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Endo Pharm > Diabetes meds > Flashcards

Diabetes meds Flashcards

1
Q

One time, I got an old lady’s blood in my eye, and the ED doc said I’m at risk of catching her diabetes.

A

Don’t be like that doc.

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2
Q

Glipizide: class

A

Sulfonylurea

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3
Q

Glipizide: MOA

A

Increases beta cell insulin secretion

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4
Q

Glipizide: indication

A

T2DM

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5
Q

Glipizide: side effects

A

Hypoglycemia, wt gain

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6
Q

Glipizide: contraindications

A

Sulfa allergy; T1DM

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7
Q

Glipizide: Dx-Dx

A

Beta blockers may mask hypoglycemic sxs

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8
Q

Do not exceed this daily dose of Glipizide…

A

20mg

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9
Q

You’re Pt’s on Glipizide. What are you expecting to happen one day?

A

B-cell burnout.

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10
Q

Repaglinide: class

A

Meglitinide

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11
Q

Repaglinide: MOA

A

Binds adjacent to the sulfonylurea receptor in increases B-cell insulin secretion.

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12
Q

Repaglinide: indication

A

T2DM with a sulfa allergy

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13
Q

Repaglinide: side effects

A

Hypoglycemia, seizures with OD

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14
Q

Repaglinide: contraindication

A

Advanced renal/hepatic disease; T1DM

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15
Q

Repaglinide: Dx-Dx

A

Multiple (CYP3A4 substrate)

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16
Q

Let’s compare Repaglinide to Glipizide…

A

Repaglinide has a faster onset and shorter duration.

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17
Q

How do you take Repaglinide?

A

PO TID 15 mins before meals

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18
Q

Metformin: class

A

Biguanide

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19
Q

Metformin: MOA

A

Decr hepatic glucose production
Decr insulin resistance
Slows intestinal glucose absorption

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20
Q

Metformin: indication

A

DOC for T2DM

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21
Q

Metformin: side effects

A

GI upset; possible lactic acidosis

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22
Q

Metformin: contrainidcations

A

Renal/hepatic disease

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23
Q

Metformin: Dx-Dx

A

IV contrast, etoh, diuretics

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24
Q

Actos: class

A

TZD

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25
Q

Actos: MOA

A

Decr insulin resistance by activating nuclear PPAR-y.

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26
Q

Actos: indication

A

T2DM

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27
Q

Actos: side effects

A

Edema, may incr Fx risk in women

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28
Q

Actos: contraindication

A

Pregnancy, diabetic retinopathy

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29
Q

Actos: Dx-Dx

A

Competes with CYP3A4 substrates

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30
Q

What does Actos require in order to work?

A

Insulin

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31
Q

Actos may stimulate…

A

Ovulation

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32
Q

Precose: class

A

Alpha-glucosidase inhibitor

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33
Q

Precose: MOA

A

Inhibits conversion of polysaccharides to monosaccharides

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34
Q

Precose: indication

A

T1DM, T2DM

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35
Q

Precose: side effects

A

GI upset

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36
Q

Precose: contraindication

A

IBD, IBS

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37
Q

How do you take Precose?

A

PO before each meal

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38
Q

Januvia: class

A

DPP-4 inhibitor

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39
Q

Januvia: MOA

A

DPP-4 inhibition reduces GLP-1 degredation

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40
Q

Januvia: indication

A

T2DM

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41
Q

Januvia: side effects

A

diarrhea, nasopharyngitis

42
Q

You’re old enough now. It’s time we talked about…

A

Insulin

43
Q

Rapid-acting insulin

A

Humalog

44
Q

Humalog: onset/peak/duration

A

Onset: 5-15 min
Peak: 1-1.5 hrs
Duration: 3-5 hrs

45
Q

Short-acting insulin

A

Humulin-R

46
Q

Humulin-R: onset/peak/duration

A

Onset: 30-60 min
Peak: 2-4 hrs
Duration: 5-8 hrs

47
Q

Intermediate-acting insulin

A

Humulin-N

48
Q

Humulin-N: onset/peak/duration

A

Onset: 2-4 hours
Peak: 4-10 hours
Duration: 10-24 hours

49
Q

Long-acting insulin

A

Lantus

50
Q

Lantus: onset/peak/duration

A

Onset: 2-4 hours
Peak: none
Duration: 20-24 hours

51
Q

Is it okay to mix other insulins with your Lantus in the same syringe?

A

No, no it isn’t.

