

Onset: 30 min to 1 hour

74
Q

What is being used more in insulin pump

A

U-500 R, 5X stronger than regular insulin

75
Q

Onset, peak, and duration or rapid acting insulin

A

Onset: 10-15 min
Peak: 1-2 hours
Duration: 3-5 hours

76
Q

Must be given no more then 15 min before eating but can be given immediately after meals

A

Rapid-acting

77
Q

Human 70/30 and human 50/50 onset peak and duration

A

Onset: 30 min to 1 hour

78
Q

Humalog 75/25 and humalog 50/50 onset peak and duration

A

Onset: 10-15 min
Peak: 1-3 hours
Duration: 10-16 hours

79
Q

Novolog 70/30 onset peak and duration

A

Onset 10-20 min
Peak 1-4 hours
Duration 10-16 hours

80
Q

Availability of insulin

A

All available in 10cc vials of U-100

81
Q

Expiration of insulin

A

Good for 30 days once opened or until expiration date if never opened and refrigerated

82
Q

What to teach

A

Insulin type, technique, response, storage, and complications

83
Q

Spongy swelling at it around injection site, need to rotate sites to prevent

A

Lipodystrophy/lipohypertrophic

84
Q

Loss of subcutaneous fat in areas of repeated injection, need to rotate sites to prevent

A

Lipoatrophy

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