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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
TZD place in therapy
2nd or 3rd line after metformin
26
Pioglitizone Dose
start: 15mg, then 30 to 45 mg QD no regard to meals
27
TZD ADRs
Edema, Hypo in combo, Wt. Gain, anemia, elevated liver enzymes
28
TZD CI
CHF NYHA class III or IV and Liver Disease
29
TZD A1C lowering
1.5%
30
TZD effect on lipids
inc HDL, dec LDL
31
Meglitinides
Repaglinide and Nateglinide
32
Repaglinide
Prandin
33
Nateglinide
Starlix
34
Meglitinides MOA
similar to sulfonylureas, secretagogues. shorter acting. target PPG
35
Meglitinides CI
T1DM, ketoacidosis
36
Meglitinides Cautions
Renal and Hepatic impairment
37
Meglitinide ADR
Hypoglycemia, and Wt gain
38
Repaglinide dose
start: .5 mg with meals, max: 16mg/day
39
Nateglinide dose
120mg w/ each meal, max 360mg/day
40
Alpha-Glucosidase Inhibitors
Acarbose and Miglitol
41
Acarbose
Precose
42
Miglitol
Glyset
43
Alpha-Glucosidase Inhibitors MOA
Inhibit alpha glucosidase in the intestinal brush border, slows absorption of complex carbs (targets PPG)
44
Alpha-Glucosidase Inhibitors CI
IBD/IBS, Colonic ulceration, GI obstruction, DKA
45
Alpha-Glucosidase Inhibitors A1C lowering
.5- 1 %
46
A-GI and evaluation of LFT's?
monitor every 3 months for first year
47
A-GI and hypoglycemia?
possible with combo, do not treat with complex carbs
48
amylin mimetic
Pramlintide
49
Pramlintide (dose)
Symlin (T1DM 15-30mcg) (T2DM 60-120 mcg)
50
Amylin Mimetic MOA
Analog of amylin, slows gastric emptying and rate of food absorption, inhibits hepatic glucose output
51
Amylin Mimetic Place in therapy
T1: 2nd line T2: 4th/5th line (injection)
52
Amylin Mimetic A1C lowering
.5%
53
Amylin Mimetic ADRs
Nausea, hypoglycemia in combo
54
Pramlintide Black Box Warning
Hypoglycemia when used with insulin
55
GLP Agonists
Exenatide and Liraglutide
56
Exenatide (dose)
Byetta (5-10 mcg BID) and Bydureon (2mg/wk)
57
Liraglutide
Victoza (.6-1.8 mg QD)
58
GLP Agonists MOA
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
GLP Agonist A1C lowering
.4-.9%
60
GLP Agonist wt loss
.9-2.8 kg
61
GLP Agonist Black Box Warning
Causes C Cell Carcinoma in rats
62
GLP Agonist ADRs
nausea and hypoglycemia in combo
63
GLP agonist place in therapy
2nd/3rd line (injection)
64
DPP4 Inhibitors
Alogliptin, Linagliptin, Sitagliptin, Saxagliptin
65
Linagliptin (Dose)
Tradjenta 5mg QD
66
Sitigliptin (Dose)
Januvia 100mg QD
67
Saxagliptin (dose)
Onglyza 2.5-5 mg QD
68
DPP4 I MOA
inhibits DPP4, increases the 1/2 life of GLP-1 and GIP, increased insulin secretion, decreased glucagon, alpha beta punch
69
DPP4 I CI
T1DM and Slowed gastric emptying states
70
DPP4 I ADR
N/V/D
71
DPP4I A1C lowering
.7-1%
72
DPP4I administration
No regards to meals
73
Sodium Glucose Transporter
Canagliflozin
74
Canogliflozin (dose)
Invokana 100 mg prior to first meal (may increase to 300mg)
75
Sodium Glucose Transporter MOA
Inhibits SGLT-2 found in S1 segment of PCT of kidney
76
Sodium Glucose Transporter A1C
.7-1%
77
SGT ADR
GI, Hypo, UTI, genital infections
78
SGT CI
GFR t initiate when less than 45) 100mg max 45-60
79
Canogliflozin benefits
Decrease weight and BP, Increase HDL, dec TG
80
Bile Acid Sequestrants
Colesevelam
81
Bile Acid Sequestrant MOA
binds to bile acid in intestin, decreases bile acid pool for reabsorption
82
Bile Acid sequestrant A1C
.4%
83
Bile Acid Sequestrant ADR
constipation and dyspepsia
84
Bile acid sequestrant CI
GI problems, swallowing issues
85
Dopamine Agonists
Bromocriptine
86
Bromocriptine (dose)
Cycloset (.8mg to 4.8mg QD)
87
Dopamine Agonists MOA
may centrally reverse the metabolic changes that are associated with insulin resistance and obesity
88
Dopamine Agonist A1C lowering
.5%
89
Bromocriptine ADR
Hypotension, syncope and nausea

Endocrine Exam 1 (4 decks)

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