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Pharmacology II > Endocrine: DM Drugs Indications & Contraindications > Flashcards

Endocrine: DM Drugs Indications & Contraindications Flashcards

1
Q

This type of insulin is used 1st in T2DM as basal insulin when A1C is > 10%

A

Long-Acting Insuling

Glargine
Detemir
Degludec

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2
Q

What two regimens are available for T1DM to create an insulin profile?

A

regular insulin + intermediate insulin:
(Regular and intermediate injected at breakfast and dinner)

rapid acting insulin + long acting insulin
(rapid before every meal, long acting at bedtime)

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3
Q

What type of insulin is used in insulin pump?

A

rapid acting

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4
Q

What drug can be used parenterally to counteract insulin-induced hypoglycemia?

A

glucagon

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5
Q

This insulin inhibitor is used in patients with insulinoma…

A

diazoxide

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6
Q

This drug can decrease serum glucose without insulin secretion.

It decreases macrovascular events and all cause mortality.

A

Metformin

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7
Q

What effect does metformin have on weight?

A

weight neutral

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8
Q

What are 4 adverse effects of metformin?

A

Diarrhea (MC), Lactic Acidosis (dangerous), B12 Deficiency (reversible), Hypoglycemia (Rare)

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9
Q

What are the 2 contraindications for metformin?

A

lactic acidosis, kidney disease (GFR < 30)

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10
Q

Tissue hypoxia (HF, COPD), alcoholism and hepatic disease are precautions for which drug?

A

metformin

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11
Q

Which GLP-1 Receptor Agonist is FDA approved to decrease major CV events and weight loss?

A

liraglutide

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12
Q

GLP-1 Receptor Agonists have what effect on beta cells?

A

increase number and function

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13
Q

What are the two adverse effects of GLP-1 Receptor Agonists? (exenatide, liraglutide, semaglutide)

A

hypoglycemia (low), acute pancreatitis

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14
Q

Which drug class has the following contraindications?

Slow GI

renal impairment

other meds that cannot have prolonged GI exposure

A

GLP-1 Receptor Agonists (exenatide, liraglutide, semaglutide)

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15
Q

What are two precautions for GLP-1 Receptor Agonists?

A

Thyroid CA, pancreatitis

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16
Q

What are two therapeutic effects of DPP-4 Inhibitors? (sitagliptin, linagliptin)

A

neutral on CVD, weight neutral

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17
Q

What are three adverse effects of DPP-4 Inhibitors?

A

hypoglycemia (low risk)
acute pancreatitis
severe joint pain

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18
Q

What are three contraindications/precautions for DPP-4 Inhibitors? (-gliptin)

A

renal impairment, pancreatitis, slow GI

19
Q

Does linagliptin cause renal impairment?

A

no

20
Q

Which two SGLT-2 Inhibitors are FDA approved to decrease CV events?

A

empagliflozin and canagliflozin

21
Q

Which SGLT-2 inhibitor reduces CKD progression?

A

canagliflozin

22
Q

which two SGLT-2 inhibitors can decrease heart failure hospitalization?

A

canagliflozin and dapagliflozin

23
Q

All SGLT-2 inhibitors have what two therapeutic effects?

A

decrease BP, weight loss

24
Q

What are three contraindications for SGLT-2 Inhibitors?

A

severe renal impairment, dialysis, prone to UTI or GU infx

25
Q

Which drug class has the following adverse effects?

Hypoglycemia (rare)
Frequency
Renal Impairment
AKI

A

SGLT-2 Inhibitors (gliflozin)

26
Q

What are the three major therapeutic effects of TZDs?

A

major: decrease insulin resistance

decrease TGs w/ long term use

increase HDL

27
Q

This drug class has the following contraindications?

hepatic disease
heart failure

A

TZDs (-glitazone)

28
Q

What are 4 adverse effects of TZDs? (-glitazone)

A

weight gain, edema, bone fx, hypoglycemia (low risk)

29
Q

Alpha-glucoside inhibitors (acarbose, miglitol) have what three therapeutic effects?

A

↓ post-prandial glucose, weight neutral, no hypoglycemia

30
Q

What drug class has the following adverse effects?

flatulence, GI issues

A

alpha-glucoside inhibitors (acarbose, miglitol)

31
Q

Which drug class has the following contraindications?

GI Disease, GI Obstruction, Ileus, IBD, Hiatal Hernia, Hepatic Disease, Renal Impairment

A

Alpha Glucoside Inhibitors:

acarbose, miglitol

32
Q

Which drug class has the following therapeutic effects?

↓ All-Cause Mortality, ↓ Serum Glucagon (Long Term)
CV: Short Term Neutral on CVD, Long Term ↓ MI risk and microvascular risk

A

Sulfonylureas:

glyburide, glipizide, glimepiride

33
Q

Which drug class is the highest risk for hypoglycemia?

A

sulfonylureas: glyburide, glipizide, glimepiride

34
Q

What is the contraindication for sulfonylureas?

A

sulfa allergy

35
Q

What are two precautions for sulfonylureas? (glyburide, glipizide, glimepiride)

A

severe renal disease, hepatic dysfunction

36
Q

What drug class has the following adverse effects?

High Risk Hypoglycemia, Insulin Resistance, Weight Gain, GI SFX

A

Sulfonylureas: glyburide, glipizide, glimepiride

37
Q

This drug has the following characteristics:

Therapeutic effects:
↓ Postprandial Glucose, Weight Neutral

Adverse Effects: Mod. Hypoglycemia

C/I: liver impairment, use w/ sulfonylureas

A

meglitinides/GLN:

Repaglinide (Prandin)

38
Q

This drug can be used in combination w. other DM medicines. It is used to lower LDL if a statin isn’t tolerable.

A

Colesevelam (WelChol)

39
Q

What are two adverse effects of colesevelam?

A

constipation, bloating

40
Q

This drug decreases postprandial glucose, FFAs and TGs.

It shouldn’t be used w. CYP3A4 drugs

A

bromocriptine (cycloset)

41
Q

This drug is used in combination with insulin to decrease postprandial glucose, and to spur weight loss.

A

amylin-like peptide:

Pramlintide (symlin)

42
Q

What is a contraindication for pramlintide (symlin)?

A

slow GI/gastroparesis

43
Q

Pramlintide (symlin) can cause hypoglycemia in what conditions?

A

when used with insulin

Pharmacology II (23 decks)

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