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Pharmacology > Diabetes 3 > Flashcards

Diabetes 3 Flashcards

1
Q

What drugs are part of the biguanides class

A

glucophage, Riomet, glucophage XL, Glumetza (metformin)

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2
Q

what is the MOA for biguanides

A

inhibits hepatic glucose production and increases insulin sensitivity to peripheral tissue

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3
Q

How much will biguanides lowers your A1C?

A

1.5-2%

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4
Q

what are side effects of biguanides

A

GI (diarrhea) take with meals
lactic acidosis
Vitamin B12 def
WEIGHT LOSS

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5
Q

when is biguanides contraindicated

A

women with Cr>or= 1.4
men Cr>or=1.5
must be put on hold before or after a CAT- scan dye

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6
Q

What drug are sulfonylureas

A

glimepiride
glipizide
glyburide
Typically dosed 1-2 x a day

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7
Q

What is the MOA of sulfonylureas

A

increase insulin production from beta cells in panreas

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8
Q

what is a problem with the sulfonyl ureas in regards to their time of use

A

after 3-5 years there is a reduction in the benefit due to loss of beta cell function

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9
Q

how much will sulfonylureas lowers your A1C

A

1-2%

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10
Q

which sulfonylurea should you use if you have renal issues

A

glipizide

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11
Q

what are the side effects with sulfonylreas

A

hypoglycemia
weight gain
cant be used with people who have sulfa allergy

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12
Q

what drugs are part of the meglitinides?

A

nateglinide

repaglinide

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13
Q

what is the MOA of meglitinides?

A

increase insulin production from beta cell in pancreas

bind to different receptors than sulfonylureas

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14
Q

what is the problem with meglitindes and their length of use?

A

after 3-5 years there is a reduction in benefit due to loss of beta cell function

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15
Q

how much will meglitinides reduce your A1C?

A

0.5-2%

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16
Q

what are the side effects of meglitinides

A

less hypoglycemia than sulfonylureas

less weight gain than sulfonylureas

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17
Q

what is the major drawback with meglitinides

A

they are more costly than sulfonyl ureas

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18
Q

what drugs are part of the TZD drug class

A

rosiglitizone
pioglitizone
takes up to 8 weeks to act

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19
Q

what is the MOA of TZDs

A

PPAR agonist
increase insulin-dependent glucose disposal and decrease hepatic glucose output by decreasing insulin resistance in periphery and liver

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20
Q

how much will TZDs reduce your A1C

A

0.5-1%

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21
Q

what are the side effects with TZDs

A

weight gain
Edema
Increased ovulation
Hepatic dysfuntion

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22
Q

what is a major side effect with rosiglitizone (avandia)

A

increase likelihood of MI and negative lipid effects

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23
Q

what are the positive effects of pioglitizone? Pio=Pee

A

positive effects on lipids but increase risk of bladder cancer

24
Q

when are TZDs contraindicated?

A

stage 3 or 4 heart failure
liver disease
ALT>2.5xnormal

25
Q

what drugs are part of the Alpha glucosidase inhibitors

A

miglitol

acarbose

26
Q

what are Alpha glucosidase inhibitors MOA

A

inhibit enzyme that hydrolyze complex starches and sugars into readily absorbable molecules, delays glucose absorption

27
Q

when is a good time to use Alpha glucosidase inhibitors class of meds

A

high post prandial glucose values

28
Q

how much will alpha glucosidase inhibitor reduce A1C?

A

0.5-1%

29
Q

what are the side effects with alpha glucosidase inhibitors?

A

GI-flatulence, diarrhea

hypoglycemia

30
Q

when are alpha glucosidase inhibitors contraidicated

A

GI problems

increased bowel perforation

31
Q

what drugs are part of the DPP-IV inhibitors?

A

sitagliptin
saxagliptin
linagliptin
alogliptin

32
Q

what is the MOA of DDP-IV inhibitors

A

they block DPP-4 and decrease glucose

33
Q

how much will DPP-IV reduce A1C

A

0.4-0.85%

34
Q

what is so great about using linagliptin

A

only needs to be dosed once daily

35
Q

what are the side effects of DPP-IV inhibitors

A

headache
URI
weigh loss/neutral

36
Q

what is the precautions with DPP-IV inhibitors

A

pancreatitis

37
Q

what drugs are part of the GLP-1 analog

A

exenatide
XR exenatide
liraglutide

38
Q

what is the MOA of GLP- analogs

A

stimulates insulin release and inhibits glucagon release

39
Q

when should you use a GLP-1 analog

A

in type 2 DM on metformin, sulfonylureas, TZDs or combo of them

40
Q

how much will GLP-1 analog reduce A1C

A

1-1.5%

41
Q

how are GLP-1 analog administered

A

injected in abdomen

42
Q

what is so special about liraglutide?

A

one daily injection and do not need to time with meals

43
Q

How is exenatide give

A

2 daily injections 1 hour before meal and no closer than 6 hours to next dose

44
Q

how often is XR exenatide give

A

once weekly

45
Q

what are the side effects of GLP-1 analog

A

GI upset
hypoglycemia
weight loss

46
Q

what is the blackbox warning with liraglutide?

A

can cause thyroid cancer

think Liars uses their vocal cords to lie to you which is near your thyroid

47
Q

what are precautions with the GLP-1 analog

A

take antibiotics and birth control pill 1 hour apart before injection

48
Q

what drug are part of the amylin analogs

A

symlin (pramlintide)

49
Q

what is the MOA with amylin analogs

A

regulates post prandial glycemia

50
Q

who can you use amylin with

A

Type 1 or 2

51
Q

how much will amylin reduce your A1C

A

0.3-0.6%

52
Q

what do you need to do with amylin analogs with pre-prandial insulin

A

reduce by 50%

53
Q

what are the side effects with amylin analogs

A

GI
headache
wight loss/neutral
hypoglycemia

54
Q

who should be excluded from using amylin analog

A 
poor compliance with current insulin
poor blood glucose monitoring
A1C>9%!!!!!!
recurrecnt severe hypoglycemia
hypoglycemia unwareness
pedis patients
55
Q

which receptors do DM have more of

A

SGLT-2

56
Q

how much will glucose will be lost with SGLT inhibitors

A

200-300k/cal

Pharmacology (7 decks)

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