Extra Oral Diabetes Flashcards
what diabetic pt will primarily get oral agents?
type 2
why is glipizide the preferred agent of 2nd gen sulfonylureas?
metabolized into an inactive metabolite, dec risk for hypoglycemia, and wont have an effect on pt with renal dysfunction
which meglitinide drug is better for renal failure patients?
repaglinide: bc only 10% is excreted in urine compared to 90% of nateglinide
what frequently should be monitored for a renal disease pt on metformin?
initial GFR check; not recommended therapy for pts under 45 ml/min but if ok, then dosages need to be closely monitored
what is MOA of thiazolidinediones?
help stimulate PPARy receptor and recognize insulin
how long are max effects of metformin seen?
up to 2 weeks
which thiazolidinedione can be used with insulin?
actos (pioglitazone)
what is the black box warning for thiazolidinediones? what is the other major ADR
black box: risk of heart failure
hepatotoxicity- check LFTs before starting pt on
how often do alpha-glucosidase inhibitors need to be taken?
with each meal in order to affect glucose concentration
what rule only pertains to the DPP-4 inhibitor linagliptin/tradjenta?
no dosage adjustment for renal impairment is necessary (but ALL the rest are)
how often do you take GLP-1 receptor agonists?
1-2 times daily or once weekly
what are three ADRs of GLP-1 receptor agonists?
GI upset- titrating the dose can help
Hypoglycemia if used with sulfonylurea
acute pancreatitis
what needs to be monitored in a pt taking a GLP-1 receptor agonist?
kidney function
what SGLT2 has an impact on CVD?
empagliflozin- reduces risk of CV death in adults with type 2 diabetes and CVD
what is black box warning for canagliflozin?
bone fractures