Diabetes medications Flashcards
lactic acidosis is a rare but worrisome side effect
metformin
most common side effect is hypoglycemia
sulfonylureas
recommended first- line treatment for most patients
metformin
not safe in the setting of hepatic dysfunction or CHF
thiazolidinediones (TZDs)
should not be used in patients with elevated serum creatinine
metformin
should not be used in patients with cirrhosis or inflammatory bowel disease
alpha- glucosidase inhibitors
not associated with weight gain
metformin, DPP4 inhibitors, GLP-1 analogs
metabolized by the liver; excellent choice in patients with renal disease
thiazolidinediones
closes potassium channel on beta cells so that they depolarize, calcium influx; insulin release
sulfonylureas
inhibits alpha- glucosidease at the intestinal brush border
alpha- glucosidase inhibitors
agonist at PPAR-gamma receptors, improved target cell response to insulin
thiazolidinediones
decreases hepatic gluconeogenesis
metformin
good for weight loss
GLP1 analog
avoid in hypoglycemia
sulfonylureas
best treatment for anyone with organ failure (renal, liver, heart)
insulin
DDx for DKA (events that increase glucagon, catecholamines, or corticosteroids in circulation)
infection diabetic medication reduction or ommission severe medical illness (MI, CVA, trauma) undiagnosed DM dehydration alcohol or drug abuse (stimulants) corticosteroids
standard treatment for DKA
IV fluids, IV insulin, potassium replacement
standard treatment for type 1 DM
exogenous insulin
standard treatment for type 2 DM
low carb diet, weightloss, oral hypoglycemic drugs, insulin
