Extra Oral Diabetes Flashcards

1
Q

what diabetic pt will primarily get oral agents?

A

type 2

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2
Q

why is glipizide the preferred agent of 2nd gen sulfonylureas?

A

metabolized into an inactive metabolite, dec risk for hypoglycemia, and wont have an effect on pt with renal dysfunction

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3
Q

which meglitinide drug is better for renal failure patients?

A

repaglinide: bc only 10% is excreted in urine compared to 90% of nateglinide

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4
Q

what frequently should be monitored for a renal disease pt on metformin?

A

initial GFR check; not recommended therapy for pts under 45 ml/min but if ok, then dosages need to be closely monitored

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5
Q

what is MOA of thiazolidinediones?

A

help stimulate PPARy receptor and recognize insulin

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6
Q

how long are max effects of metformin seen?

A

up to 2 weeks

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7
Q

which thiazolidinedione can be used with insulin?

A

actos (pioglitazone)

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8
Q

what is the black box warning for thiazolidinediones? what is the other major ADR

A

black box: risk of heart failure

hepatotoxicity- check LFTs before starting pt on

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9
Q

how often do alpha-glucosidase inhibitors need to be taken?

A

with each meal in order to affect glucose concentration

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10
Q

what rule only pertains to the DPP-4 inhibitor linagliptin/tradjenta?

A

no dosage adjustment for renal impairment is necessary (but ALL the rest are)

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11
Q

how often do you take GLP-1 receptor agonists?

A

1-2 times daily or once weekly

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12
Q

what are three ADRs of GLP-1 receptor agonists?

A

GI upset- titrating the dose can help
Hypoglycemia if used with sulfonylurea
acute pancreatitis

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13
Q

what needs to be monitored in a pt taking a GLP-1 receptor agonist?

A

kidney function

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14
Q

what SGLT2 has an impact on CVD?

A

empagliflozin- reduces risk of CV death in adults with type 2 diabetes and CVD

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15
Q

what is black box warning for canagliflozin?

A

bone fractures

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16
Q

what number do we want a patient’s A1C under?

A

7

17
Q

what type of agents are Colesevelam (welchol) and bromocriptine (cycloset)?

A

4th line for type 2

18
Q

what should you check when a pt is on metformin?

A

B12 levels (once a year)

19
Q

what are the 9 categories of oral diabetic agents?

A

sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, DPP-4 inhibitors, GLP-1 receptor agonist, SGLT2, amylin agonist

20
Q

clinical use of amylin agonists?

A

type 1 and 2 patients who use mealtime insulin and have failed to achieved desired glycemic control