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Endocrine Exam 1 > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

1
Q

Sulfonylureas

A

Glyburide, Glipizide, Glimepiride

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2
Q

Glyburide

A

Diabeta, Micronase, Glynase

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3
Q

Glipizide

A

Glucatrol and Glucatrol XL

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4
Q

Glimepiride

A

Amaryl

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5
Q

Sulfonylurea MOA

A

secretagogue (by stimulating ATP sensitive K channel)

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6
Q

Sulfonylurea A1C lowering

A

1.5-1.7

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7
Q

Sulfonylurea place in therapy

A

2nd line after Metformin

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8
Q

Sulfonylurea dosing

A

5-20 mg (depending) 15-30 min before meals

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9
Q

Sulfonylurea ADRs

A

Hypoglycemia and Wt Gain

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10
Q

Biguanide

A

Metformin

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11
Q

Metformin

A

Glucophage

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12
Q

Metformin MOA (primary)

A

Decrease hepatic glucose output (activation of AMPDK)

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13
Q

Metformin MOA (secondary)

A

Decrease insulin resistance and Decrease absorption of carbs

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14
Q

Metformin A1C lowering

A

1.5-2%

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15
Q

Metformin CI

A

Age >80, SCr >1.4-1.5, CHF, COPD

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16
Q

Metformin and contrast dye

A

dc day of and resume 48 hr post

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17
Q

Metformin ADR

A

NVD, bloating, flatulance (disappear with slow titration/ lower dose) B12 deficiency, lactic acidosis

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18
Q

Metformin Place in Therapy

A

First Line

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19
Q

Metformin and Lactic Acidosis

A

Rare but 50% die, weakness, fatigue, malaise, exhaustion, rapid breathing

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20
Q

Metformin Dose

A

500 mg QD x7d, 500 mg BID x7d, 1000 QAM and 500 QPM x7d, then 1000mg BID (take with food)

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21
Q

Thiazolidinediones

A

Pioglitizone and Rosiglitizone

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22
Q

Pioglitizone

A

Actos

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23
Q

Rosiglitizone

A

Avandia (only available via REMS)

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24
Q

TZD MOA

A

Increase insulin sensitivity at the muscle by acting as an agonist on the PPARy which results in glucose uptake (primary) Decrease hepatic glucose output (secondary)

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25
Q

TZD place in therapy

A

2nd or 3rd line after metformin

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26
Q

Pioglitizone Dose

A

start: 15mg, then 30 to 45 mg QD no regard to meals

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27
Q

TZD ADRs

A

Edema, Hypo in combo, Wt. Gain, anemia, elevated liver enzymes

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28
Q

TZD CI

A

CHF NYHA class III or IV and Liver Disease

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29
Q

TZD A1C lowering

A

1.5%

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30
Q

TZD effect on lipids

A

inc HDL, dec LDL

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31
Q

Meglitinides

A

Repaglinide and Nateglinide

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32
Q

Repaglinide

A

Prandin

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33
Q

Nateglinide

A

Starlix

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34
Q

Meglitinides MOA

A

similar to sulfonylureas, secretagogues. shorter acting. target PPG

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35
Q

Meglitinides CI

A

T1DM, ketoacidosis

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36
Q

Meglitinides Cautions

A

Renal and Hepatic impairment

37
Q

Meglitinide ADR

A

Hypoglycemia, and Wt gain

38
Q

Repaglinide dose

A

start: .5 mg with meals, max: 16mg/day

39
Q

Nateglinide dose

A

120mg w/ each meal, max 360mg/day

40
Q

Alpha-Glucosidase Inhibitors

A

Acarbose and Miglitol

41
Q

Acarbose

A

Precose

42
Q

Miglitol

A

Glyset

43
Q

Alpha-Glucosidase Inhibitors MOA

A

Inhibit alpha glucosidase in the intestinal brush border, slows absorption of complex carbs (targets PPG)

44
Q

Alpha-Glucosidase Inhibitors CI

A

IBD/IBS, Colonic ulceration, GI obstruction, DKA

45
Q

Alpha-Glucosidase Inhibitors A1C lowering

A

.5- 1 %

46
Q

A-GI and evaluation of LFT’s?

