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Phamacology Summer > ENDOCRINE: Diabetes Part 2 > Flashcards

ENDOCRINE: Diabetes Part 2 Flashcards

1
Q

Biguanides

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

a. metformin

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2
Q

Sulfonylureas

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

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3
Q

◦ Glinides (meglitinides)

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

c. Repaglinide

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4
Q

◦ TZD’s (Thiazolidinediones)

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

d. Pioglitazone

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5
Q

◦ Alpha-glucosidase inhibitors

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

e. Acarbose

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6
Q

◦ DPP-IV inhibitors (Dipeptidyl peptidase-4), Gliptins

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

f. Sitagliptin

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7
Q

◦ Sodium-Glucose Co-Transport 2 (SGLT-2) Inhibitor

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

g. Canagliflozin

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8
Q

◦ Glucagon Like Peptide-1 (GLP-1) Receptor Analogs

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

h. exenatide

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9
Q 
USED TO TREAT
◦ Diabetes
◦ Pre-Diabetes!
◦ Polycystic Ovary Syndrome (PCOS)
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

a. metformin

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10
Q

• Commonly associated with GI issues- N/D- 20%

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

a. metformin

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11
Q

• BOXED WARNING: Lactic Acidosis- can accumulate in
renal impairment, rare…but can be deadly
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

a. metformin

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12
Q

If receiving contrast (media dye) , you MUST hold

metformin x ? hours AFTER procedure

A

48

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13
Q

◦ Due to the GI upset- patients may not absorb B vitamins (may need
to supplement B12 + folic acid)
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

a. metformin

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14
Q 
Weight Neutral! (some state weight loss)
• NO HYPOGLYCEMIA- called “euglycemic
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
A

a. metformin

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15
Q

USED TO TREAT
◦ Only for DM2 (increase insulin secretion)
◦ Usually take with food, sometimes patients may take
long acting versions before bed
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

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16
Q

Think of HypoGLYcemia

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

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17
Q

MECHANISM OF ACTION:
◦ It SQUEEZES insulin out of the pancreas
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

c. Repaglinide

18
Q

◦ Generally, take with FOOD (30 min before breakfast)

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

19
Q 
ADVERSE EFFECTS
Hypoglycemia
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

c. Repaglinide

20
Q 
ADVERSE EFFECTS
weight gain (5-10 lbs.)
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

21
Q 
ADVERSE EFFECTS
◦ No ALCOHOL (EtOH)
◦ Can cause disulfiram like reaction
◦ Alcohol can increase hypoglycemic risk
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

c. Repaglinide

22
Q 
Sulfa Allergy + Photosensitivity
◦ Alcohol can increase hypoglycemic risk
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
A

b. 2nd generations- Glipizide, Glyburide, Glimepiride

c. Repaglinide

23
Q

USED TO TREAT
◦ Only for DM2 (increase insulin secretion)
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

c. Repaglinide

24
Q

Causes weight gain?

a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

A

b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone

25
USED TO TREAT ◦ Only for DM2 (increase insulin sensitivity) a. metformin b. 2nd generations- Glipizide, Glyburide, Glimepiride c. Repaglinide d. Pioglitazone
d. Pioglitazone
26
• CARDIAC CONCERNS: • BOXED WARNING: Not for symptomatic heart failure (NYHA Class III and IV) a. metformin b. 2nd generations- Glipizide, Glyburide, Glimepiride c. Repaglinide d. Pioglitazone
d. Pioglitazone
27
``` • LIVER CONCERNS: • CARDIAC CONCERNS: a. metformin b. 2nd generations- Glipizide, Glyburide, Glimepiride c. Repaglinide d. Pioglitazone ```
d. Pioglitazone
28
``` USED TO TREAT ◦ Only for DM2 (slows intestinal absorption of carbohydrates) e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
e. Acarbose
29
``` ADVERSE EFFECTS ◦ GI- it works in your stomach! ◦ Diarrhea (30% of patients) ◦ Flatulence (74% of patients) ◦ Abdominal pain (19%) e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
e. Acarbose
30
``` USED TO TREAT ◦ Only for DM2 e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
f. Sitagliptin
31
``` ADVERSE EFFECTS JOINT PAIN FDA SPECIAL ALERT Aug 2015: This class of medications can cause joint pain that can be severe and disabling e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
f. Sitagliptin
32
``` ADVERSE EFFECTS JOINT PAIN pancreatitis Hypersensitivity reactions e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
f. Sitagliptin
33
``` USED TO TREAT ◦ Only for DM2 (Blocks glucose reabsorption by the kidney, potential for use in DM1?) e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
g. Canagliflozin
34
``` MECHANISM OF ACTION ◦ You pee out extra glucose e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
g. Canagliflozin
35
``` ADVERSE EFFECTS • increased urine output, nocturia • Urinary Tract Infections • Hypotension (dizziness) • Weight loss, rare hypoglycemia e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
g. Canagliflozin
36
``` MECHANISM OF ACTION ◦ Synthetic GLP1 agonist ◦ Causes glucose dependent insulin secretion ◦ Decreases glucagon secretion ◦ Slows gastric emptying ◦ Increases satiety e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
h. exenatide
37
TIDE OF NEW DRUGS! e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon
h. exenatide
38
``` •ADVERSE EFFECTS weight loss (advantage) (slows gastric emptying- loss of appetite) e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
h. exenatide
39
``` • BOXED WARNING: increased risk for thyroid C-cell Tumors in rats and mice (both sexes) e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
h. exenatide
40
give oral medications ? hour prior to administration of exenatide
1
41
``` •USED TO TREAT • Hypoglycemia e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon ```
i. Glucagon
42
ADMINISTRATIONTypically meant for unconscious patients, give a source of carbohydrates once patient is arousable! e. Acarbose f. Sitagliptin g. Canagliflozin h. exenatide i. Glucagon
i. Glucagon

Phamacology Summer (48 decks)

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