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TOP 300 > Glucose Lowering Medications > Flashcards

Glucose Lowering Medications Flashcards

1
Q

generic name

Glucotrol

A

Glipizide

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2
Q

class of glipizide

A

sulfonylureas

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3
Q

indication for glucose lowering medications

A

diabetes

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4
Q

MOA

sulfonylureas

A

stimulates insulin release from pancreatic beta cells

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5
Q

contraindications

sulfonylureas

A
  • hypersensitivity
  • type 1 diabetes
  • diabetic ketoacidosis
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6
Q

common ADRs

sulfonylureas

A
  • hypoglycemia
  • dizziness
  • weight gain
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7
Q

rare but serious ADRs

sulfonylureas

A
  • hemolytic anemia
  • hepatotoxicity
  • disulfiram reaction
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8
Q

key counseling points

sulfonylureas

A
  • take first thing in the morning (30 minutes before breakfast or first meal of the day)
  • avoid alcohol while taking may cause rare disulfiram reactions
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9
Q

other top 300 medications

sulfonylureas

A

brand: amaryl
generic: glimepiride

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10
Q

brand name of meglitinides

A

prandin

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11
Q

generic name of meglitinides

A

repaglinide

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12
Q

MOA

meglitinides

A

stimulates insulin release from pancreatic beta cells

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13
Q

contraindications

meglitinides

A
  • diabetic ketoacidosis
  • type 1 diabetes
  • concurrent use of gemfibrozil
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14
Q

common ADRs

meglitinides

A
  • hypoglycemia
  • headache
  • nausea/vomiting
  • weight gain
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15
Q

rare but serious ADRs

meglitinides

A
  • chest pain
  • ischemia
  • hypersensitivity (SJS)
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16
Q

key counseling points

meglitinides

A
  • needs to be taken with each meal (15-30 minutes before each meal)
  • if patient skips a meal, skip that dose
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17
Q

generic name

biguanides

A

metformin

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18
Q

brand name

biguanides

A

glucophage

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19
Q

MOA

biguanides

A
  • primary: decrease output from the liver (hepatic glucose production)
  • secondary: increase peripheral muscle glucose sensitivity (glucose uptake and utilization)
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20
Q

contraindications

biguanides

A
  • eGFR < 30 mL/min
  • metabolic acidosis
  • use with contrast media
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21
Q

black box warning

biguanides

A

lactic acidosis

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22
Q

common ADRs

biguanides

A
  • GI upset
  • diarrhea
  • nausea/vomiting
  • flatulence
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23
Q

rare but serious ADRs

biguanides

A
  • lactic acidosis
  • hemolytic anemia
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24
Q

key counseling points

biguanides

A
  • take with food to reduce GI upset
  • avoid use within 48 hours of iodinated contrast media
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25
Q

generic name

Actos

A

pioglitazone

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26
Q

class of pioglitazone

A

thiazolidinediones

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27
Q

MOA

thiazolidinediones

A
  • primary: increase peripheral muscle glucose sensitivity (glucose uptake and utilization)
  • secondary: decrease glucose output from liver (hepatic glucose output)
28
Q

contraindications

thiazolidinediones

A

New York Heart Association Class III/IV heart failure

29
Q

common ADRs

thiazolidinediones

A
  • edema
  • weight gain
30
Q

rare but serious ADRs

thiazolidinediones

A
  • congestive heart failure
  • bladder cancer
  • fractures
  • hepatotoxicity
31
Q

key counseling points

thiazolidinediones

A
  • take once daily without regard to meals
  • monitor for weight gain and/or swelling of legs
32
Q

other top 300 meds

thiazolidinediones

A

brand: avandia
generic: rosiglitazone

33
Q

generic name

tradjenta

A

linagliptin

34
Q

class of linagliptin

A

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

35
Q

MOA

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A
  • binds to and inhibits the DPP-4 enzyme, resulting in prolonged incretin hormone levels
  • incretin hormones regulate glucose metabolism by increasing insuling secretion and release
36
Q

contraindications

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A
  • type 1 diabetes
  • diabetic ketoacidosis
  • hypersensitivity
37
Q

common ADRs

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A
  • nasopharyngitis
  • hypoglycemia
38
Q

