Diabetes medications

Question 1

Rapid acting insulins

Answer 1

Aspart (Novolog),

Lispro (Humalog)

Glulisine (apidra)

Question 2

Short acting insulins

Answer 2

regular insuiln (Novolin R)

Question 3

Intermediate acting

Answer 3

Humulin N, Novolin N

Question 4

Long acting insulins

Answer 4

detemir (levemir), degludec (Tresiba), glargine (Lantus

Question 5

Combination insulin

Answer 5

NPH

Question 6

Biguanides (Metformin)

Answer 6

1st line. Works to reduce hepatic glucose production, decreases intestinal glucose absorption, improves insulin sensitivity by increasing peripheral glucose uptake.;

Question 7

Sulfonylurea (Glipizide, glyburide, Glimepiride)

Answer 7

Stimulate pancreatic insulin secretion. Work by “squeezing” the pancreas to make more insulin

s/e increased risk of hypoglycemia, weight gain

Question 8

thiazolidinediones (pioglitazone)

Answer 8

The “ones”

work by secreting peripheral tissues, including muscle and fat tissue to insulin by increasing glucose transporter expression.

s/e: contraindicated in CV disease, weight gain, Increase plasma volume

Question 9

GLP-1 Receptor agonists (exenatide (byetta,), (liraglutide (Victoza)

Answer 9

the “tides”

Work as agonists of GLP-1. GLP-1 causes insulin stimulatory effect by mimicking the incretin hormone. Incretin is a hormone that stimulates insulin secretion in response to meals from the gut.

s/e: nausea, vomiting, diarrhea, pancreatitis

Question 10

DPP-4 inhibitors (sitagliptin, linagliptin)

Answer 10

“the liptans”

Work by preventing DPP-4 from working. DPP4 is an enzyme that breaks down GLP-1. Remember GLP-1 can stimulate/act as an incretin which stimulates insulin release.

s/e: n/v, diarrhea, pancreatitis

Question 11

SGLT2 inhibitors (canagliflozin, empagliflozin, dapagliflozin)

Answer 11

“the flozins”

inhibitor that blocks the reabsorption of glucose by the kidneys and increases glucose excretion in the urine.

s/e: Urinary tract infection, dehydration, acidosis

CV benefit

Question 12

Insulin Therapy in type II

Answer 12

Needed if A1c is greater than 10

Blood glucose is greater than 300

markedly symptomatic

Want to give a long acting or intermediate insulin such as Humulin N, Novolin N, or detemir, or deglludec, glargine

or short acting through a pump

PLUS: Additional doses of pre-meal short acting insulin regular or rapid acting.

Question 13

DKA treatment

Answer 13

Insulin - ONLY SHORT ACTING,

also given with glucose and sometimes K+