Exam 3 - Meds Only Flashcards
Sulfonylureas - glipizide (Glucotrol); glyburide (Micronase, Diabeta, glimepride (Amaryl)
- Secretagogue: stimulates insulin secretion from beta cell.
- Constantly working - - could lead to hypoglycemia
- take with food
Meglitinides - repaglinide (Prandin), nateglinide (Starlix)
- Stimulate a rapid and short lived release of insulin from the pancreas
- Burst of insulin - - then it stops
- Take with food
Biguanide - metformin (Glucophage), metformin ER (Glumetza)
- *First Line for Type 2**
- Reduces hepatic glucose production
- Sensitizer: increases insulin sensitivity to peripheral uptake
Thiazolidineodione - pioglitazone (Actos), rosiglitazone (Avandia)
- Makes tissues more sensitive to insulin
- Sensitizer: increases insulin sensitivity to peripheral uptake
a-glucosidase inhibitor - acarbose (Precose), miglitol (Glyset)
Take with very 1st bite of every meal or don’t take at all. Food gets absorbed further down GI tract - causes cramps, gas, GI problems.
- Slows absorption of food in stomach
- Slows absorption of glucose, slows postprandial hyperglycemia.
DPP-4 Inhibitors - sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta)
- Enhances the incretin system, stimulates release of insulin from pancreatic B cells.
SGLT2 Inhibitors - Canagliflozin (Invokana), dapagliflozin (farxiga)
- Sodium-glucose transporter 2 (SGLT2) works in the kidney to reabsorb glucose, this new class of medication, SGLT2 inhibitors, blocks this action causing excess glucose to be eliminated in urine.
- At risk for UTI because of increase in glucose in urine.
Bile Acid Sequestrant (BAS) - colesevelam (Welchol)
A cholesterol lowering medication that also reduces blood glucose levels in patients with diabetes.
Dopamine Receptor Agonist - Bromocitine (Cycloset)
Increases CNS dopamine receptor activity, increases insulin sensitivity and decreases A1C by improving postprandial hepatic glucose metabolism and increasing glucose uptake.
Incretins (Injections but not insulin)
Exenatide (Byetta), Exenatide ER once-weekly (Bydureon), Liraglutide (Victoza)
Stimulates release of insulin, decrease glucagon secretion, increase satiety, decrease gastric emptying
Amylin Analog (Injections but not insulin) - Pramlintide (Symlin)
Decrease gastric emptying, decrease glucagon secretions and endogenous glucose output from the liver, increase satiety
Insulin - Lispro or Aspart
Rapid Acting
- Onset: 15 min
- Peak: 60-90 min
- Duration: 2-4 hrs
Insulin - Human Regular
mix with Human NPH
NPO/Tube feeding
- Onset: 30-60 min
- Peak: 2-3 hrs
- Duration: 3-6 hrs
Insulin - Human NPH
mix with Human Regular
Intermediate Acting
- Onset: 2-4 hrs
- Peak: 4-10 hrs
- Duration: 10-16 hrs
Insulin - Glargine
Long Acting
- Onset: 1-2 hrs
- Peak: Peakless
- Duration: 24 hrs
- Crystallizes under skin because different pH than body; slowly adjusts to the bodies pH
The medication that should be used with caution in patients with diabetes and respiratory disorders
Beta Blockers
DM – hypoglycemia unawareness
Resp – beta 2 non-selective
Why is insulin not a pill?
Can’t get passed the GI tract before it gets destroyed and not able to be absorbed.
Hydrodiuril (hydrochlorathiazide)
First line treatment for Hypertension
Thiazide Diuretics: promotes renal excretion of water, Na, K, H.
Lasix (furosemide)
First line treatment for Hypertension
Loop Diuretic: inhibits absorption of Na & Cl from ascending loop of Henle
Sprionaldactone
First line treatment for Hypertension
Potassium sparing Diuretic: competes with aldosterone for receptor sites in distal renal tubes.
Lopressor (metoprolol)
Tenormin (atenolol)
First line treatment for Hypertension
Beta Blockers: block action at beta receptor sites to slow HR, decrease BP and decrease contractility.
**Do NOT give diabetic= masks S&S of Hypoglycemia
Captopril, enalapril, fosinopril, lisinopril
First line treatment for Hypertension
ACE Inhibitor: block conversion of Ang1 and Ang II
Helps blood vessels relax and helps decrease pressure on heart.
** Good for Diabetic
Side Effect - Cough
Cardizem (diltiazem); Procardia (nifedipine)
First line treatment for Hypertension
Calcium Channel Blockers: blocks entry of calcium ions into smooth muscle channels in arterials causing smooth muscle relaxation. Lower BP, slows HR.
Cozaar (losartan); Diovan (valsartan)
First line treatment for Hypertension
Angiotensin II Antagonists (ARBs)
Inhibits constriction of vessels and increase release of H2O and Na.
Hydralazine (apresoline)
Minoxidil
Isordil (isosorbide)
2nd Line for Hypertension
Vasodilartors: relaxes arterioles, lowers peripheral vas resis and BP.
Can increase HR
- Ticlodipine (Ticlid)
- Clopidogrel (Plavix)
- Cilostazol (Pletal)
Antiplatelet agents: prevents platelet aggregation. does not breakup existing clots only stops new ones from forming.
*Avoid Grapefruit Juice
Pentoxifylline (Trental)
Decreases blood viscosity
Streptokinase, urokinase
Tissue plasminogen activator (TPA)
Thrombolytic Therapy - used to breakup clot
Risk for severe bleeding
Lab to look at for a pt on Heparin Drip
PTT
Heparin
Enoxaparin (Lovenox)
Warfarin (Coumadin)
Low molecular weight heparin
Anticoagulant Therapy
Monitor PTINR
Impact ability to coagulate when they are bleeding.
Antidote for too much coumadin?
Antidote for too much Heprin?
Coumadin= Vitamin K Heprin= Protamine sulfate
Simvastatin (Zocor); atorvastatin (Lipitor); rosuvastatin (Crestor)
Statins - Lowers blood lipids, LDL, Tgl and total cholesterol, raises HDL and Possibly decreases inflammation.
