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endocrine > Diabetes drugs > Flashcards

Diabetes drugs Flashcards

1
Q

What drugs are short acting insulins?

A

lispro
aspart
glulisine
regular

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2
Q

What are uses for short acting insulins?

A

bolus insulin at mealtime
often used in pumps
used in hospitals- rapid onsiet

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3
Q

What drugs are intermediate-long acting insulins?

A

NPH
glargine
detemer

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4
Q

What are uses for intermediate-long acting insulins?

A

basal insulin, taken independent of food intake

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5
Q

NPH does produce a _____

A

peak

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6
Q

What drugs are sulfonylureas?

A

Glipizide
Glyburide
Glimepride

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7
Q

What is the mechanism of action of sulfonylureas?

A

Bind to the sulfonylurea receptor (SUR1), closing the ATP-dependent potassium channel on the beta cells, depolarizing the cell, leads to increased insulin secretion

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8
Q

What reduction in A1c can be expected in a patient taking a sulfonylurea?

A

1-2%

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9
Q

What are adverse effects of sulfonylureas?

A
  • Hypoglycemia
  • Weight gain
  • Use with caution in elderly, and in renal and liver failure
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10
Q

What drugs are meglitinides?

A

Nateglinide

Repaglinide

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11
Q

What is the mechanism of action of meglitinites?

A

Similar to sulfonylureas but shorter acting
Bind to the sulfonylurea receptor (SUR1), closing the ATP-dependent potassium channel on the beta cells, depolarizing the cell, leads to increased insulin secretion

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12
Q

What reduction in A1c can be expected in patients taking meglitinides?

A

0.5-1%

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13
Q

What are adverse effects of meglitinides?

A

MILD hypoglycemia, weight gain, caution in renal and liver failure

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14
Q

What drugs are biguanides?

A

metformin

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15
Q

What is the mechanism of action of metformin?

A

Poorly understood

  • increases insulin sensitivity
  • decreases hepatic glucose production
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16
Q

What reduction in A1c can be expected in patients taking metformin?

A

1-2%

17
Q

Describe the advantages of metformin

A

weight loss or weight neutral

No hypoglycemia

18
Q

What are the adverse effects of metformin?

A

GI- nausea, diarrhea, metallic taste

Lactic acidosis

19
Q

What are contraindications to metformin use?

A 
renal insufficiency
liver disease
alcohol abuse
heart failure
age >80
hold during acute illness
20
Q

What drugs are in the thiazolidinedione class?

A

rosiglitazone

pioglitazone

21
Q

What is the mechanism of action of thiazolidnediones?

A

PPAR agononist–> sensitizes skeletal msucle ot insulin, decreases hepatic glucose production

22
Q

What reduction in A1c can be expected in patients taking thiazolidinediones?

A

0.5-1.4%

23
Q

What are the advantages of thiazolidinediones?

A

NO hypoglycemia

Pioglitizone improves lipid profile

24
Q

What are adverse effects of thiazolidinediones?

A

Weight gain
Edema
Risk of osteoporosis/fractures
Contraindicated in heart failure, caution in liver failure
Rosiglitizone- associated with increased risk of CV events

25
Q

What are adverse effects of thiazolidinediones?

A

Weight gain
Edema
Risk of osteoporosis/fractures
Contraindicated in heart failure, caution in liver failure
Rosiglitizone- associated with increased risk of CV events

26
Q

What drugs are in the a-glucosidase inhibitor class?

A

acarbose

27
Q

What is the mechanism of action of acarbose?

A

a-glucosidase enzyme is intestinal wall responsible for conversion of carbohydrates into monosaccharides.
inhibition of a-glucosidase–> delaying digestion and absorption of carbohydrate, lowering BG

28
Q

What are adverse effects of acarbose?

A

flatulence, diarrhea

29
Q

What drugs are in the incretin mimetic class?

A

Exenatide

Liraglutide

30
Q

What is the mechanism of action of incretin mimetics?

A

Promotes glucose-mediated insulin secretion (low risk of hypoglycemia- glucose must also be present).
Decreases hepatic glucose production
Slows gastric emptying

31
Q

What are advantages of incretin mimetics?

A

improves satiety leading to weight loss
does not cause hypoglycemia
may support beta cell survival

32
Q

What are adverse effects of incretin mimetics?

A

GI- NV

caution in renal insufficiency

33
Q

What drugs are in the dipeptidyl peptidase 4 inhibitor class?

A

sitagliptin

saxagliptin

34
Q

What is the mechanism of action of DPP-4 inhibitors?

A

Inhibits DPP-4, the enzyme responsible for degradation of GLP-1, increasing circulating endogenous GLP-1 levels and insulin secretion

35
Q

What drugs are in the SGLT2 inhibitor class?

A

Canagliflozin
Dapagliflozin
Empagliflozin

36
Q

What is the mechanism of action of SGLT2 inhibitors?

A

Inhibition of SGLT2 –> increased urinary glucose excretion and decreased

37
Q

What are advantages of SGLT2 inhibitors?

A

weight loss
decrease in systolic BP
low risk of hypoglycemia

38
Q

What are adverse effects of SGLT2 inhibitors?

A

GU infection
orthostatic hypotension
caution in renal insufficiency, severe liver impairment

39
Q

______ is used to treat hypoglycemia when oral glucose intake is not possible

A

glucagon

endocrine (19 decks)

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