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Diabetes Flashcards

1
Q

What is the MOA of Metformin?

A

Activates AMPK to inc. insulin sensitivity

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2
Q

What AEs are associated with meformin?

A

GI effects

```
Lactic acidosis
inc. risk with patients who have renal/hepatic impairment; hypoxia; excess EtOH use
~~~

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3
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with Metformin?

A

efficacy: HIGH
H risk: low
weight: neutral/dec.

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4
Q

What AEs are associated with insulin?

A

hypoglycemia

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5
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with insulin?

A 
E = HIGHEST!
H = high
W = inc.
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6
Q

what drugs are sulfonylureas?

A

Glipizide
Glyburide
Glimepiride

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7
Q

What’s the MOA of SUs?

A

inhibit ATP-sensitive K+ channel

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8
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with SUs?

A 
E = high
H = moderate
W = inc.
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9
Q

what AEs are associated with SUs?

A

hypoglycemia

caution in renal or hepatic disease

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10
Q

What is the MOA of non-SUs?

A

inhibit ATP-sensitive K+ channel

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11
Q

What drugs are non-SUs?

A

Nateglinide

Repaglinide

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12
Q

What AEs are associated with non-SUs?

A

hypoglycemia

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13
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with non-SUs?

A 
E = high
H = intermediate
W = gain
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14
Q

What drugs are GLP-1 R agonists?

A

Exenatide

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15
Q

What is the MOA of GLP-1 R agonists?

A 
GLP has multiple effects:
CNS = inc. satiety
liver = dec. glucose output
stomach = slowed emptying
Beta cells = inc. insulin secretion
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16
Q

What AEs are associated with GLP-1 R agonists?

A

GI

pancreatitis

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17
Q

What CI and DDIs are associated with GLP-1 R agonists?

A 
CI = thyroid C cell tumor
DDI = take apart from other drugs since it delays gastric emptying!
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18
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with GLP-1 R agonists?

A 
E = high
H = low
W = dec.
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19
Q

What drugs are Thiazolidinediones (TZDs)?

A

Pioglitazone

Rosiglitazone

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20
Q

What is the MOA of TZDs?

A

PPAR gamma agonist

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21
Q

What AEs are associated with TZDs?

A

Edema
Bone loss
Hepatotoxic
Inc. risk for bladder cancer

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22
Q

What’s the CI for TZDs?

A

HF

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23
Q

What drugs improve lipid profile?

A

Metformin

TZDs

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24
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with TZDs?

A 
E = high
H = low
W = inc.
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25
What drugs are alpha-glucosidase inhibitors (AGIs)?
Acarbose | Miglitol
26
What is the MOA of AGIs?
inhibit alpha glucosidase to delay glucose hydrolysis and absorption (dec. postprandial glucose)
27
What AEs are associated with AGIs?
GI upset | Precaution - skip a meal, skip dose!
28
What is the efficacy, hypoglycemia risk, and weight loss associated with AGIs?
``` E = high H = low W = neutral/dec. ```
29
What drugs are SGLT-2 inhibitors?
canagliflozin dapagliflozin Empagliflozin
30
What is the MOA of SGLT-2 inhibitors?
inhibit urinary glucose reabsorption
31
What AEs are associated with SGLT-2 inhibitors?
Yeast infection/UTI Diabetic ketoacidosis (DKA) dehydration (which can lead to hypotension)
32
What is the efficacy, hypoglycemia risk, and weight loss associated with SGLT-2 inhibitors?
``` E = intermediate H = low W = dec. ```
33
What drugs are DPP4 inhibitors?
Sitagliptin Saxagliptin Linaglipin
34
What is the MOA of DPP4 inhibitors?
inc. insulin secretion in glucose dependent manner
35
What AEs are associated with DPP4 inhibitors?
inc. respiratory infections pancreatitis (rare) CHF (for saxagliptin)
36
What is the efficacy, hypoglycemia risk, and weight loss associated with DPP4 inhibitors?
``` E = intermediate H = low W = neutral ```
37
what drugs can cause hypoglycemia?
insulin SU non-SU
38
What drugs can cause weight gain?
insulin SU TZDs Non-SUs
39
Indicate which insulins are rapid, short, intermediate, and long acting
Lispro + Aspart = rapid Regular = short NPH = intermediate Glargine + Detemir = long
40
what is the BBW associated with affrezza?
acute bronchospasm
41
What AE and CI are associated with affrezza?
AE: hypoglycemia, cough, throat pain CI: COPD, asthma, smokers
42
What is the target A1C for patients with diabetes?
<7%
43
What is normal fasting glucose?
80-130 mg/dL
44
What is normal postprandial glucose?
<180 mg/dL
45
What do SGLT2 inhibitors act on?
transporter
46
What do GLP-1 agonists, insulin, TDZs act on?
receptor
47
what do SU and non-SU act on?
ion channel
48
what do metformin, alpha glucosidase inhibitors, and DPP4 inhibitors act on?
enzymes
49
What drugs should be used in caution in a patient with renal impairment?
Metformin Glyburide Canagliflozin
50
What drugs should be used in caution with impaired liver function?
Metformin Glyburide Pioglitazone
51
What drugs should be used in caution in a patient with pre-existing edema?
Pioglitazone
52
What drugs should be used in caution in patients with HF?
Pioglitazone | Metformin + Saxagliptin if uncontrolled
53
What is the target organ of Canagliflozin?
(SGLT2) | kidney
54
What is the target organ of Exenatide?
(GLP-1 agonist) Beta cell GIT Liver (indirect)
55
What is the target organ of Glipizide?
(SU) | Beta cell
56
What is the target organ of Insulin?
Liver | SKM
57
What is the target organ of Metformin?
Liver | SKM
58
What is the target organ of Miglitol?
(alpha-glucosidase inhibitor) | GIT
59
What is the target organ of Pioglitazone?
(TZDs) Liver SKM
60
What is the target organ of Repaglinide?
(non-SU) | Beta cell
61
What drugs can be used to treat these diabetic complications: delayed gastric emptying (gastroparesis); HF; ED
Metoclopramide Captopril (also helps with proteinuria) Sildenafil
62
What drugs cause weight LOSS?
GLP-1 agonists | SGLT2 inhibitors

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