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Diabetes Flashcards

1
Q

What drugs are in this class:

Biguanide

A

Metformin

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2
Q

What drugs are in this class:

Sulfonylureas

A

Glimepiride
Glipizide
Glyburide

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3
Q

What drugs are in this class:

Meglitinides

A

Nateglinide

Repaglinide

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4
Q

What drugs are in this class:

Thiaxolidinediones (TZD)

A

Pioglitazone

Rosiglitazone

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5
Q

What drugs are in this class:

Dipeptidyl peptidase-4 (DPP-4)

A

Alogliptin
Linagliptin
Saxagliptin
Sitagliptin

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6
Q

What drugs are in this class:

Sodium-glucose co-transporter 2 (SGLT-2) inhibitors

A

Canagliflozin
Dapagliflozin
Empagliflozin

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7
Q

What drugs are in this class:

Alpha-glucosidase inhibitors

A

Acarbose

Miglitol

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8
Q

What drugs are in this class:

Glucagon-like peptide-1 (GLP-1) agonists

A 
Albiglutide
Dulaglutide
Exenatide
Exenatide ER
Liraglutide
Lixisenatide
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9
Q

What drugs are in this class:

Amylin mimetic

A

Pramlinitide

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10
Q 
Brand name(s) for
Metformin
A

Glucophage, Riomet

ER: Glucophage XR, Glumetza, Fortamet

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11
Q 
Brand name(s) for
Glimepiride
A

Amaryl

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12
Q 
Brand name(s) for
Glipizide
A

Glucotrol

Glucotrol XL

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13
Q 
Brand name(s) for
Glyburide
A

Diabeta

Micronase

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14
Q 
Brand name(s) for
Glyburide, micronized
A

Glynase

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15
Q 
Brand name(s) for
Nateglinide
A

Starlix

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16
Q 
Brand name(s) for
Repaglinide
A

Prandin

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17
Q 
Brand name(s) for
Pioglitazone
A

Actos

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18
Q 
Brand name(s) for
Rosiglitazone
A

Avandia

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19
Q 
Brand name(s) for
Alogliptin
A

Nesina

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20
Q 
Brand name(s) for
Linagliptin
A

Tradjenta

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21
Q 
Brand name(s) for
Saxagliptin
A

Onglyza

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22
Q 
Brand name(s) for
Sitagliptin
A

Januvia

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23
Q 
Brand name(s) for
Canagliflozin
A

Invokana

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24
Q 
Brand name(s) for
Dapagliflozin
A

Farxiga

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25
Q 
Brand name(s) for
Empagliflozin
A

Jardiance

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26
Q 
Brand name(s) for
Acarbose
A

Precose

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27
Q 
Brand name(s) for
Miglitol
A

Glyset

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28
Q 
Brand name(s) for
Albiglutide
A

Tanzeum

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29
Q 
Brand name(s) for
Dulaglutide
A

Trulicity

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30
Q 
Brand name(s) for
Exenatide
A

Byetta

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31
Q 
Brand name(s) for
Exenatide ER
A

Bydureon

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32
Q 
Brand name(s) for
Liraglutide
A

Victoza

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33
Q 
Brand name(s) for
Lixisenatide
A

Adlyxin

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34
Q 
Brand name(s) for
Pramlintide
A