rare but serious ADRs

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A
  • pancreatitis
  • heart failure
39
Q

key counseling points

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A
  • take once daily at same time each day
  • may be taken with or without food
40
Q

other top 300 meds

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A
  • brand: onglyza, generic: saxagliptin
  • brand: januvia, generic: sitagliptin
41
Q

brand name

dapaglifozin

42
Q

class of farxiga

A

sodium glucose cotransporter 2 (SGLT2) inhibitors

43
Q

MOA

sodium glucose cotransporter 2 (SGLT2) inhibitors

A
  • inhibits SGLT2 in the proximal renal tubules which reduces reabsorption of filtered glucose
  • reabsorption of filtered glucose = increased urinary excretion of glucose
44
Q

contraindications

sodium glucose cotransporter 2 (SGLT2) inhibitors

A

severe renal impairment (ESRD, dialysis)

45
Q

common ADRs

sodium glucose cotransporter 2 (SGLT2) inhibitors

A
  • dehydration
  • hypotension
  • UTI
  • yeast infection
46
Q

rare but serious ADRs

sodium glucose cotransporter 2 (SGLT2) inhibitors

A
  • euglycemic diabetic ketoacidosis
  • bone fracture
  • perineal necrotizing fascitis
  • acute kidney injury
47
Q

key counseling points

sodium glucose cotransporter 2 (SGLT2) inhibitors

A
  • take once daily in the morning
  • stay well hydrated while taking
48
Q

other top 300 meds

sodium glucose cotransporter 2 (SGLT2) inhibitors

A
  • brand: invokana, generic: canagliflozin
  • brand: jardiance, generic: empagliflozin (won’t be tested)
49
Q

generic name

trulicity

A

dulaglutide

50
Q

class of trulicity

A

glucagon-like peptide-1 (GLP-1) receptor agonists

51
Q

MOA

glucagon-like peptide-1 (GLP-1) receptor agonists

A

binds to human GLP-1 receptor which augments glucose dependent insulin secretion and slows gastric emptying

52
Q

contraindications

glucagon-like peptide-1 (GLP-1) receptor agonists

A

personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasisa syndrome type 2 (MEN2)

53
Q

black box warning

glucagon-like peptide-1 (GLP-1) receptor agonists

A

risk of thyroid c-cell tumors

54
Q

common ADRs

glucagon-like peptide-1 (GLP-1) receptor agonists

A
  • nausea/vomiting
  • diarrhea
  • GI upset
  • weight loss
  • decreased appetite
55
Q

rare but serious ADRs

A
  • pancreatitis
  • gallbladder disease
  • acute kidney injury
56
Q

key counseling point

glucagon-like peptide-1 (GLP-1) receptor agonists

A
  • SQ injection, rotate injection site each week
  • GI side effects should improve over time
57
Q

other top 300 meds

glucagon-like peptide-1 (GLP-1) receptor agonists

A
  • brand: victoza & saxenda, generic: liraglutide
  • brand: ozempic & wegovy, generic: semaglutide
  • brand: byetta &bydureon, generic: exenatide (won’t be tested)
58
Q

generic name

lantus

A

insulin glargine

59
Q

brand name

insulin degludec

60
Q

class of lantus & tresiba

A

basal (long acting) insulin

61
Q

MOA

basal (long acting) insulin

A

insulin promotes cellular uptake of glucose, fatty acids and amino acids and their conversion to glycogen, triglycerides and proteins

62
Q

contraindications

basal (long acting) insulin

A

hypersensitivity

63
Q

common ADRs

basal (long acting) insulin

A
  • hypoglycemia
  • weight gain
  • injection site reactions
64
Q

rare ADRs

basal (long acting) insulin

A
  • severe hypoglycemia
  • insulin resistance
65
Q

key counseling points

basal (long acting) insulin

A
  • SQ injection
  • rotate injection site
  • use new needle each injection
  • dosing dial for pens
  • draw up dose in syringe for vials
66
Q

other top 300 meds

basal (long acting) insulin

A
  1. brand: Toujeo or Basaglar, generic: insulin glargine
  2. biosimilar: insulin glargine-aglr (rezvoglar)
  3. biosimilar: insulin glargine-yfgn (semglee yfgn)

TOP 300 (19 decks)

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