Endocrine agents Flashcards
dulaglutide
Brand - Trulicity
Class - Injectable Antidiabetic Agent, Glucagon-Like Peptide-1 Receptor Agonist
Indication - Diabetes Mellitus 2
Contraindications - Family history of medullary thyroid carcinoma, MEN2
Pregnancy - Low risk
Black Box - Risk of thyroid cancers
Counseling - Inject SQ into the upper arm, thigh, or abdomen; use a different injection site each week. Administer once weekly on the same day each week, without regard to meals or time of day. Administration day can be changed as long as at least 3 d have passed. If using concomitantly with insulin, administer as separate injections (do not mix); may inject in the same body region as insulin, but do not administer both agents directly adjacent to one another. Keep refrigerated, but is stable at room temperature for 14 d. Be aware of symptoms of thyroid cancer (lump in neck, trouble breathing or swallowing) and kidney problems (decreased urination, blood in urine) and report to HCP.
MoA - Dulaglutide is an agonist of human glucagon-like peptide-1 (GLP-1) receptor and augments glucose-dependent insulin secretion and slows gastric emptying.
empagliflozin
Brand - Jardiance
Class - Sodium-glucose co-transporter 2 (SGLT2) inhibitors
Indication - Diabetes Mellitus 2 (Reduce risk of CV death)
Contraindications - Severe impairment or end-stage renal disease
Pregnancy - Risk
Black Box - Risk of thyroid C-cell tumors, contraindicated in family history of Medullary Thyroid Carcinoma (MTC)
Counseling - If signs of ketoacidosis (nausea, vomiting, abdominal pain, tiredness, and labored breathing) occur, seek medical attention. Contact healthcare provider if signs of HTN occur. Dehydration may increase risk of HTN so pt must maintain adequate fluid intake. Concurrent use with sulfonylureas or insulin may increase risk of hypoglycemia. Necrotizing infections of perineum and vaginal / penile yeast infections may occur.
MoA - Empagliflozin works by inhibiting the sodium-glucose co-transporter-2 (SGLT-2) found in the proximal tubules in the kidneys. Through SGLT2 inhibition, empagliflozin reduces renal reabsorption of glucose and increases urinary excretion of glucose (sweet piss encourages infections) Reduction in blood glucose without stimulating insulin release
estradiol
Brand - Estrace
Class - Estrogen hormone
Indication - Abnormal vasomotor function (moderate to severe), Atrophic vulva or vagina (moderate to severe), menopause, Breast cancer (palliation only), Carcinoma of prostate (advanced, androgen-dependent, for palliation only), Decreased estrogen level, secondary to hypogonadism, castration or primary ovarian failutre, Postmenopausal osteoporosis (prophylaxis)
Contraindications - history of thromboembolic disorders, breast cancer, any estrogen-dependent neoplasm, suspected pregnancy
Pregnancy - Contraindicated
Black Box - Endometrial and breast cancer risk, dementia risk; should not be used to reduce CV risk; secondary exposure risk (transdermal solution)
Counseling - Report abnormal vaginal bleeding or signs/symptoms of a thromboembolic disorder. Do not smoke during therapy, as this increases the risk of thromboembolic events.
MoA - Estradiol (17β-estradiol; E2) is the most potent of the naturally occurring estrogens and the major estrogen secreted during the reproductive years. Estradiol and other estrogens produce characteristic effects on specific tissues (such as breast), cause proliferation of vaginal and uterine mucosa, increase calcium deposition in bone, and accelerate epiphyseal closure after initial growth stimulation.
ethinyl estradiol / desogestrel
Class - Contraceptive, Estrogen
Indication -Contraception
Contraindications - Blood pressure 160mm Hg or greater systolic or 100 mmHg or greater diastolic, persistent. Carcinoma of the breast, known or suspected, or personal history. Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia. Cerebral vascular or coronary artery disease, current or history.Cholestatic jaundice of pregnancy or jaundice with prior hormonal contraceptive use.Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. Deep vein thrombophlebitis or thromboembolic disorders, past history. Diabetes with vascular involvement. Genital bleeding, undiagnosed abnormal. Headaches with focal neurological symptoms. Smoke, if over age 35. Heavy cigarette smoking. Hepatic adenomas or carcinomas or active liver disease. Hepatocellular disease with abnormal liver function. Hypersensitivity to any component of these products. Hypertension, severe. Major surgery with prolonged immobilization. pregnancy, known or suspected. Thrombophlebitis, valvular heart disease. inherited or acquired hypercoagulopathies
Pregnancy - Contraindicated
Black Box - Oral: Smoking is not advised in women using oral contraceptives. Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age
Tablet: Ortho-Cept(R): Cigarette smoking increases the risk of serious cardiovascular side effects from combination oral contraceptive use. This risk increases with age and with the number of cigarettes smoked and is quite marked in women over 35 years of age. Use of combination oral contraceptives is not recommended in women who are over 35 years of age that smoke [5].