52
Q

In what two concentrations is Lantus available?

A

100u/mL

300u/mL

53
Q

Afrezza: class

A

Oral inhalation rapid acting insulin

54
Q

Afrezza: MOA

A

Inhaled insulin

55
Q

Afrezza: indication

A

T1DM, T2DM

Use with a long-acting insulin

56
Q

Afrezza: side effects

A

May decr FEV1

57
Q

Afrezza: contraindication

A

Smoking w/in 6 months

58
Q

Symlin: class

A

Amylin analog

59
Q

Symlin: MOA

A

Decr gastric emptying, glucagon secretion, appetite

60
Q

Symlin: indication

A

T1DM, T2DM

Use with a long-acting insulin

61
Q

Symlin: side effects

A

anorexia, hypoglycemia

62
Q

Symlin: contraindication

A

Gastroparesis

63
Q

When do you take Symlin?

A

15 mins before meals

64
Q

Can you mix Symlin with insulin?

A

No….I’m beginning to be concerned about your obsession with mixing things into your insulin….get a hobby already.

65
Q

Byetta: class

A

Incretin mimetic: GLP-1

66
Q

Byetta: MOA

A

Incr insulin secretion
Decr glucagon secretion
Slows gastric emptying
Decr appetite

67
Q

Byetta: indication

A

T2DM with Metformin, +/- Sulfonylurea

68
Q

Byette: side effects

A

Necrotizing hemorrhagic pancreatitis

69
Q

Oh, you have necrotizing hemorrhagic pancreatitis?

A

Come back when you’ve got real problems.

70
Q

How do you take Byette?

A

SQ BID 60 mins before meals

71
Q

T1/2 of Byette?

A

2.5 hours

72
Q

Victoza: class

A

Incretin mimetic: GLP-1

73
Q

Victoza: MOA

A

Incr insulin secretion
Decr glucagon secretion
Slows gastric emptying
Decr appetite

74
Q

Victoza: indication

A

T2DM with Metformin, +/- Sulfonylurea

75
Q

Victoza: side effects

A

Necrotizing hemorrhagic pancreatitis AND

HTN….okay now you have problems

76
Q

How do you take Victoza?

A

With a side of necrotizing hemorrhagic pancreatitis plase

77
Q

Okay, how do you really take Victoza?

A

SQ BID before meals

78
Q

Victoza: t1/2

A

13 hours

79
Q

Invokana: class

A

SGLT2 inhibitor

80
Q

Invokana: MOA

A

Inhibits glucose resorption in proximal renal tubule

81
Q

Invokana: indication

A

T2DM adjunct therapy

82
Q

Invokan: side effects

A

Vulvovaginitis, UTI

83
Q

Invokana: contraindications

A

GFR below 30

84
Q

Invokana: Dx-Dx

A

Ace-I/ARBs
Steroids
K+ sparing diuretics
SSRIs

85
Q

Welchol: class

A

Bile acid sequesterant

86
Q

Welchol: MOA

A

Unknown in DM

87
Q

Welchol: indication

A

Adjunct to Metformin, Sulfonylureas, insulin in T2DM

88
Q

Welchol: side effects

A

Constipation, abd pn, incr triglycerides

89
Q

Welchol: contraindication

A

Bowel obstruction

90
Q

Welchol: Dx-Dx

A

May inhibit absorption of other drugs

91
Q

D/C Welchol if triglycerides exceed

A

500

92
Q

Desmopression: class

A

Vasopressin receptor agonist

93
Q

Desmopressin: MOA

A

Incr renal H2O resoprtion

94
Q

Desmopressin: indication

A

Diabetes insipidus

95
Q

Desmopressin: side effects

A

BP changes

decr plasma osmalality

96
Q

Desmopressin: contraindication

A

Hyponatremia

97
Q

Desmopressin: Dx-Dx

A

Lithium, SSRIs, NSAIDs, etoh

98
Q

Okay, let’s talk about A1c

A

Okay, let’s.

99
Q

What drug classes lower A1c by ~0.5-1.0%?

A 
GLP-1
Meglitinide
Alpha-glucosidase
DPP-4 inhibitor
Amylin analog
SGLT2 inhibitor
Bile acid sequestrant
100
Q

What drug classes lower A1c ~1-1.5%?

A

Sulfonylurea
Biguanide
TZD

101
Q

What drug class lowers A1c ~1.5-3.5%?

A

Insulin

Endo Pharm (3 decks)

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