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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
Q

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

A

d. Pioglitazone

26
Q

• 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

A

d. Pioglitazone

27
Q 
• LIVER CONCERNS:
• CARDIAC CONCERNS:
a. metformin
b. 2nd generations- Glipizide, Glyburide, Glimepiride
c. Repaglinide
d. Pioglitazone
A

d. Pioglitazone

28
Q 
USED TO TREAT
◦ Only for DM2 (slows intestinal absorption of
carbohydrates)
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

e. Acarbose

29
Q 
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
A

e. Acarbose

30
Q 
USED TO TREAT
◦ Only for DM2 
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

f. Sitagliptin

31
Q 
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
A

f. Sitagliptin

32
Q 
ADVERSE EFFECTS
JOINT PAIN
pancreatitis
Hypersensitivity reactions
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

f. Sitagliptin

33
Q 
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
A

g. Canagliflozin

34
Q 
MECHANISM OF ACTION
◦ You pee out extra glucose
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

g. Canagliflozin

35
Q 
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
A

g. Canagliflozin

36
Q 
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
A

h. exenatide

37
Q

TIDE OF NEW DRUGS!

e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

h. exenatide

38
Q 
•ADVERSE EFFECTS
weight loss (advantage) (slows gastric emptying- loss of
appetite)
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

h. exenatide

39
Q 
• 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
A

h. exenatide

40
Q

give oral medications ? hour prior to administration of exenatide

41
Q 
•USED TO TREAT
• Hypoglycemia
e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon
A

i. Glucagon

42
Q

ADMINISTRATIONTypically meant for unconscious patients, give a source of carbohydrates once patient is arousable!

e. Acarbose
f. Sitagliptin
g. Canagliflozin
h. exenatide
i. Glucagon

A

i. Glucagon

Phamacology Summer (48 decks)

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