Diabetes Flashcards
What are the 5 types of oral Diabetes therapies?
Biguanides Sulfonylureas Thiazolidinedions/Glitazones DPP-4 inhibitors SGLT2 inhibitors
Which diabetic drug stimulates PPAR?
Pioglitazone
What are the 2 types of injectable diabetes drugs?
GLP-1 agonists
Insulin
What is the first line therapy for DM-II?
Metformin
What type of drug is Metformin?
Biguanide
Other than DM-II, what my Metformin be Rxed for?
Polycystic Ovary Syndrome
What does Metformin activate to suppresses gluconeogensis?
AMP activated protein kinase (AMPK)
When AMPK is suppressed, what 3 things happen?
Suppression of hepatic gluconeogenesis
Suppression of intestinal glucose absorption
Increase in insulin sensitivity
What are the 3 common effects of Metformin?
Headache
Metallic taste
Rash
What are the 2 serious adverse effects of Metformin?
Lactic acidosis
Megaloblastic anemia
What happens when fish oils or decongestants interact with Metformin?
Increase in blood sugar
Metformin may interact with what 2 things to cause an increase in blood sugar?
Fish oils
Decongestants
Metformin may interact with what to decrease blood sugar?
Flaxseed
When Metformin interacts with flaxseed, what happens?
Decreased blood sugar
When ___ interacts with Metformin, hypoglycemia gets masked.
Beta Blockers
What may occur when Metformin interacts with Beta-blockers?
Masks hypoglycemia
What may occur when Metformin interacts with Aminoglycosides, Amphotericin, Ganciclovir, or Acyclovir?
Nephrotoxicity-induced lactic acidosis
Metformin may interact with what 4 drugs/types to cause nephrotoxicity-induced lactic acidosis?
Aminoglycosides (micins)
Amphotericin
Ganciclovir
Aciclovir
What may occur when Metformin interacts with Cyclosporin?
Decreased metabolism
The interaction of Metformin with what drug class may cause a decrease in metabolism?
Cyclosporine
What does a hepatic activation of Beta-2 cause?
Glycogenolysis
Gluconeogenesis
What does a pancreatic activation of Beta-2 cause?
Increased insulin release
What does a pancreatic activation of alpha-2 cause?
Decreased insulin release
Which Diabetes drug is a Sulfanylurea?
Glipizide
What is the MOA of Glipizide?
Stimulates pancreatic islet beta cells
Binds ATP-dependent K+channel blocker, causing depolarization, Ca++ release and vesicle effusion
What does stimulation of pancreatic islet beta cells cause?
Insulin release
What are the 3 common side effects of Glipizide?
Headache
Hypoglycemia
Photosensitivity
What is the 1 serious adverse effect of Glipizide?
Death
Which is the diabetes drug that may cause death?
Glipizide
What may occur when Glipizide interacts with steroids or decongestants?
Antagonistic
Glipizide my interact with which two drug types to cause an antagonistic effect?
Decongestants
Steroids
What may occur if glipizide interacts with Flax Seed Oil?
Additive effect
Glipizide may interact with which substance to cause an additive effect?
Flax Seed Oil
What may happen when Glipizide interacts with Fluoroquinolones?
Unpredictable effect
Glipizide may interact with which drug class to cause an unpredictable effect?
Fluoroquinolones
What may occur if NSIADs and Glipizide interact?
Prolonged effect
Which diabetes drug is a Thiazolidinedione?
Pioglitazone
Which diabetes drug may cause bladder cancer?
Pioglitazone
What is the MOA of Pioglitazone?
Insulin sensitizer
Stimulates PPAR, increasing insulin sensitivity in liver, skeletal muscle, and adipose
What are the 6 common side effects of Pioglitazone?
Fluid retention Weight gain Headache Sinusitis Pharyngitis Dyspnea
What is the 1 ocular side effect of Pioglitazon?
Diabetic Macular Edema
Pioglitazone may interact with which 3 drugs to give an antagonistic effect?
Decongestants
Corticosteroids
Sympathomimetics
Azoles and Trimethoprim may interact with Pioglitazone to cause what?
Impaired metabolism
Which Diabetes drug is a DPP-4 inhibitor?
Sitagliptin
What does inhibition of DPP-4 cause?
Slowing of incretin breakdown
Increasing insulin synthesis/release
Decreasing glucagon
What is the 1 common adverse effect of Sitagliptin?
Headache
What are the 2 serious adverse effects of Sitagliptin?
Renal failure
SJS
Which type of diabetes drug is Canagliflozin?
SGLT-2 Inhibitor
What does inhibition of SGLT-2 cause?
Reduced glucose reabsorption
Increased urinary glucose secretion
What are the 3 common side effects of Canagliflozin?
Increased urination
Thirst
Dehydration
What are the 3 serious adverse effects of Canagliflozin?
Orthostatic hypotension
Fractures
Bone density loss
Which diabetes drug may cause bone density loss or fractures?
Canagliflozin
Which 6 drug types may cause additive renal toxicity upon interaction with Canagliflozin?
CAIs Acyclovir Amphotericin Bacitracin Cyclosporine NSAIDs
What may occur if Ophthalmic Beta-blockers interact with Canagliflozin?
Additive risk of hypotension
What may occur if Canagliflozin interacts with Fluoroquinolones?
Additive hypoglycemia