Velivet(TM): Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use oral contraceptives should be strongly advised not to smoke [9].
Desogen(R): Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs are contraindicated in women who are over 35 years of age, and smoke
Counseling - Report upcoming elective surgeries, prolonged periods of immunocilization, or recent childbirth as this may increase the risk of blod clots. Side effects may include nausea, vomiting, breakthrough bleeding, weight gain, breast tenderness, headache, and migraine. Caution patient to report symptoms of blood clots, liver tumors, or high blood pressure. Report persistent bleeding. Counsel patient to report changes in vision or difficulty with contact lens wear. Advise patient to report symptoms of fluid retention. Take drug at the same time every day and do not allow mroe than 24 hours between doses. Use a non-hormonal backup form of contraception for the first 7 days. Do not smoke during baby .Encourage to patient not smoke during therapy. Instruct patient that if a single active dose is missed take the tablet as soon as possible and resume a normal schedule. If more than one active dose is missed, contact a physician for instructions. Use of additional nonhormonal methods of contraception may be necessary
MoA - The contraceptive effect of desogestrel/ethinyl estradiol is based on interaction of various factors, the most important of which is ovulation inhibition and changes in cervical secretion [467]. Desogestrel/ethinyl estradiol is a combination of oral contraceptives that acts by suppressing gonadotropins. This activity leads to inhibition of ovulation, changes in cervical mucus and endometrium, thus, preventing fertilization and implantation [3]. Ethinyl estradiol is a well-known synthetic estrogen. Desogestrel is a synthetic progestogen. After oral administration it has a strong ovulation-inhibiting activity, a strong progestational and anti-estrogenic activity, no estrogenic activity, very weak androgenic/anabolic activity
ethinyl estradiol / drospirenone
Class - Contraceptive combination
Indication - Acne (Moderate), Contraception, Premenstrual dysphoric disorder
Contraindications - A) Adrenal insufficiency
B) Breast cancer or other estrogen or progestin-sensitive cancer, current or past history
C) Cerebrovascular disease
D) Concomitant use with hepatitis C drug combinations containing ombitasvir, paritaprevir/ritonavir, with or without dasabuvir
E) Coronary artery disease
F) Deep vein thrombosis or pulmonary embolism, current or past history
G) Diabetes mellitus with vascular disease
H) Headaches with focal neurological symptoms or migraine headaches with or without aura if over age 35 years
I) Hepatic dysfunction
J) Hepatic tumors, benign or malignant
K) Hypercoagulopathies, inherited or acquired
L) Hypertension, uncontrolled
N) Renal insufficiency
O) Smoking and over age 35 years
P) Thrombogenic valvular or thrombogenic rhythm diseases of the heart (eg, subacute bacterial endocarditis with valvular disease or atrial fibrillation)
Q) Uterine bleeding, undiagnosed, abnormal
Pregnancy - Contraindicated
Black Box - Cigarette Smoking and Serious Cardiovascular Events (esp in +35 y women)
Counseling - Patients over 35 years of age should not smoke during therapy, as this increases the risk of serious cardiovascular side effects.
