DM Flashcards
Januvia
What type of drug?
Oral or SubQ?
Does in need dose adjustments?
Sitagliptin
Oral
DPP-4 inhibitor
Increases insulin release, decreases glucagon secretion
CrCl: 30-49: dose in half to 50 mg daily CrCl< 30 give 25 mg daily
generic dpp-4 inhibitors end in?
WHat do they have a risk of?
gliptin
Risk of heart failure Saxa and alogliptin specifically
What dpp-4 inhibitor ending in gliptin does not need renal adjustments?
Linagliptin
Tradjenta
Warnings for DPP_4 inhibitos
Gliptins
Acute pancreatitis and Risk of Heart failure Saxa and alo
What GLP-1 agonist is approved to reduce the risk of cardiovascular events in pt with TsDM and ASCVD
Liraglutide
Victoza
What two classis of DM agens have warnings for pancreatitis?
DPP-4 and GPP-1 Inhibitors
Goals for DM in pregnancy
Fasting <=95
1 hour post: <=140
2 hour post: <=120
A pt that is >=40 withoout ASCVD and DM
Moderate intensity statin
Rule of 500 calculation for rapid acting
500/total daily dose of insulin= grams of carbs covered by 1 unit rapid acting
Rule of 450 for regular indulin
450/total daily insulin
Grams covered by 1 unit
Rule of 1800 correction factor for rapid acting
Correction factor for 1 unit of total daily insulin
Insulin pens where no needle is included 4 types
- Flexpen: Novolog products
- Kwikpen: Humalog, humilin, Basaglar
- Flextouch, Levemir, Fiasp, Tresiba
- Solostar: Lantus, admelog, Toujeo
GLP-1 agonists that do not have needle 3
- Victoza
- Byetta
- Adlyxin
Pramilinide that does not have a needle
SymlinPen
5 drugs that can lower blood glucose
- Linezolid
- Lorcaserin (Belviq)
- Pentamidine
- Beta blockers
- Quinolones
- BB and quinolones can also cause hyperglycemia
Hyperglycemic crisis treatment
4 things
- Fluids
- Start with NS when BG reaches 250 mg/dL change to D5W 1/2NS
- Regular insulin Infusion (insulin of choice)
- 0.15 units/kg bolus then start continuous infusion at a rate of 0.1 units/kg/hr
- Prevent hypokalemia
- Monitor and keep 4-5
- Treat acidosis if pH is <7 give sodium bicarb as needed
What 5 drugs have the biggest decrease in A1C?
- Insulin biggest
- Metformin
- SUs
- TZDs
- GLP-1 agonists
Greatest hypoglycemic risk? 4
- Insulin most
- SUs
- Meglinitides
- pramlintide (with insulin)
Most likely to cause wt gain 4
- Insulin
- SUs
- Meglinitides
- TZDs
Drugs most likely to cause wt loss? 3
- SGLT2
- GLP-1 agonists
- Pramlintide
Cardiac benefit drugs? DM plus CVD event 3
- Empagliflozin
- Liraglutide
Cheapest DM meds 3
Metformin, SUs, TZDs
Injectable formulations 3
- Insulin
- GLP
- Pramlinitide
What drugs should be avoided in pts with HF? 3
- TZDs
- Alogliptin
- Saxagliptin
What drugs should you NOT use if a patient has PAD, DM foot, ulcers, peripheral neuropathy
Canagliflozin
If a patient has gsatroporesis or GI disorder what two dont you use?
- GLP-agonists
- Pramlitinide
Sulfa allergy What should be avoided?
SUs