SymlinPen

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35
Q

Daily dose for

Metformin

A

500mg QD - 1000mg BID

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36
Q

Daily dose for

Glimepiride

A

1-8 mg QD

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37
Q

Daily dose for

Glipizide

A

5-40 mg QD

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38
Q

Daily dose for

Glyburide

A

1.25-20 mg daily dosed QD or BID

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39
Q

Daily dose for

Glyburide,, micronized

A

1.5-12 mg QD

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40
Q

Daily dose for

Nateglinide

A

60-120 mg before each meal

41
Q

Daily dose for

Repaglinide

A

0.5-4 mg before each meal

Max of 16 mg/d

42
Q

Daily dose for

Pioglitazone

A

15-45 mg QD

43
Q

Daily dose for

Rosiglitazone

A

4-8 mg QD

2-4 mg BID

44
Q

Daily dose for

Alogliptin

45
Q

Daily dose for

Linagliptin

46
Q

Daily dose for

Saxagliptin

47
Q

Daily dose for

Sitagliptin

A

100 mg po QD

48
Q

Daily dose for

Canagliflozin

A

100-300 mg QD

49
Q

Daily dose for

Dapagliflozin

A

5-10 mg QD

50
Q

Daily dose for

Empagliflozin

A

10-25 mg QD

51
Q

Daily dose for

Acarbose

A

50-100 mg TID

52
Q

Daily dose for

Miglitol

A

25-100 mg TID

53
Q

Daily dose for

Albiglutide

A

30-50 mg SQ weekly

54
Q

Daily dose for

Dulaglutide

A

0.75-1.5 mg SQ weekly

55
Q

Daily dose for

Exenatide

A

5-10 mg SQ BID

56
Q

Daily dose for

Exenatide ER

A

2mg SQ weekly

57
Q

Daily dose for

Liraglutide

A

0.6-1.8 mg SQ daily

58
Q

Daily dose for

Lixisenatide

A

10-20 mg SQ daily

59
Q

Daily dose for

Pramlintide

A

Type 1 DM: 15-60 mcg TID before meals

Type 2 DM: 60-120 mcg TID before meals

60
Q 
How is this class effective in the treatment of DM
Biguanides
A

Decrease hepatic glucose production
Increase glucose uptake in peripheral tissue
Decrease intestinal glucose absorption

61
Q 
How is this class effective in the treatment of DM
Sulfonylureas
A

Increase insulin secretion

Decrease hepatic glucose production

62
Q 
How is this class effective in the treatment of DM
Meglitinides
A

Increase insulin secretion

Decrease hepatic glucose production

63
Q 
How is this class effective in the treatment of DM
Thiaxolidinediones
A

Increase insulin sensitivity

Decrease hepatic glucose production

64
Q 
How is this class effective in the treatment of DM
Dipeptidyl peptidase-4 (DPP-4) inhibitors
A

Decrease breakdown of endogenous GLP-1

65
Q 
How is this class effective in the treatment of DM
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors
A

Inhibits SGLT-2

Increases urinary glucose excretion

66
Q 
How is this class effective in the treatment of DM
Alpha-glucosidase inhibitors
A

Delay digestion of carbohydrates

67
Q 
How is this class effective in the treatment of DM
Glucagon-like peptide-1 (GLP-1) agonists
A

Stimulate GLP-1 receptors resulting in GLUCOSE-DEPENDENT insulin secretion
Decreased postprandial glucagon secretion
Decreased gastric emptying rate
Early satiety

68
Q 
How is this class effective in the treatment of DM
Amylin mimetic
A

Amylin analog resulting in
Decreased postprandial glucagon secretion
Decreased gastric emptying rate, early satiety

69
Q

Common side effects of

Biguanide

A

Diarrhea
N/V
Abdominal pain/bloating
Low B12

70
Q

Common side effects of

Sulfonylureas

A

Hypoglycemia

Weight gain

71
Q

Common side effects of

Meglitinides

A

Hypoglycemia

Weight gain

72
Q

Common side effects of

Thiazolidinediones

A

Weight gain

Edema

73
Q

Common side effects of

Dipeptidyl peptidase-4 (DPP-4) inhibitors

A

Nasopharyngitis
Upper respiratory tract infections
HA
UTI

74
Q

Common side effects of

Sodium-glucose co-transporter 2 (SGLT-2) inhibitors

A 
Hypotension
Dehydration
Weight loss
Genital mycotic infections
UTI
Hyperkalemia (canagliflozin)
Increase in LDLs
Increased hematocrit (dapa, empa)
75
Q

