Diabetes Flashcards
What is the mechanism of action of sulfonylureas?
stimulate beta cells in the pancreas to make more insulin which is released directly to the liver via the portal veins.
How do Biguanides work?
(metformin, phenoformin) Shut off the livers excess glucose production. Helps lower the blood sugar, especially after eating with no risk of hypoglycemia when taken alone.
How do Alpha-Glucosidase Inhibitors work?
slow the absorption of complex carbohydrates in the intestine. This greatly reduces the spikes in blood sugar that can be seen after meals as well as fasting blood sugar.
How do Thiazolidinediones work?
Increase the body’s sensitivity to insulin
How do Meglitinides work?
Stimulate the pancreas to make more insulin
How do Incretin Mimetics work?
New class of DM type 2 drugs that “mimic” the effect of naturally occurring hormones from the intestine and can help the body make more of its own insulin
What are the side effects of sulfonylureas?
low blood sugar (mild), bloating, nausea, heartburn, anemia, weight gain metallic or change in taste (1-3%)
What are the contraindication for sulfonylureas?
Type 1 diabetes, advanced liver or kidney disease, sulfa allergy
What are some drug interactions with sulfonylureas?
Drinking alcohol, steroids, beta blockers, niacin, and Retin-A
What are two types of biguanides?
Metformin and phenoformin
What are contraindications of sufonylureas?
Type 1 DM
Advanced liver or kidney disease
sulfa alergy
What should people who aretaking insulin do once they start taking metformin?
Reduce their insulin levels. Since you don’t have as high of glucose levels, you need less insulin to regulate it.
What is the purpose of rapid insulin releasers?
to control blood sugar post-prandially.
What are two examples of alpha-glucosidase inhibitors?
Precose and Glyset
What are two examples of rapid insulin releasers?
Prandin and Starlix
Rapid insulin releasers enhance insulin release from pancreas over _____ period of time only when the glucose level it _____.
Short
High
What are the drug interactions for Metformin?
alcohol and tagamet
What is an example of an incretin mimetic?
Byetta
What components are released from the liver and used in exercise metabolism?
Glycogen and triglyceride stores, free fatty acids (FFAs), and glucose (glu)
What are some contraindication for Aplha-glucosidase inhibitors?
Liver disease, bowel or intestinal disease, intestinal obstruction
What consideration is important at the site of insulin injection with exercise?
avoid exercise at the site until the duration of action for that insulin injection is over
Short acting insulins are given for what purpose?
To regulate blood sugars when eating
Injected insulin provides basal coverage for what purpose?
to keep fasting blood sugar at good level.
T or F: Rapid insulin releasers are never coupled with basil insulin to improve control.
False! They are often coupled for improved control
Which type of patients is not given Metformin?
women w/ creatinines 1.3 or higher or men w/ creatinines 1.4 or higher due to fear about rare but fatal lactic acidosis
What should people who aretaking insulin do once they start taking metformin?
Reduce their insulin levels. Since you don’t have as high of glucose levels, you need less insulin to regulate it.
What are some side effects from Metformin?
change in taste, loss of appetite, nausea and vomiting, abdominal bloating or gas, diarrhea or skin rash. Seldom long lasting
What is lactic acidosis? What are the warning signs?
buildup of lactic acid occurs due to an inability to clear metformin from the system. fast and shallow breathing, diarrhea, severe muscle aches, cramping, unusual weakness or tiredness, or feeling cold.
What is the mortality rate of lactic acidosis?
~40%
What are the contraindications for metformin?
Those who “use” more than 2 oz or two drinks of alcohol a day, who have congestive heart failure, or who have significant kidney, liver or lung disease
What are the drug interactions for Metformin?
alcohol and tagamet
What are two types of Alpha-glucosidase inhibitors?
Precose and Glyset
What are the side effects of Alpha-glucosidase inhibitors?
Precose and Glyset may cause bloating, nausea, diarrhea, excess gas, abdominal pain
What are some contraindication for Aplha-glucosidase inhibitors?
Liver disease, bowel or intestinal disease, intestinal obstruction