Advise patient to practice safe sex. Drug does not prevent disease transmission. [6][7]
Discuss potential long-term adverse effects of hormone therapy including myocardial infarction, stroke, thrombophlebitis, dementia, venous thromboembolism (VTE), pulmonary embolism, and breast cancer. Inform patient that risk of VTE is greatest after initially starting therapy or restarting therapy after a 4-week or greater pill-free interval. [6][7]
Drug may cause premenstrual syndrome, headache/migraine, breast pain/tenderness/discomfort, nausea/vomiting, fatigue, abdominal pain/tenderness/discomfort, weight gain, and mood changes. [6][7]
Instruct patient to report signs/symptoms of serious cardiovascular events, such as myocardial infarction, stroke, and arterial or venous thrombosis. [6][7]
Patient should report new headaches that are persistent, severe, or recurrent, abnormal vaginal bleeding, amenorrhea of 2 or more consecutive cycles, or jaundice. [6][7]
Patients should report any unexplained partial or complete loss of vision. In addition, patients who wear contact lenses should report visual changes or changes in lens tolerance. [6][7]
This drug should be taken every day, at the same time each day, in the exact order noted on the packaging. [6][7]
Advise patient to use a nonhormonal back-up form of contraception for the first 7 days if a Sunday-start regimen is initiated or if drug is started postpartum but before menstruation resumes. [6][7]
Advise patient that certain drugs may cause oral contraceptives to be less effective and backup contraception may be necessary. Consult healthcare professional prior to new drug use. [6][7]
Review with the patient the procedure for handling missed doses. It is very important that the patient follow carefully missed-dose instructions for the particular brand or formulation prescribed in order to prevent pregnancy. [6][7]
MoA -The contraceptive effect of drospirenone/ethinyl estradiol is based on interaction of various factors, the most important of which is ovulation inhibition and changes in the endometrium [485]. Drospirenone/ethinyl estradiol is an combination oral contraceptive (COC) that works primarily by suppressing ovulation. Additionally, COC agents cause cervical mucus changes that block sperm penetration and endometrial changes that reduce the chance of implantation [482][483]. Although the exact mechanism of action in acne is unknown, drospirenone and ethinyl estradiol increase sex hormone binding globulin and decrease free testosterone, which may play a role
ethinyl estradiol / etonogestrel [vaginal ring]
Brand - NuvaRing
Class - Contraceptive
Indication - Contraception
Reduce risk of cardiovascular death in adult patients with Diabetes Mellitus 2 and established cardiovascular disease
Contraindications - History of thromboembolic disorders, endometrial cancer, uncontrolled HTN, pregnancy, smoking >15 cigs per d and >35 age
Pregnancy - Contra
Black Box - Smoking risk
Counseling - Ring administration counseling and general contraceptive info
MoA - See Preface C Card
ethinyl estradiol / levonorgestrel
Class - Contraceptive, Contraceptive combination
Indication - Contraception
Contraindications - A) Acute viral hepatitis, or severe (decompensated) cirrhosis [6]
B) BMI greater than or equal to 30 kg/m(2)
C) Carcinoma of the breast, known, suspected, or personal history
D) Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
or progestin-sensitive cancer, current or past
E) Cerebrovascular or coronary artery disease, current or past history
F) Cholestatic jaundice of pregnancy or jaundice with prior pill use
G) Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
H) Deep vein thrombophlebitis or thromboembolic disorders (eg, pulmonary embolism), current or history of
I) Diabetes with vascular disease
J) Diabetes mellitus and are over age 35, diabetes mellitus with hypertension or other end-organ damage, or diabetes mellitus of greater than 20 years duration
K) Genital bleeding, undiagnosed, abnormal
L) Headaches with focal neurological symptoms
M) Hepatic adenomas or carcinomas or other liver tumors, benign or malignant
N) Hypersensitivity to any of the product components
O) Liver disease, active
P) Major surgery with prolonged immobilization
Q) Migraines with aura
R) Migraines with or without aura and older than 35 years
S) Pregnancy, known or suspected Smoking and older than 35 years
U) Thrombogenic rhythm disorders
V) Thrombophilias, hereditary or acquired
W) Thrombophlebitis or thromboembolic disorders
X) Uncontrolled hypertension or hypertension with vascular disease
Y) Undiagnosed abnormal uterine bleeding
Z) Valvular heart disease with thrombogenic complications
Pregnancy - Contraindicated
Black Box - Oral (Tablet)
a) Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptives (COC) use. This risk increases with age, particularly in women older than 35 years, and with the number of cigarettes smoked. Women who use oral contraceptives should be strongly advised not to smoke
2) Transdermal (Patch, Extended Release)
a) Warning: Cigarette Smoking and Serious Cardiovascular Events and Contraindicated in Women with BMI greater than or equal to 30 kg/m(2)
Cigarette Smoking and Serious Cardiovascular Events
Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, CHCs, including levonorgestrel/ethinyl estradiol, are contraindicated in women who are over 35 years of age and smoke.
Contraindicated in Women with a BMI greater than or equal to 30 kg/m(2)
Levonorgestrel/ethinyl estradiol is contraindicated in women with a BMI greater than or equal to 30 kg/m(2). Compared to women with a lower BMI, women with a BMI greater than or equal to 30 kg/m(2) had reduced effectiveness and may have a higher risk for venous thromboembolism events (VTEs)[6].
Counseling - Inform patient of serious long-term adverse effects of hormone therapy including myocardial infarction, stroke, deep vein thrombosis, pulmonary embolism, dementia, and breast or endometrial cancer [6][19].
Advise patient to report symptoms of pregnancy, including amenorrhea that occurs in 2 or more consecutive cycles, and to discontinue use if pregnancy is confirmed
Oral side effects may include elevated blood pressure, headache, migraines, enlarged or tender breasts, dizziness, mood changes, nausea and pancreatitis [19].
