Diabetes Control

Question 1

Glyburide

Answer 1

sulfonylurea, oral hypoglycemic;
Mech: close beta cell K+-ATP channels = stimulate insulin.
Use: DM2
SE: hypoglycemia, weight gain

Question 2

Glipizide

Answer 2

sulfonylurea, oral hypoglycemic;
Mech: close beta cell K+-ATP channels = stimulate insulin.
Use: DM2
SE: hypoglycemia, weight gain

Question 3

Glimepiride

Answer 3

sulfonylurea, oral hypoglycemic;
Mech: close beta cell K+-ATP channels = stimulate insulin.
Use: DM2
SE: hypoglycemia, weight gain

Question 4

• Tolbutamide

Answer 4

sulfonylurea, oral hypoglycemic;
Mech: close beta cell K+-ATP channels = stimulate insulin.
Use: DM2

Question 5

• Chlorpropramide

Answer 5

sulfonylurea, oral hypoglycemic;
Mech: close beta cell K+-ATP channels = stimulate insulin.
Use: DM2

Question 6

Repaglinide, Nateglinide

Answer 6

sulfonylurea, oral hypoglycemic;
Mech: close beta cell K+-ATP channels = stimulate insulin.
Use: DM2
SE: hypoglycemia, weight gain

Question 7

Metformin

Answer 7

potent insulin sensitizer;
Mech: increase glucose uptake, suppress endog. glucose production
Use: DM2 (#1 drug to start with!), often in combo
SE: diarrhea, lactic acidosis
Contraind: renal/liver failure, hypotension

Question 8

Pioglitazone, Rosiglitazone

Answer 8

PPAR-g agonists, insulin sensitizers;
Mech: alter gene transcription = increase fat cell diff.
Use: DM2
SE: edema, weight gain, CHF, osteoporisis, CV events

Question 9

Acarbose, Miglitol

Answer 9

a-glucosidase inhibitor, *low potency
=> inhibit carb metab = delay absorption
Use: DM2
SE: GI

Question 10

Colesevelam

Answer 10

Bile acid sequestrant, hypoglycemic;
Mech: unknown, up-regulate LDL R
Use: DM2
SE: GI (constipation, bloating)

Question 11

Exenatide, Lyraglutide

Answer 11

GLP-1 analog (Incretin);
=> increase insulin/decrease glucagon secretion, + CNS satiety
Use: DM2 (*injection)
SE: pancreatitis (rare), nausea

Question 12

x Canagliflozin

Answer 12

SGLT-2 (Na-Glucose transporter) inhibitor;
=> decerase glucose reabsorption @ kidney
Use: DM2
SE: yeast inf./UTI, hypotension/hypovolemia

Question 13

x Bromocriptine mesylate

Answer 13

D2 (dopamine) agonist, *ergot deriv.;
=> increase insulin sensitivity & glucose tolerance via CNS.
Use: DM2, hyperprolactinemia, acromegaly
SE: orthostatic hypotension, headache, digital vasospasm

Question 14

Pramlintide

Answer 14

amylin analog (synthetic),
=> via CNS: slow gastric emptying & reduce glucagon secretion
Use: DM2
SE: hypoglycemia (need to decrease premeal insulin dose!)

Question 15

Sitagliptin, Linagliptin, Saxagliptin, Vidagliptin

Answer 15

“DPP-4” (dipeptyl Peptidase 4) inhibitors,
–l degradation of GLP-1 & endog. incretins
Use: DM2, low potency
* Few SEs

Question 16

Regular Insulin

Answer 16

short-acting (bolus) insulin,
Use: DM1 or 2; take 30 min b4 meal
- lasts 8-10 hrs (duration increases w/ dose size)
SE: hypoglycemia, weight gain

Question 17

Lispro, Aspart, Giulisine

Answer 17

short-acting (bolus) insulin analog,
Use: DM1 or 2; take immediately b4 meal, lasts 4-6 hrs
SE: hypoglycemia, weight gain

Question 18

NPH insulin

Answer 18

long-acting (basal) insulin, injected;
Use: DM1 or 2; take 2x/day
* can be mixed with other insulins for 1 injection
SE: hypoglycemia (*strong peak!), weight gain

Question 19

Glargine

Answer 19

long-acting (basal) insulin analog,
Use: DM1 or 2; Onset 2-4 hrs, lasts 24 hrs (1x/day)
SE: hypolgycemia (less bc ~no peak), weight gain

Question 20

Detemir

Answer 20

long-acting insulin analog,
Use: DM1 or 2; onset 2-4 hrs, take 2x/day
*very little risk hypoglycemia (peakless)