Diabetes

Question 1

Metformin

Answer 1

MOA: AMPK in Skel (raise glut4 to incrase sensitivity) and Hepa (lower gluconeogenisi)
Use: 1st line, no hypo, PCOS, High efficaciy 1.5
AD: GI, lower b12, lactic acid
Notes: Need to take with food, renal, liver, HF, Hemo beware

Question 2

-Glitazone

Answer 2

MOA: PPAR𝛾 agonist nuclear gene transcription (works on fat, skm (GLUT4), Hepa)
Use: Medium eff 1.5, no hypo, lower TG and raise HDL-C
AD: hepatoxic, edema, weight gain, bone desnity, bladder cancer with piog
Notes: monitor LFTS and is slow
C: HF, liver, bone, baldder cancer

Question 3

1st gen Gli and Gly
2nd gen -Glines

Answer 3

MOA: Binds ATP in B cells ( k channels close and activate Ca to increase Insuilin) Pacreas
Use: High efficacy, CANT USE IN T1DM
AD: hypo, weight gain
Notesincrease indepent of plasma glucose

Question 4

natide/glutade

Answer 4

MOA: GLP-1 receptor
use: high efficacy, weight lose, lower CV only for liraglutide
AD: GI
notes: off label T1DM use
Dose: SC
C: thyriod cancer and pacreatitis

Question 5

-gliptin

Answer 5

MOA: Inhibit DPP-4 on Endothelium raise G1P - B cells
Use: low efficacy, no Hypo
AD: respiratory infections, angioedema, rash, joint pain
C: HF

Question 6

-gliflozin

Answer 6

MOA: SGLT2 in proximal tube
Use: T1D off use low efficacy, weightloss, Diabetic neuropathy, CV and BP down
AD: UTI, euglycemia DKA, Canagliflozin amputation, hypotenstion AKI

Question 7

Insulin Doses

Answer 7

Question 8

Bolus Dosing

Answer 8

1. taking set amount U6 per meal
2. Carb dependent U1 per 15g