Diabetes Oral Drugs Flashcards
Glipizide Adverse Effects
- Hypoglycemia
- Weight gain and GI problems
- Hematologic: leukopenia, thrombocytopenia, aplastic anemia
- Allergic skin reactions/photosensitivity
Glipizide Dosages
Starting dose: 2.5 - 5 mg QD
Max: 40 mg (in practice 20 mg)
Pioglitazone Adverse Effects
- Hepatotoxicity
- Resumption of ovulation
- Exacerbation of HF
- Macular edema
- Increased fracture risk
Pioglitazone Dosing
Starting Dose: 15 - 30 mg QD
Max Dose: 30 -45 mg QD
Titrate every 12 hours
Metformin Interactions
CONTRAINDICATED in those disorders which increase the tendency toward lactic acidosis, renal dysfunctions, unstable HF patients, alcoholics
Metformin Adverse Effects
GI discomfort (N/V/D), B12 deficiency, dementia risk
SGLT2 inhibitors Adverse Effects
- UTIs
- Yeast/fungal infections
- Increased urination
- others - hypotension, hyperkalemia, increased cholesterol
Dapagliflozin Dosing
if eGFR is greater than 45: Initial dose is 5mg QD and Max is 10 mg QD
if eGFR is less than 25: DO NOT USE
DPP-IV inhibitors MOA
DPP-IV is a protease that degrades GIP and GLP-1 and decreases their concentration in the blood -> decreases incretin effect -> decreases insulin secretion; inhibiting this would increase in insulin secretion (cAMP pathway) and increase in beta-cell proliferation and protection from cell death in the ERK ½ pathway
DPP-IV inhibitors Drug Examples
saxagliptin, sitagliptin, linagliptin, alogliptin
Metformin Dosing
Initial Dosing: 500 mg PO BID or 850 mg PO QD w/ meals
Max Dose: 2 g/day or PI = 2.55 g/day
Titrate dose weekly or bi-monthly and increase by 250 - 500 mg/day
Metformin Dosing in Renal Insufficiency
if eGFR is between 30-40: reduce metformin dose by 50%
if eGFR is less than 30: STOP METFORMIN
Empagliflozin Dosing
if eGFR is greater than 30: Initial dose is 10 mg QD and Max is 25 mg QD
do not use if less than 30
Canagliflozin Dosing