Transdermal side effects may include application site disorders, nausea, headache, dysmenorrhea, and increased weight.
Tell patient to report persistent or prolonged vaginal bleeding.
Instruct patient to report any unexplained partial or complete loss of vision and patient who wears contact lenses to report visual changes or changes in lens tolerance.
Advise patient to use a non-hormonal backup form of contraception for the first 7 days of use.
Counsel patient to take oral tablets at the same time each day.
Instruct patient using transdermal patch to avoid frequent or prolonged water exposure and large amounts of body lotions or oils and to check for partial or complete detachment once daily and also after water exposure.
Tell patient to avoid smoking cigarettes during therapy.
Instruct patient to avoid St. John’s Wort during therapy.
Counsel patient to contact healthcare professional for instructions if a dose is missed and that additional contraception may be required in the event of a missed dose.
MoA -Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation) [480][481].
ethinyl estradiol / norethindrone
Class - Contraceptive, Estrogen
Indication - Contraception
Contraindications - A)Blood pressure 160 mmHg or greater systolic or 100 mgHg or greater, persistent
B) Carcinoma of the breast, known or suspected, or personal history of breast cancer
C) Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
D) Cerebral vascular or coronary artery disease, current or history
E) Cholestatic jaundice of pregnancy or jaundice with prior pill use
F) Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
G) Deep vein thrombophlebitis or thromboembolic disorders, past history
H) Diabetes with vascular involvement
I) Genital bleeding, undiagnosed abnormal
J) Headaches with focal neurological symptoms
K) Hepatic adenomas or carcinomas
L) Hepatocellular disease with abnormal liver function, acute or chronic
M) Hypersensitivity to any component of the product
N) Hypertension, uncontrolled
O) Major surgery with prolonged immobilization
P) Pregnancy, known or suspected
Q) Thrombophlebitis, thromboembolic disorders, or known thrombophilic conditions
R) Valvular heart disease with complications
Pregnancy - Contraindicated
Black Box - 1) Oral (Tablet)
Modicon(R), Ortho-Novum(R):
Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, combination oral contraceptives, including norethindrone/ethinyl estradiol, should not be used by women who are over 35 years of age and smoke.
Ovcon 35(R):
Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with the extent of smoking (in epidemiologic studies, 15 or more cigarettes per day was associated with a significantly increased risk) and is quite marked in women over 35 years of age. Women who use oral contraceptives should be strongly advised not to smoke.
Counseling - Advise patient to practice safe sex. Drug does not prevent disease transmission.
Discuss potential long-term adverse effects of hormone therapy including myocardial infarction, stroke, thrombophlebitis, dementia, pulmonary embolism, or breast cancer.
This drug may cause chloasma, change in weight, bloating, nausea, stomach cramps, vomiting, migraine, depression, amenorrhea, breakthrough bleeding, breast tenderness or swelling, or nipple discharge.
Tell patient to report persistent/recurrent abnormal vaginal bleeding.
Patients should report any unexplained partial or complete loss of vision. In addition, patients who wear contact lenses should report visual changes or changes in lens tolerance.
This drug should be taken every day, at the same time each day with not more than 24 h between doses.
Advise patient to use a non-hormonal backup form of contraception for the first 7 days if a Sunday-start regimen is initiated.
Patients should not smoke during therapy, as this increases the risk of serious cardiovascular side effects.
Review with the patient the procedure for handling missed doses. It is very important that the patient follow carefully missed-dose instructions for the particular brand or formulation prescribed in order to prevent pregnancy. In many cases, this will necessitate the use of a back-up method of contraception until the regular schedule has been reestablished.
If patient is still unsure of what to do in the event of a missed dose, patient should use a back-up form of contraception and contact healthcare professional for instructions.
MoA - Combined oral contraceptives suppress gonadotropins to prevent pregnancy. Inhibition of ovulation is the primary mechanism by which pregnancy is prevented. Gonadotropin suppression also changes the cervical mucus, increasing the difficulty of sperm entry into the uterus, and altering the endometrium to reduce the likelihood of implantation
ethinyl estradiol / norgestimate
Class - Contraceptive, Endocrine-Metabolic Agent
Indication - Acne - Contraception
Contraception
Contraindications - A)Arterial or venous thrombotic diseases, patients at high risk
B) Breast cancer or other estrogen-or progestin-sensitive cancer, history of or current
C) Cerebrovascular disease
D) Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
E) Coronary artery disease
F) Diabetes mellitus with vascular disease
G) DVT or pulmonary embolism, history of or current
H) Headaches with focal neurological symptoms
I) Hypercoagulopathies, inherited or acquired
J) Hypertension, uncontrolled
K) Liver disease or liver tumors, benign or malignant
L) Migraine headaches in patients older than 35 years
M) Migraine headaches with aura
N) Pregnancy
O) Smoking, women older than 35 years
P) Thrombogenic valvular or thrombogenic rhythm diseases of the heart (eg, atrial fibrillation or subacute bacterial endocarditis with valvular disease)
Q) Uterine bleeding, undiagnosed abnormal
Pregnancy - Contraindicated
Black Box - 1) Oral (Tablet)
Cigarette Smoking and Serious Cardiovascular Events
Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive use.
