dibetes

Question 1

Biguanide

Answer 1

works primarily by decreasing hepatic glucose production. Also decreases instestinal absorption of glucose and improves insulin sensitivity

Question 2

Glucophage, XR, Fortamet, Glumetza

Answer 2

decrease A1C 1-2%, BBW: lactic acidosis, C/I: men Scr>=1.5, female >=1.4, Crcl < 60, caution in heart failure if worsening hold metformin, SE: NVD, flatulence, B12 deficiency, NO hypoglycemia, hold iodinated contrast dye for 48 hours, decrease in B12 absoroption

Question 3

Metaglip

Answer 3

metformin + glipizide

Question 4

Glucovance

Answer 4

metformin + glyburide

Question 5

Actoplus Met

Answer 5

metformin + pioglitazone

Question 6

Avandamet

Answer 6

metformin + rosiglitazone

Question 7

Janumet, XR

Answer 7

metformin + sitagliptin

Question 8

Kombiglyze, XR

Answer 8

metformin + saxagliptin

Question 9

Jentadueto

Answer 9

metformin + linagliptin

Question 10

PrandiMet

Answer 10

metformin + repaglinide

Question 11

Sulfonylureas

Answer 11

work by stimulating insulin secretion from the pancreatic beta cells. Do not use with meglitinides due to similar MOA

Question 12

Diabinese

Answer 12

chlorpropamide, SE hypoglycemia, weight gain

Question 13

Older sulfonylureas no longer used

Answer 13

acetohexamide, tolazamide, tolbutamide

Question 14

Glucotrol, XL

Answer 14

glipizide

Question 15

Amaryl

Answer 15

glimepiride

Question 16

Duetact

Answer 16

glimepiride + pioglitazone

Question 17

DiaBeta

Answer 17

glyburide

Question 18

Glynase PresTab

Answer 18

micronized glyburide

Question 19

Meglitinides

Answer 19

work by stimulating insulin secretion from the pancreatic beta cells. Do not use with sulfonylureas due to similar MOA

Question 20

Prandin

Answer 20

repaglinide SE:hypoglycemia, weight gain, URTI, gemfibrozil increases prandin concentration

Question 21

Starlix

Answer 21

nateglinide

Question 22

Thiazolidinediones (TZDs)

Answer 22

are peroxisome proliferator-activated receptor gamma agonist causing increase peripheral insulin sensitivity, increase uptake and utilization of glucose by the peripheral tissue, insulin sensitizer

Question 23

Actos

Answer 23

pioglitazone, BBW: NYHA class 3 & 4 heart failure may exacerbate HF, do not use with active bladder cancer, SE: weight gain, CHF, peripheral & macular edema, increase fracture risk, increase LFTs

Question 24

Avandia

Answer 24

rosiglitazone, BBW: NYHA class 3 & 4 heart failure may exacerbate HF, SE: weight gain, CHF, peripheral & macular edema, increase fracture risk, increase LFTs

Question 25

Avandaryl

Answer 25

rosiglitazone + glimepiride

Question 26

Alpha-glucosidase inhibitors

Answer 26

inhibit alpha glucosidase in the intestines resulting in delayed absorption of glucose. Also inhibit metabolism of sucrose to glucose and fructose. Inhibits pancreatic nz which delay the digestion of starch

Question 27

Precose

Answer 27

acarbose, with first bite of each main meal, CI: IBD, colonic ulceration, intestinal obstruction, SE: GI effects, good: increase HDL, and decrease TG & total cholesterol

Question 28

Glyset

Answer 28

miglitol, with first bite of each main meal, CI: IBD, colonic ulceration, intestinal obstruction, SE: GI effects, good: increase HDL, and decrease TG & total cholesterol

Question 29

DDP4 inhibitors aka incretin enhancers

Answer 29

dipeptidyl peptidase IV inhibitors prevent the enzyme DPP4 from breaking down incretin hormones, glucagon like peptide-1 (GLP1) and glucose dependent insulinotropic polypeptide. These hormones help to regulate blood glucose by increasing insulin release from the pancreatic beta cells and decreasing glucagon secretion from pancreatic alpha cells. A reduction in glucagon results in decreased glucose production.

Question 30

Januvia

Answer 30

sitagliptin, SE: weight neutral

Question 31

Juvisync

Answer 31

sitagliptin + simvastatin

Question 32

Onglyza

Answer 32

saxagliptin

Question 33

Tradjenta

Answer 33

linagliptin

Question 34

Glucagon like peptide 1 (GLP1) Agonist aka incretin mimetics

Answer 34

analogs of glucagon-like peptide-1 which increase insulin secretion and decrease glucagon secretion, slow gastric emptying, improve satiety, and may result in weight loss

Question 35

Byetta

Answer 35

exenatide, warning: pancreatitis, SE: nausea, avoid Crcl < 30 , SC

Question 36

Bydureon

Answer 36

exenatide ER, bbw: hx or FH of medullary thyroid carcinoma, warning: pancreatitis, SE: nausea, avoid Crcl < 30, SC

Question 37

Victoza

Answer 37

liraglutide, can be used as mono or combo, SC

Question 38

Pramlinitide MOA

Answer 38

synthetic analog of the human neuroendocrine hormone, amylin which is produced by pancreatic beta cells to assist in postprandial glucose control. Amylin helps slow gastric emptying and prevents an increase in serum glucagon following a meal and increases satiety. This is a amylinomimetic agent

Question 39

Symlin

Answer 39

pramlinitide, BBW: coadminister w insulin may cause hypoglycemia, SE: hypoglycemia, nausea, anorexia, Administer SC abdomen or thigh prior to each meal, comes in pen or vial and can be used in DM 1 & 2

Question 40

Bile Acid Binding Resins MOA

Answer 40

resins work by binding bile, blocking reabsorption. Bile is produced from cholesterol and cholesterol levels decrease.

Question 41

Welchol

Answer 41

colesevelam, CI: bowel obstruction

Question 42

Rapid Acting Insulin

Answer 42

aspart, glulisine, lispro

Question 43

Novolog, Novolog FlexPen

Answer 43

aspart

Question 44

Apidra, Apidra SoloStar

Answer 44

glulisine

Question 45

Humalog, Humalog KwikPen

Answer 45

lispro

Question 46

Humulin R, Novolin R

Answer 46

Regular, short acting insulin

Question 47

Humulin N, Novolin N

Answer 47

NPH, intermediate acting

Question 48

Long Acting insulin

Answer 48

detemir, glargine

Question 49

Levemir, Levemir FlexPen

Answer 49

detemir

Question 50

Lantus, Lantus SoloStar

Answer 50

glargine