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pharm unit 5 > diabetes drugs > Flashcards

diabetes drugs Flashcards

1
Q

metformin class

A

biguanide

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2
Q

metformin mechanism of action

A

decreases hepatic glucose production by inhibiting AMP-kinase and mito glycerophosphate dehydrogenase.

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3
Q

metformin benefits.

A

weight neutral, no hypoglycemia,

there are generics, fewer cardiovascular events and cancer.

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4
Q

metformin disadvantages.

A

diarrhea, abdominal discomfort. nausea, vomit, anorexia, b12 def.

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5
Q

metformin rare side effect

A

lactic acidosis

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6
Q

glyburide class

A

sulfonylurea

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7
Q

glyburide mechanism

A

closes KATP channels stimulating insulin secretion.

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8
Q

glyburide benefits

A

well-tolerated, generics available.

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9
Q

glyburide disadvantages

A

hypoglycemia. weight gain, effects ischemic preconditioning.

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10
Q

why don’t we give sulfonylureas to fat people?

A

because it increases weight.

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11
Q

glipizide class

A

sulfonylurea

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12
Q

glipizide mechanism

A

closes KATP channels stimulating insulin secretion

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13
Q

glipizide advantages

A

well-tolerated, generics

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14
Q

glipizide disadvantages

A

weight gain, hypoglycemia. may affect ischemic preconditioning

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15
Q

glimepiride class

A

sulfonylurea

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16
Q

glimepiride mechanism

A

closes K-ATP channels stimulating insulin secretion

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17
Q

glimepiride advantages

A

well-tolerated, generics

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18
Q

glimepiride disadvantages

A

hypoglycemia, weight gain, preconditioning

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19
Q

repaglinide class

A

meglitinide

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20
Q

repaglinide mechanism

A

closes KATP channels stimulates insulin secretion

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21
Q

repaglinide advantages

A

short-acting, well tolerated.

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22
Q

repaglinide disadvantages

A

there is hypoglycemia, but less than sulfonylureas. weight gain, dose before each meal.

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23
Q

what classes have the same mechanism? what is the difference

A

sulfonylurea and maglitinides. mags are shorter acting. must dose before each meal. mags also have less hypoglycemia.

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24
Q

natelglinide class

A

maglitinide

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25
Q

natelglinide mechanism

A

closes kATP channels stimulating insulin secretion

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26
Q

natelglinide advantages

A

short-acting, well-tolerated.

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27
Q

natelglinide disadvantages

A

weight gain, hypoglycemia, less than sulfonylureas, dose before each meal.

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28
Q

pioglitazone class

A

thiazolidinediones

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29
Q

pioglitazone mechanism

A

transcription-factor PPAR-gamma activation. decreases insulin resistance.

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30
Q

pioglitazone advantages

A

no hypoglycemia, decrease in MI.

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31
Q

pioglitazone disadvantages

A

weight gain, edema, CHF, bone fractures, macular edema, increase in bladder cancer.

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32
Q

rosiglitazone class

A

thiazolidinediones

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33
Q

rosiglatazone mechanism

A

activation of the PPAR-gamma TF. decreases insulin resistance.

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34
Q

rosiglatazone advantages

A

no hypoglycemia. decrease in MI (only for pio)

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35
Q

rosiglatazone disadvantages

A

edema, weight gain, CHF, bone fractures, macular edema.

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36
Q

acarbose class

A

alpha-glucosidase inhibitors.

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37
Q

acarbose mechanism

A

competatively inhibits alpha-glucosidase in intestines, delays carbohydrate absorption reduces postprandial glucose.

38
Q

acarbose advantages

A

no hypoglycemia, weight neutral, moderate efficacy in lowering the postprandial

39
Q

acarbose disadvantages

A

flatulence, diarrhea, abdominal fullness, must take with a carbo meal. modest decrease in A1c.

40
Q

miglitol class

A

alpha-glucosidase inhibitors.

41
Q

miglitol mecahanism q

A

inhibition of alpha-glucosidase in the intestine. delays carbo absorption, reduces postprandial glucose

42
Q

miglitol advantages.

A

no hypoglycemia, weight neutral, moderate efficacy in reducing the postprandial glucose.

43
Q

miglitol disadvantages

A

flatulence, diarrhea, abdominal fullness. take with carbo meal, modest decrease in the A1c.

44
Q

exenatide class

A

GLP-1 agonists

45
Q

exenatide mechanism

A

activation of GLP-1, increased glucose stimulated insulin secretion. decreased glucagon secretion, slows gastric motility, increases satiety

46
Q

exenatide advantages

A

promote weight loss, no hypoglycemia.

47
Q

exenatide disadvantages

A

pancreatitis, nausea, vomiting, diarrhea, hypoglycemia (less than sulfonylureas), contra with renal insuff. inject subcutaneously, c-cell hyperplasia and medullary thyroid cancers in animals.