Common side effects of

Alpha-glucosidase inhibitors

A 
Flatulence
GI upset
Abdominal pain/bloating
Diarrhea
Increase in LFTs and bilirubin
76
Q

Common side effects of

Glucagon-like peptide-1 (GLP-1) agonists

A

N/V/D
HA
Weight loss

77
Q

Common side effects of

Amylin mimetics

A

Hypoglycemia
N/V/D
HA
Anorexia

78
Q

Contraindications of

Biguanide

A

eGFR < 30
Unstable, symptomatic HF
Hepatic impairment

79
Q

Contraindications of

Sulfonylureas

A

Caution in elderly patients

Avoid use of glyburide b/c of increased risk of hypoglycemia

80
Q

Contraindications of

Meglitinides

A

Do not administer repaglinide with gemfibrozil

81
Q

Contraindications of

Thiazolidinediones

A 
Bladder cancer (pioglitazone)
HF
Hepatic impairment
Ischemic heart disease
MI (rosiglitazone)
Risk of bone fracture
82
Q

Contraindications of

Dipeptidyl peptidase-4 (DPP-4) inhibitors

A

Pancreatitis

83
Q

Contraindications of

Sodium-glucose co-transporter 2 (SGLT-2) inhibitors

A

Canagliflozin - eGFR <45
Empagliflozin - eGFR <45
Dapagliflozin - eGFR <60

84
Q

Contraindications of

Alpha-glucosidase inhibitors

A 
Inflammatory Bowel Disease (IBD)
Ulcerative colitis
Crohn's disease
Partial intestinal obstruction
Short bowel syndrome
Renal impairment (SCr >2 or CrCl < 25)
85
Q

Contraindications of

Glucagon-like peptide-1 (GLP-1) agonists

A

Gastroparesis
Pancreatitis
Multiple endocrine neoplasia syndrome type 2
Personal or family history of medullary thyroid carcinoma

86
Q

Contraindications of

Amylin mimetics

A 
Severe, recurrent hypoglycemia
Hypoglycemic unawareness
Gastroparesis
ESRD
Poor adherence to insulin regimen
Poor adherence to self-monitoring blood glucose
87
Q

True/False

You can cut/crush/chew metformin ER

88
Q

Sulfonylureas have a long/short duration of action? Why is this important?

A

Long

Patients need to eat in regular intervals to avoid hypoglycemic episodes

89
Q

Which have a longer duration of action sulfonylureas or meglintinides

A

Sulfonylureas

90
Q

True/False

If you skip a meal you should skip your dose of Meglitinide

91
Q

Can you use Meglitinides and Sulfonylureas together? Why?

A

No!

They both increase insulin release so this can lead to hypoglycemia

92
Q

Which thiazolidinedioine (TZD) needs to be dispensed with a medication guide?

A

Rosiglitazone

93
Q

Dose adjustment for DPP-4 inhibitors

A

Saxagliptin (Onglyza): CrCl <50 - 2.5 mg/d

Sitagliptin (Januvia): CrCl 30-50 - 50 mg/d; CrCl <30 - 25 mg/d

94
Q

Which DPP-4 does NOT need a dose adjustment?

A

Linagliptin (Tradjenta)

95
Q

What pt populations should SGLT-2 inhibitors be used with caution

A

Pts taking diuretics and elderly

96
Q

True or False

Alpha-glucosidase inhibitors are recommended for use by the ADA

97
Q

Dose adjustment GLP-1 agonists

A

Albiglutide , Dulaglutide (Trulicity), Liraglutide (Victoza): no adjustment necessary
Exenatide (Byetta): CI CrCl <30
Lixisenatide (Adlyxin): CI CrCl<15

98
Q

When initiating an amylin mimetic, how much should you reduce mealtime insulin by and why?

A

50% to avoid hypoglycemia

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