A

monitor every 3 months for first year

47
Q

A-GI and hypoglycemia?

A

possible with combo, do not treat with complex carbs

48
Q

amylin mimetic

A

Pramlintide

49
Q

Pramlintide (dose)

A

Symlin (T1DM 15-30mcg) (T2DM 60-120 mcg)

50
Q

Amylin Mimetic MOA

A

Analog of amylin, slows gastric emptying and rate of food absorption, inhibits hepatic glucose output

51
Q

Amylin Mimetic Place in therapy

A

T1: 2nd line T2: 4th/5th line (injection)

52
Q

Amylin Mimetic A1C lowering

A

.5%

53
Q

Amylin Mimetic ADRs

A

Nausea, hypoglycemia in combo

54
Q

Pramlintide Black Box Warning

A

Hypoglycemia when used with insulin

55
Q

GLP Agonists

A

Exenatide and Liraglutide

56
Q

Exenatide (dose)

A

Byetta (5-10 mcg BID) and Bydureon (2mg/wk)

57
Q

Liraglutide

A

Victoza (.6-1.8 mg QD)

58
Q

GLP Agonists MOA

A

synthetic hormone which mimics the effects of GLP-1 stimulates insulin release, inhibits glucagon release, inhibits hepatic glucose output, slows gastric emptying, promotes satietyGLP

59
Q

GLP Agonist A1C lowering

A

.4-.9%

60
Q

GLP Agonist wt loss

A

.9-2.8 kg

61
Q

GLP Agonist Black Box Warning

A

Causes C Cell Carcinoma in rats

62
Q

GLP Agonist ADRs

A

nausea and hypoglycemia in combo

63
Q

GLP agonist place in therapy

A

2nd/3rd line (injection)

64
Q

DPP4 Inhibitors

A

Alogliptin, Linagliptin, Sitagliptin, Saxagliptin

65
Q

Linagliptin (Dose)

A

Tradjenta 5mg QD

66
Q

Sitigliptin (Dose)

A

Januvia 100mg QD

67
Q

Saxagliptin (dose)

A

Onglyza 2.5-5 mg QD

68
Q

DPP4 I MOA

A

inhibits DPP4, increases the 1/2 life of GLP-1 and GIP, increased insulin secretion, decreased glucagon, alpha beta punch

69
Q

DPP4 I CI

A

T1DM and Slowed gastric emptying states

70
Q

DPP4 I ADR

A

N/V/D

71
Q

DPP4I A1C lowering

A

.7-1%

72
Q

DPP4I administration

A

No regards to meals

73
Q

Sodium Glucose Transporter

A

Canagliflozin

74
Q

Canogliflozin (dose)

A

Invokana 100 mg prior to first meal (may increase to 300mg)

75
Q

Sodium Glucose Transporter MOA

A

Inhibits SGLT-2 found in S1 segment of PCT of kidney

76
Q

Sodium Glucose Transporter A1C

A

.7-1%

77
Q

SGT ADR

A

GI, Hypo, UTI, genital infections

78
Q

SGT CI

A

GFR t initiate when less than 45) 100mg max 45-60

79
Q

Canogliflozin benefits

A

Decrease weight and BP, Increase HDL, dec TG

80
Q

Bile Acid Sequestrants

A

Colesevelam

81
Q

Bile Acid Sequestrant MOA

A

binds to bile acid in intestin, decreases bile acid pool for reabsorption

82
Q

Bile Acid sequestrant A1C

A

.4%

83
Q

Bile Acid Sequestrant ADR

A

constipation and dyspepsia

84
Q

Bile acid sequestrant CI

A

GI problems, swallowing issues

85
Q

Dopamine Agonists

A

Bromocriptine

86
Q

Bromocriptine (dose)

A

Cycloset (.8mg to 4.8mg QD)

87
Q

Dopamine Agonists MOA

A

may centrally reverse the metabolic changes that are associated with insulin resistance and obesity

88
Q

Dopamine Agonist A1C lowering

A

.5%

89
Q

Bromocriptine ADR

A

Hypotension, syncope and nausea

Endocrine Exam 1 (4 decks)

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