Diabetes Medication Flashcards
How should insulin be written in the drug chart?
- Write insulin in the standard drug chart but do the specifics in the insulin chart
- Write brand name eg. lantus
- Write regime
How do biguanides work?
ORAL
Decreases gluconeogenesis
Increases glucose uptake into cells
How does insulin work?
SC
Acts like the endogenous hormone to regulate blood sugar
How do sulphonylureas work?
ORAL
PPAR agonists - Increase insulin secretion from the pancreas
Give an example of a biguanide
Metformin
Give an example of a sulphonylurea
Gliclazide
How do thiazolidinediones work?
ORAL
Influences genes regulating glucose use
Give an example of a thiazolidinedione
Pioglitazone
How do GLP1 agonists work?
SC
Synthetic form of GLP1 (incretin)- inhibits glucagon release which increases insulin secretion
Give an example of a GLP1 agonist
Exenatide
How do DPP4 antagonists work?
Block the enzyme that breaks down GLP1 (therefore increase insulin release)
Give an example of a DPP4 antagonist
Sitagliptin
How do alpha glycosides inhibitors work?
Reduce intestinal absorption of glucose, so that more is excreted as complex carbohydrates
Give an example of an alpha glycoside inhibitor
Acarbose
Which medications cause hypos (3Gs)?
Gliclazide, glitazones, and gliptins
How do SGLT2 inhibitors work?
Inhibit renal glucose reabsorption promoting net calories loss of 200kcal/day
(NB - increase genital infections as ‘gunk’ is coming out through the urine)
Give an example of a SGLT2 inhibitor
Dapagliflozin, empaglifozin, ipraglifozin
What are the different types of insulin treatment?
SHORT-ACTING - novorapid, humalog, actrapid
MEDIUM-ACTING - humulin N
LONG-ACTING - lantus (glargine), detemir (levemir)
MIXED - novomix 30, humulin M3, Humalog Mix50
How long does short-acting insulin last?
2-5 hours
How long does medium-acting insulin last?
18-24 hours
How long does long-acting insulin last?
24 hours
How should hypoglycaemia be managed?
ABCDEFG (dont ever forget glucose) Conscious - oral glucose Unconscious - IV dextrose, glucogel, IM glucagon - monitor BMs every 15 min - give long acting carbohydrate - review medication
What are the 3 regimes for insulin therapy?
Basal insulin - long acting 1/2 times a day
Premixed insulin - mixed, 1/2/3 times a day
Basal-blos - short acting with meals
