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Medications > Diabetes Medications > Flashcards

Diabetes Medications Flashcards

1
Q

What is the mechanism of action for Sulfonylureas?
Diabinese, Tolinase, Orinase
2nd Generation: glyburide, glipizide

A

Increases insulin production (beta-cell stimulator) and increases the sensitivity of receptor sites for interaction c insulin(endogenous insulin secretion)

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2
Q

What is the mechanism of action for meglitinides?

Repaglinide(prandin), and Nateglinide(starlix)

A

Stimulates release of insulin, it acts more rapidly than sulfonylureas in the presence of glucose.It is a short acting agent that is taken pre prandial to prevent pc glucose elevation

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3
Q

What are the second generation names of Sulfonylureas?

A

Glyburide, glipizide, and the long acting glimepiride

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4
Q

What are some special considerations for Glipizides? (Glucotrol, Glucotrol XL)

A

Take 30 minutes before meal, and you may see some capsule in the stool. This is because the capsule is made of a non-absorbable shell.

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5
Q

What is the pt education for Sulfonylureas?

A
  • Adm before meals

- Avoid ETOH

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6
Q

What are some generic names for Meglitinides?

A

repaglinide(Prandin), and Nateglinide(Starlix)

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7
Q

Which medication has is faster acting c a shorter half life? Sulfonylureas or Meglitinides?

A

Meglitinides stimulate the release of insulin and act more rapidly than Sulfonylureas c a shorter half life

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8
Q

What are some precautions for Meglitinides? like Repaglinide, and Nateglinide

A

Not recommended during pregnancy and use cautiously c impaired liver function

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9
Q

What is the pt education for Meglitinides? And side effects?

A

Adm 0-30 min pre prandial,

SE: hypoglycemia, and weight gain

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10
Q

What is the function of Biguanides? Metformin (glucophage)

A

Lowers basal and post meal glucose levels in pts c type 2 DM by reducing hepatic glucose production and reducing tissue sensitivity to insulin

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11
Q

What are some generic/trade names of Biguanide?

A

Metformin hydrochloride(Glucophage), and metformin extended release

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12
Q

What are some precautions for Biguanides? metformin (glucophage)

A

Big one is hold for 48hrs befor nd after administration of contrast material and surgical procedures requiring anesthesia

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13
Q

What are some contraindications for Biguanide?Metformin (glucophage)

A

Contraindicated in:

  • impaired renal function
  • impaired liver function
  • > 80 years old
  • Pregnancy
  • Hypoxia
  • CHF
  • ETOH abuse
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14
Q

What is the pt education for Biguanides? Side effects? Metformin (glucophage)

A

Take c 2 largest meals to minimize GI distress
report s&s of fatigue, muscle pain, palpitations, dyspnea, dizziness
SE: diarrhea and nausea

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15
Q

What is the function of Alpha-glucosidase inhibitors? Acarbose (precose), and Miglitol (glyset)

A

Delays CHO absorption from the small intestine by inhibiting the SI enzyme alpha-glucsidase. Also impairs the breakdown of complex sugars in stomach (means lower post prandial glucose)

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16
Q

What are some generic and trade names of alpha-glucosidase inhibitors?

A

acarbose(Precose)

miglitol (Glyset)

17
Q

What pt do you NOT use alpha-glucosidase inhibitor on? Dont use acarbose or miglitol on whom?

A

Pts c inflammatory bowel disease or any other serious intestinal disorder. Because it acts on the small intestine.

18
Q

What is the pt education for alpha-glucosidase inhibitors? And SE?

A
  • take c first bite of food
  • when taken alone it does not cause hypoglycemia
  • can be taken in combination c sulfonylureas or metformin
    SE: GI flatulence, diarrhea, and abd discomfort
19
Q

A pt is taking alpha-gluosidase inhibitors (acarbose) and sulfonylurea and they become hypoglycemic. How do you treat them?

A

You can treat them c glucose tbs, sublingual glucose gel, or low fat milk rather than products that contain cane sugar which cant be digested and absorbed due to the drugs effect

20
Q

What is the mechanism of action for Thiazolidinediones? Rosiglitazone (Avandia), and Pioglitazone (Actos)

A

Reduces insulin resistance at receptors sites so insulin is more efficient. decreases hepatic glucose production

21
Q

What are some generic and trade names of Thiazolidinediones?

A

rosiglitzone (Avandia)

pioglitazone (Actos)

22
Q

What are the precautions of using Thiazolidinediones?

A

use c caution in pts with hepatic disease

23
Q

What is the pt education for someone taking Thiazolidinediones? And what are the SE?

A

take c main meal of the day to maximize absorption

SE: fluid retention, weight gain, H/A, increases cholesterol

24
Q

Insulin varies according to what 3 factors?

A

onset of action, peak of action, duration of action

25
Q

What are insulins classified by?

A

Their onset of action: rapid action, short acting, intermediate acting and long acting

26
Q

What are rapid and short insulin used for?

A

used to regulate the rises in blood glucose after meals

27
Q

What are intermediate and long acting insulin used for?

A

to maintain basal insulin levels throughout the dy

28
Q

How fast, what is the peak , and duration of short acting and rapid acting insulin?

A

Short acting reaches bloodstream in 30”-60”, peaks 2-4hrs, and duration of 5-7
Rapid acting rech bloodstream in about 15”; peak 1-3hrs, and duration of 2-5hrs

29
Q

What is the onset peak and duration of long and intermediate acting insulins?

A

begins to work within1-2hrs, eak of 4-12hrs, and are effective for 18-24hrs

30
Q

What is the most commonly used insulin in the US?

A

Recombinant DNA human insulin

31
Q

Onset, Peak, and Duration of Rapid Acting insulin?

Lispro, aspart, glulisine.

A

Onset: 15 minutes
Peak Action: 1-2 hrs
Duration: 3-4 hours
**Inject 5 minutes before meal DO NOT GIVE WITHOUT MEAL TRAY PRESENT

32
Q

Onset, Peak, and Duration of short acting insulin (Regular)? Humilin R and novolin R

A

Onset: 30-60minutes
Peak: 4-10 hours
Duration: 5-7 hours
**inject 30 minutes before meal

33
Q

Onset, Peak, and Duration of Intermediate acting (NPH) insulin? Humulin N, and Novolin N

A

Onset: 2-4hrs
Peak: -10 hours
Duration: 10-16 hours

34
Q

What are some trade names for DPP-4 inhibitor?

A

sitagliptin phosphate (Januvia) and Saxagliptin (Onglyza)

35
Q

What is the mechanism of DPP-4 inhibitor?

A

Sitagliptin and saxagliptin prolong activity of proteins tht boost the release of insulin after BS rises. by blocking the enzyme called DPP-4 which breaks down these proteins

36
Q

what do increting mimetics do?

A

They mimic the glucose-lowering action of naturally ocurring human hormones called incretin. Makes sense right?

37
Q

What is the mechanism of action for Amylin analog?

A

slows gastric emptying
suppresses postprandial glucagon secretion
enhances satiety

38
Q

What is the generic and trade name for Amylin analog?

A

Pramlintide acetate (symlin)

Medications (4 decks)

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