Diabetes 3

Question 1

What drugs are part of the biguanides class

Answer 1

glucophage, Riomet, glucophage XL, Glumetza (metformin)

Question 2

what is the MOA for biguanides

Answer 2

inhibits hepatic glucose production and increases insulin sensitivity to peripheral tissue

Question 3

How much will biguanides lowers your A1C?

Answer 3

1.5-2%

Question 4

what are side effects of biguanides

Answer 4

GI (diarrhea) take with mealslactic acidosisVitamin B12 defWEIGHT LOSS

Question 5

when is biguanides contraindicated

Answer 5

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

Question 6

What drug are sulfonylureas

Answer 6

glimepirideglipizideglyburideTypically dosed 1-2 x a day

Question 7

What is the MOA of sulfonylureas

Answer 7

increase insulin production from beta cells in panreas

Question 8

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

Answer 8

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

Question 9

how much will sulfonylureas lowers your A1C

Answer 9

1-2%

Question 10

which sulfonylurea should you use if you have renal issues

Answer 10

glipizide

Question 11

what are the side effects with sulfonylreas

Answer 11

hypoglycemiaweight gaincant be used with people who have sulfa allergy

Question 12

what drugs are part of the meglitinides?

Answer 12

nategliniderepaglinide

Question 13

what is the MOA of meglitinides?

Answer 13

increase insulin production from beta cell in pancreasbind to different receptors than sulfonylureas

Question 14

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

Answer 14

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

Question 15

how much will meglitinides reduce your A1C?

Answer 15

0.5-2%

Question 16

what are the side effects of meglitinides

Answer 16

less hypoglycemia than sulfonylureasless weight gain than sulfonylureas

Question 17

what is the major drawback with meglitinides

Answer 17

they are more costly than sulfonyl ureas

Question 18

what drugs are part of the TZD drug class

Answer 18

rosiglitizonepioglitizonetakes up to 8 weeks to act

Question 19

what is the MOA of TZDs

Answer 19

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

Question 20

how much will TZDs reduce your A1C

Answer 20

0.5-1%

Question 21

what are the side effects with TZDs

Answer 21

weight gainEdemaIncreased ovulationHepatic dysfuntion

Question 22

what is a major side effect with rosiglitizone (avandia)

Answer 22

increase likelihood of MI and negative lipid effects

Question 23

what are the positive effects of pioglitizone? Pio=Pee

Answer 23

positive effects on lipids but increase risk of bladder cancer

Question 24

when are TZDs contraindicated?

Answer 24

stage 3 or 4 heart failureliver disease ALT>2.5xnormal

Question 25

what drugs are part of the Alpha glucosidase inhibitors

Answer 25

miglitolacarbose

Question 26

what are Alpha glucosidase inhibitors MOA

Answer 26

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

Question 27

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

Answer 27

high post prandial glucose values

Question 28

how much will alpha glucosidase inhibitor reduce A1C?

Answer 28

0.5-1%

Question 29

what are the side effects with alpha glucosidase inhibitors?

Answer 29

GI-flatulence, diarrheahypoglycemia

Question 30

when are alpha glucosidase inhibitors contraidicated

Answer 30

GI problemsincreased bowel perforation

Question 31

what drugs are part of the DPP-IV inhibitors?

Answer 31

sitagliptinsaxagliptinlinagliptinalogliptin

Question 32

what is the MOA of DDP-IV inhibitors

Answer 32

they block DPP-4 and decrease glucose

Question 33

how much will DPP-IV reduce A1C

Answer 33

0.4-0.85%

Question 34

what is so great about using linagliptin

Answer 34

only needs to be dosed once daily

Question 35

what are the side effects of DPP-IV inhibitors

Answer 35

headacheURIweigh loss/neutral

Question 36

what is the precautions with DPP-IV inhibitors

Answer 36

pancreatitis

Question 37

what drugs are part of the GLP-1 analog

Answer 37

exenatideXR exenatideliraglutide

Question 38

what is the MOA of GLP- analogs

Answer 38

stimulates insulin release and inhibits glucagon release

Question 39

when should you use a GLP-1 analog

Answer 39

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

Question 40

how much will GLP-1 analog reduce A1C

Answer 40

1-1.5%

Question 41

how are GLP-1 analog administered

Answer 41

injected in abdomen

Question 42

what is so special about liraglutide?

Answer 42

one daily injection and do not need to time with meals

Question 43

How is exenatide give

Answer 43

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

Question 44

how often is XR exenatide give

Answer 44

once weekly

Question 45

what are the side effects of GLP-1 analog

Answer 45

GI upsethypoglycemiaweight loss

Question 46

what is the blackbox warning with liraglutide?

Answer 46

can cause thyroid cancerthink Liars uses their vocal cords to lie to you which is near your thyroid

Question 47

what are precautions with the GLP-1 analog

Answer 47

take antibiotics and birth control pill 1 hour apart before injection

Question 48

what drug are part of the amylin analogs

Answer 48

symlin (pramlintide)

Question 49

what is the MOA with amylin analogs

Answer 49

regulates post prandial glycemia

Question 50

who can you use amylin with

Answer 50

Type 1 or 2

Question 51

how much will amylin reduce your A1C

Answer 51

0.3-0.6%

Question 52

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

Answer 52

reduce by 50%

Question 53

what are the side effects with amylin analogs

Answer 53

GIheadachewight loss/neutralhypoglycemia

Question 54

who should be excluded from using amylin analog

Answer 54

poor compliance with current insulinpoor blood glucose monitoringA1C>9%!!!!!!recurrecnt severe hypoglycemiahypoglycemia unwarenesspedis patients

Question 55

which receptors do DM have more of

Answer 55

SGLT-2

Question 56

how much will glucose will be lost with SGLT inhibitors

Answer 56

200-300k/cal