Diabetes Medications Flashcards
How GLP-1 Receptor Agonist works?
Increase insulin release with food Slow gastric emptying Promote satiety Suppress glucagon SE: pancreatitis, n/v, wt loss
GLP-1 medications
exenatide (Byetta, Bydureon) liraglutide (Victoza) lixisenatide (Adlyxin) albiglutide (Tanzium) delaglutide (Trulicity)
How Amylin Mimetic works?
Slow gastric emptying
Suppress glucagon
Promote satiety
SE: hypoglycemia 3 hrs post -injection, nausea, wt loss
Amylin mimetic medications
pramlintide (Symlin)
How Biguanides work?
Decrease hepatic glucose release
First line med at T2D diagnosis
Biguanides medications
metformin (Glucophage)
Riomet (liquid metformin)
SE: B12 deficiency, nausea, bloating, diarrhea
How Sulfonylureas work?
Stimulate sustained insulin release
SE: hypoglycemia. Wt gain
Sulfonylurea medications
glyburide
glipizide (Glucotrol)
glimepiride (Amaryl)
How SGLT2 Inhibitors work?
Decrease glucose reabsorption in kidneys
SE: risk for hypotension, increased urination, genital infection, ketoacidosis
SGLT2 medications
canagliflozin (Invokana)
dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
How DPP 4 inhibitors work?
"Incretin Enhancers" Prolongs action of gut hormones Increases insulin secretion Delays gastric emptying SE: Can cause severe, disabling joint pain
DPP 4 inhibitors medications
sitagliptin (Januvia)
saxagliptin (Onglyza)
linagliptin (Tradjenta)
alogliptin (Nesina)
How Thiazolidinediones TZDs work?
Increase insulin sensitivity
SE: CHF, increased peripheral fracture, risk of bladder cancer
TZDs medications
pioglitazone (Actos)
rosiglitazone (Avandia)
How Alpha-glucosidase Inhibitors work?
Inhibit the enzyme responsible for breaking down complex carbs in the small intestine. Lactose is not affected and milk is absorbed at its normal rate.
OJ, candy or regular soda have delayed metabolism in the presence of Acarbose.
Delay carb absorption
SE: GI effects
Glucosidase Inhibitor medications
acarbose (Precose)
miglitol (Glyset)
How Meglitinides work?
Stimulates rapid insulin burst
SE: hypoglycemia and wt gain
Meglitinides medications
repaglinide (Prandin)
nateglinide (Starlix)
Monotherapy
Lifestyle management +
Metformin alone
Dual Therapy
Lifestyle management + Metformin + Sulfonylurea Metformin + TZD Metformin + DPP- 4 inhibitor Metformin + SGLT2 inhibitor Metformin + GLP-1 receptor agonist Metformin + Insulin (basal)
Triple Therapy
Metformin + one of the following:
SUI + TZD or DPP 4, SGLT2-i, GLP-1, insulin
TZD + SU or DPP 4, SGLT2-i, GLP-1, insulin
DPP-4 + SU or TZD, SGLT2, insulin
SGLT2i + SU, TZD, DPP-4, GLP-1, insulin
GLP-1 + SU, TZD, SGLT2, insulin
Basal Insulin + TZD, DPP-4, SGLT2, GLP-1
Combination Injectable Therapy
Basal insulin + mealtime insulin or GLP-1 RA
Alternative insulin regimen: premix insulin (2-3 injections daily)
How many people have diabetes
18.8 million diagnosed
7 million have it but don’t know
76 have pre-diabetes
empagliflozin (Jardiance) role in CVD
An SGLT-2 inhibitor
Reduces the risk of cardiovascular death in adults with type 2 DM.
