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PPP Spring > Diabetes > Flashcards

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
Q

What drugs are alpha-glucosidase inhibitors (AGIs)?

A

Acarbose

Miglitol

26
Q

What is the MOA of AGIs?

A

inhibit alpha glucosidase to delay glucose hydrolysis and absorption (dec. postprandial glucose)

27
Q

What AEs are associated with AGIs?

A

GI upset

Precaution - skip a meal, skip dose!

28
Q

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

A 
E = high
H = low
W = neutral/dec.
29
Q

What drugs are SGLT-2 inhibitors?

A

canagliflozin
dapagliflozin
Empagliflozin

30
Q

What is the MOA of SGLT-2 inhibitors?

A

inhibit urinary glucose reabsorption

31
Q

What AEs are associated with SGLT-2 inhibitors?

A

Yeast infection/UTI
Diabetic ketoacidosis (DKA)
dehydration (which can lead to hypotension)

32
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with SGLT-2 inhibitors?

A 
E = intermediate
H = low
W = dec.
33
Q

What drugs are DPP4 inhibitors?

A

Sitagliptin
Saxagliptin
Linaglipin

34
Q

What is the MOA of DPP4 inhibitors?

A

inc. insulin secretion in glucose dependent manner

35
Q

What AEs are associated with DPP4 inhibitors?

A

inc. respiratory infections
pancreatitis (rare)
CHF (for saxagliptin)

36
Q

What is the efficacy, hypoglycemia risk, and weight loss associated with DPP4 inhibitors?

A 
E = intermediate
H = low
W = neutral
37
Q

what drugs can cause hypoglycemia?

A

insulin
SU
non-SU

38
Q

What drugs can cause weight gain?

A

insulin
SU
TZDs
Non-SUs

39
Q

Indicate which insulins are rapid, short, intermediate, and long acting

A

Lispro + Aspart = rapid
Regular = short
NPH = intermediate
Glargine + Detemir = long

40
Q

what is the BBW associated with affrezza?

A

acute bronchospasm

41
Q

What AE and CI are associated with affrezza?

A

AE: hypoglycemia, cough, throat pain
CI: COPD, asthma, smokers

42
Q

What is the target A1C for patients with diabetes?

A

<7%

43
Q

What is normal fasting glucose?

A

80-130 mg/dL

44
Q

What is normal postprandial glucose?

A

<180 mg/dL

45
Q

What do SGLT2 inhibitors act on?

A

transporter

46
Q

What do GLP-1 agonists, insulin, TDZs act on?

A

receptor

47
Q

what do SU and non-SU act on?

A

ion channel

48
Q

what do metformin, alpha glucosidase inhibitors, and DPP4 inhibitors act on?

A

enzymes

49
Q

What drugs should be used in caution in a patient with renal impairment?

A

Metformin
Glyburide
Canagliflozin

50
Q

What drugs should be used in caution with impaired liver function?

A

Metformin
Glyburide
Pioglitazone

51
Q

What drugs should be used in caution in a patient with pre-existing edema?

A

Pioglitazone

52
Q

What drugs should be used in caution in patients with HF?

A

Pioglitazone

Metformin + Saxagliptin if uncontrolled

53
Q

What is the target organ of Canagliflozin?

A

(SGLT2)

kidney

54
Q

What is the target organ of Exenatide?

A

(GLP-1 agonist)
Beta cell
GIT
Liver (indirect)

55
Q

What is the target organ of Glipizide?

A

(SU)

Beta cell

56
Q

What is the target organ of Insulin?

A

Liver

SKM

57
Q

What is the target organ of Metformin?

A

Liver

SKM

58
Q

What is the target organ of Miglitol?

A

(alpha-glucosidase inhibitor)

GIT

59
Q

What is the target organ of Pioglitazone?

A

(TZDs)
Liver
SKM

60
Q

What is the target organ of Repaglinide?

A

(non-SU)

Beta cell

61
Q

What drugs can be used to treat these diabetic complications: delayed gastric emptying (gastroparesis); HF; ED

A

Metoclopramide
Captopril (also helps with proteinuria)
Sildenafil

62
Q

What drugs cause weight LOSS?

A

GLP-1 agonists

SGLT2 inhibitors

PPP Spring (9 decks)

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