This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked.
For this reason, combination oral contraceptives are contraindicated in women who are over 35 years of age and smoke
Counseling - Warn patient to report symptoms of venous or arterial thrombosis.
Instruct patient to report symptoms of gallbladder disease or jaundice.
Counsel patient to report any irregularities in vaginal bleeding.
Side effects may include headache, migraine, abdominal pain, flatulence, vaginal infection, genital discharge, breast discharge, breast pain or enlargement, mood disorders, nervousness, chloasma, and weight changes.
Advise patient to take tablet at the same time every day.
Instruct patient that if a single active dose is missed, including vomiting or diarrhea within 3 to 4 hours after the active dose, take the tablet as soon as possible and resume a normal schedule. If more than one active dose is missed, contact a physician for instructions. Use of additional nonhormonal methods of contraception may be necessary.
MoA - Ethinyl estradiol, an estrogen, and norgestimate, a progestin, are a combination product that reduces the possibility of pregnancy primarily via suppression of ovulation; although, other mechanisms may include changes in cervical mucus that inhibit sperm penetration and in the endometrium that reduce the chances of implantation. The exact mechanism involved in the treatment of acne is not established, but may be related to increase of sex hormone-binding globulin and reduction of free testosterone
glimepiride
Brand - Amaryl
Class - Second-Generation Sulfonylurea, Antidiabetic
Indication - Diabetes mellitus, type 2
Contraindications - diabetic ketoacidosis
Counseling - Monitor blood glucose in frequent intervals (2-4 times per d); if <70 mg/dL, eat candy or sugar and contact prescriber. Take with food in the morning. Use a sunscreen and avoid sunlamps and tanning beds. Do not drink alcohol; may cause a disulfiram reaction.
MoA - Sulfonylureas enhance insulin secretion from pancreatic β-cells and potentiate insulin action on several extrahepatic tissues. Long-term sulfonylureas increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase the sensitivity and/or number of peripheral insulin receptors.
glipizide
Brand - Glucotrol
Class - Second-Generation Sulfonylurea, Antidiabetic
Indication - Diabetes mellitus only type 2
Contraindications - Hypersensitivity to sulfonylureas, diabetic ketoacidosis, type 1 diabetes
Counseling - Monitor blood glucose in frequent intervals (2-4 times per d); if <70 mg/dL, eat candy or sugar and contact prescriber. Use a sunscreen and avoid sunlamps and tanning beds. Do not drink alcohol; may cause a disulfiram reaction. Take 30 min before morning meal. Do not chew or crush extended-release formulation.
MoA - Sulfonylureas enhance insulin secretion from pancreatic β-cells and potentiate insulin action on several extrahepatic tissues. Long-term sulfonylureas increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase the sensitivity and/or number of peripheral insulin receptors.
insulin aspart
Brand - Fiasp, Novolog
Class - Insulin (FAST ACTING)
Indication - Diabetes mellitus
Contraindications - Hypersensitivity
Pregnancy - Compatible
Black Box - Risk of acute bronchospasm with inhaled formulation
Counseling - Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
MoA - Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
insulin degludec
Brand - Tresiba
Class - Insulin (LONG ACTING)
Indication -Diabetes mellitus
Contraindications - Hypersensitivity
Pregnancy - None
Black Box - Risk of acute bronchospasm with inhaled formulation
Counseling - Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
MoA - Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
insulin detemir
Brand - Levemir
Class - Insulin (LONG ACTING)
Indication - Diabetes mellitus type
Contraindications - Hypersensitivity
Pregnancy - Compatible
Black Box - Risk of acute bronchospasm with inhaled formulation
Counseling - Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
MoA - Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
insulin glargine
Brand - Lantus
Class - Insulin (LONG ACTING)
Indication - Diabetes mellitus T
Contraindications - Hypersensitivity
Pregnancy - Compatible
Black Box - Risk of acute bronchospasm with inhaled formulation
Counseling - Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
MoA - Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
