Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology II > Diabetes Oral Medications > Flashcards

Diabetes Oral Medications Flashcards

1
Q

During a fasting state/gluconeogenesis, what do the alpha cells of the pancreas secrete?

A

Glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is secreted by the Beta cells of the pancreas?

A
  • Insulin
  • C-peptide
  • Proinsulin
  • Amylin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Metabolic syndrome components of diagnosis

A
  1. Hypertriglyceridemia
  2. HDL (below 40 in men, or below 50 in women)
  3. Hypertension: >130/85
  4. Fasting plasma glucose (>100)

Need two of these (or being treated for 2) with waist circumfirence >40 men, >35 women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

For diabetic nephropathy, what hypertension medications are typically used?

A

1st line: ACE and ARB

2nd line: Diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name the 5 most important invertentions in decreasing order of benefit

A
  1. Smoking cessation
  2. Blood pressure control
  3. Metformin therapy
  4. Lipid reduction
  5. Glycemic control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does fasting blood sugar help you gauge?

A

effectiveness of basal insulin or agents that decrease hepatic gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is postmeal blood sugar obtained?

A

2 hours post prandial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which oral medications work to decrease glucose absorption from the gut?

A
  1. Alpha-glucosidase inhibitors

2. Amylin mimetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which oral diabetes medications decrease glucose production by the liver?

A
  1. Metformin (Biguanides)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which medications increase glucose utilization by the muscles?

A

TZDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which oral meds increase insulin secretion?

A
  1. Sulfonylureas
  2. GLP-1 activators
  3. DPP-4 inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which drug is associated with black box warning of amputation?

A

SGLT-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which drug is associated with black box warning of thyroid c-cell tumors??

A

GLP-1s (ex. liraglutide, albiglutide, dulaglutide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DPP-4 inhibitors ADE

A
  • risk of acute pancreatitis

- Joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which oral drug has a black box warning of congestive heart failure?

A

Thiazolidinediones (pioglitazone, rosiglitazone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which drug carries with it a risk of bladder cancer?

A

pioglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which sulfonylurea is not recommended?

A

Glyburide

Glipizide and glimepiride are okay

18
Q

Metformin: Pharmacodynamics

A
  • Improved insulin sensitivity
  • Decreased glucose production by liver
  • Improved glucose uptake by muscles
19
Q

Metformin (Biguanides): key points

A
  • 1st line
  • start slow to minimize diarrhea
  • weight neutral
20
Q

Thiazolidinedione: effect

A

enhanced insulin sensitivity in muscle, liver, and fat

-Pioglitazone may decrease triglycerides

21
Q

Thiazolidinedione: ADE

A
  • weight gain*

- Fluid retention

22
Q

What is important to remember about Sulfonylureas and Metaglinides regarding carbs?

A

must keep under 60g a meal for these to work well

23
Q

Sulfonylureas: ADE

A
  • hypoglycemia**
  • weight gain
  • 3rd line agents (but usually this is what people can afford)
24
Q

Glucagon-like Peptide 1 Receptor agonists: Examples

A

Exenatide, Liraglutide, albiglutide, Dulaglutide, Semaglutide

25
Q

GLP-1 effects

A
  • enhanced insulin secretion
  • suppresses high postprandial glucagon secretion
  • Decreased hepatic glucose production
  • Increased satiety
  • Slowed gastric emptying
  • Weight loss
26
Q

Dipeptidyl Peptidase-4 (DPP-4) “gliptins”

A

Ex. Sitagliptin (Januvia), Saxagliptin, Linagliptin, Alogliptin

27
Q

DPP-4 effects

A

prolong half-life of endogenously produced GLP-1 significantly reducing inappropriately elevated postprandial glucagon and improving beta cell response to hyperglycemia

28
Q

SGLT-2: examples

A

“gliflozins”

Canagliflozin (Invokana), Dapagliflozin, Empagliflozin

29
Q

SGLT-2 effects

A
  • More glucose lost in the urine

- 2nd or 3rd line therapy

30
Q

alpha-Glucosidase inhibitors: examples

A

Acarbose, Miglitol

31
Q

alpha-Glucosidase Inhibitors: effect

A
  • prolong carbohydrate absorption in the small intestine

- reduction in postprandial glucose (no effect on fasting blood glucose)

32
Q

alpha-glucosidase inhibitors: ADE

A

flatulence, bloating, abdominal discomfort, and diarrhea

33
Q

Bromocriptine (dopamine agonist) dosing

A

Daily dose taken with food within 2 hours of waking from sleep (skip if not in this window)

34
Q

If a patient presents to you with an A1C < 7.5% what therapy is suggested?

A

Monotherapy = metformin

35
Q

If a patient presents to you with an A1C > 7.5% what therapy is suggested?

A

Dualtherapy = Metformin + GLP-1 or SGLT-2 or DPP-4

36
Q

If a patient presents to you with an A1C >9% with symptoms what therapy is suggested?

A

Insulin + oral agents

37
Q

For adding basal insulin, if a patient has A1C <8% what is the recommended starting dose?

A
  1. 1-0.2 U/kg

- titrate every 2-3 days to reach glycemic goal

38
Q

What is the starting basal dose if A1C is >8%?

A

0.2-0.3 U/kg

39
Q

What is the starting dose for prandial insulin?

A

10% of the basal dose (or 5 units)

40
Q

Somogyi Effect

A

Hypoglycemia in the nighttime resulting in rebound high blood sugar in the morning

Pharmacology II (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions