Diabetes

Question 1

8 pharma approaches to diabetes

Answer 1

Metformin
Sulfonylureas
TZDs
Meglitinides
Alpha-Glucosidase inhibitors
DPP-4 inhibitors
GLP-1 agonists
Insulin

Question 2

MOA of Metformin

Answer 2

Decreases hepatic glucose production
Decreases intestinal glucose absorption
Improves insulin sensitivity

Question 3

Metformin ADRs

Answer 3

Diarrhea, nausea, vomiting
Weight neutral or loss
Lactic acidosis
HOLD PRIOR TO IV CONTRAST UNTIL 48 HOURS WHEN RENAL FUNCTION HAS BEEN CONFIRMED AS NORMAL

Question 4

MOA of Sulfonylureas

Answer 4

Stimulate insulin secretion

Question 5

3 Sulfonylureas

Answer 5

Glipizide
Glimepiride
Glyburide

Question 6

Sulfonylureas ADRs

Answer 6

Watch for sulfa allergy
Can cause hypoglycemia
Weight gain

Question 7

MOA of Meglitinides

Answer 7

Stimulate insulin secretion

don’t use with sulfonylureas, same MOA

Question 8

2 Meglitinides

Answer 8

Repaglinide

Nateglinide

Question 9

ADRs of Meglitinides

Answer 9

Hypoglycemia

Weight gain

Question 10

MOA of TZDs

Answer 10

Increases peripheral insulin sensitivity

Question 11

2 TZDs

Answer 11

Pioglitazone

Roziglitazone

Question 12

ADRs of TZDs

Answer 12

Avoid in advance heart failure
Avoid in pts with active or history of bladder cancer
Cause edema
Weight gain

Question 13

MOA of Alpha-Glucosidase Inhibitors

Answer 13

Delays absorption of glucose

Question 14

ADRs of Alpha-Glucosidase inhibitors

Answer 14

GI side effects

Question 15

MOA of DPP-4 Inhibitors

Answer 15

Increase insulin release
Decrease glucagon release
Reduction in hepatic glucose production

Question 16

2 DPP-4 inhibitors

Answer 16

Sitagliptin

Saxagliptin

Question 17

ADRs of DPP-4 inhibitors

Answer 17

Acute pancreatitis (pts with pancreatic dz)
Edema
Weight neutral

Question 18

MOA of GLP-1 (Glucagon-Like Peptide-1 Agonists)

Answer 18

Increase insulin secretion
Decrease glucagon secretion
Slow gastric emptying
Improve satiety

Question 19

2 GLP-1s

Answer 19

Exenatide

Liraglutide

Question 20

ADRs of GLP-1s

Answer 20

Weight loss

Question 21

Rapid acting insulin

Answer 21

Aspart
Glulisine
Lispro

Question 22

Short acting insulin

Answer 22

Regular

Question 23

Basal insulin

Answer 23

NPH

Question 24

Long acting insulin

Answer 24

Levemir

Glargine (one one perfect for 24 hrs)

Question 25

ADRs of insulin

Answer 25

Hypoglycemia
Weight gain
Local skin rxns

Question 26

Symptoms of Hypoglycemia

Answer 26

Dizziness
Headache
Diaphoresis
Excessive hunger
Confusion
Tremor
Palpitation
Shakiness