48
Q

liraglutide class

A

GLP-1 agonists

49
Q

liraglutide mechanism

A

GLP-1 activation, glucose stimulated insulin secretion, decreased glucagon secretion, increases satiety, slows gastric motlity.

50
Q

liraglutide advantages

A

weight loss, no hypoglycemia.

51
Q

liraglutide disadvantages

A

pancreatitis, nausea, vomiting, diarrhea, hypoglycemia (less than sulfonylureas), contra with renal insufficiency, inject subcut, c-cell hyperplasia and medullary tumor in animals.

52
Q

dulaglutide class

A

GLP-1 agonist

53
Q

dulaglutide mechanism

A

activates GLP-1 glucose stimulated insulin release. decreases glucagon secretion. promotes satiety, slows gastric motility.

54
Q

dulaglutide advantages

A

promotes weight loss. no hypoglycemia.

55
Q

dulaglutide disadvantages

A

pancreatitis, nausea, vomting, diarrhea, injection subcutaneously, c-cell hyperplasia and medullary tumor in animals. contra in renal insuff. hypoglycemia (less than sulfonylureas)

56
Q

albiglutide class

A

GLP-1 agonists

57
Q

albiglutide mechanism

A

activates GLP-1 glucose stimulated insulin release, decreases glucagon secretion, slows gastric motility, increases satiety.

58
Q

albiglutide advantages

A

weight loss, no hypoglycemia.

59
Q

albiglutide disadvantages

A

pancreatitis, nausea, vomting, diarrhea, contraindicated in renal insufficiency, injection subcutaneously, hypoglycemia (less than sulfonylureas), c-cell hyperplasia and medullary tumors in animals

60
Q

satagliptin class

A

DPP-4 inhibitors

61
Q

satagliptin mechanism

A

inhibit the metabolism of GLP-1

62
Q

satagliptin advantages

A

weight neutral, no hypoglycemia, well-tolerated.

63
Q

satagliptin disadvantages

A

pacreatitis, runny nose, URI, HA

64
Q

saxagliptin class

A

DPP-4 inhibitors

65
Q

saxagliptin mechanisdm

A

inhibits the metabolism of GLP-1

66
Q

saxagliptin advantages

A

no hypoglycemia, well-tolerated, weight neutral.

67
Q

saxagliptin disadvantages

A

pancreatitis, runny nose, URI, HA

68
Q

linagliptin class

A

DPP-1 inhbitors

69
Q

linagliptin mechanism

A

inhibits the metabolism of GLP-1

70
Q

linagliptin advantages

A

weight neutral, well-tolerated, no hypoglycemia.

71
Q

linagliptin disadvantages

A

pancreatitis, runny nose, HA, URI

72
Q

agloliptin class

A

DPP-4 inhibition

73
Q

agloliptin mechanism

A

inhibits the metabolism of GLP-1

74
Q

agloliptin advantages

A

weight neutral, no hypoglycemia, well-tolerateed.

75
Q

agloliptin disadvantages

A

pancreatitis, runny nose, URI, HA

76
Q

canagloflozin class

A

SGLT2-inhibitors

77
Q

canagloflozin mechanism

A

reduces glucose reuptake in the kidney. increases urinary glucose

78
Q

canagloflozin advantages

A

weight loss, no hypoglycemia

79
Q

canagloflozin disadvantages

A

genital mycotic infections, UTI, hypotension, impaired renal function, hyperkalemia, HSR, increases LDL

80
Q

dapagliflozin class

A

SGLT2-inhibitor

81
Q

dapagliflozin mechanism

A

inhibits glucose reuptake in the kidney. increases urinary glucose.

82
Q

dapagliflozin advantages

A

weight loss, no hypoglycemia,

83
Q

dapagliflozin disadvantages

A

genital mycotic infection, hypotension, hyperkalemia, UTI, impaired renal function, HSR, increases in LDL.

84
Q

empagliflozin class

A

SGLT2-inhibtion

85
Q

empagliflozin mechanism

A

inhibition of glucose repute in the kidney. increases urinary glucose.

86
Q

empagliflozin adbvantages

A

weightloss, no hypoglycemia

87
Q

empagliflozin disadvantages

A

genital mycotic infection, UTI, impaired renal function, hypotension, HSR, increases LDL, hyperkalemia.

88
Q

which oral drugs cause weight loss in T2D

A

SGLT-2 and the GLP-1

89
Q

which orals are weight neutral in T2D

A

metformin, alpha glucosidase inhbitors and DPP-4

90
Q

which agents cause weight gain in T2D

A

insulin, thiazolid. sulfonylureas, and meglitinides

pharm unit 5 (12 decks)

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