Med List 4 - Diabetes and Gastrointestinal Flashcards
Insulin Lispro (rapid acting)
Individualized dosing; Inject 15 min before or immediately after meals
Type I Diabetes
Type 2 Diabetes
Insulin Lispro (rapid acting) brand
Humalog
Insulin Glargine (long acting):
Individualized dosing - once daily
Type I diabetes
Type 2 daibetes
Insulin Glargine brand
Lantus
Insulin counseling
Low blood sugar (sweating, nausea, dizziness)
Refrigerate unopened vials
Discard after 28 days if at room temp prior to injection to avoid painful injection
Rotate injection sites
Metformin
BID, TID
MAX: 2550 mg/day
Tx: Type 2 Diabetes
PCOS
Weight loss
Metformin brand name:
Glucophage
Metformin counseling:
Diarrhea, nausea, abdominal pain
Take w/food
Titrate dose up weekly (to reduce stomach upset, diarrhea)
Long-term use can cause Vitamin B-12 deficiency
Dapagliflozin
Once daily
Tx: Type 2 diabetes
Chronic kidney disease
Heart failure w/reduced ejection fraction
Dapagliflozin brand name
Farxiga
Dapagliflozin counseling
UTI
Increased urine output
Decreased BP
Semaglutide
Oral: once daily
SubQ: Once weekly
Type 2 diabetes
Weight management
Semaglutide brand names
Rybelsus (oral)
Ozempic (subcutaneous)
Wegovy (subcutaneous)
Semaglutide counseling
Nausea, vomiting, diarrhea
Headache
Low blood sugar
Rotate weekly injection sites
Gabapentin
BID, TID
Tx: Neuropathic pain
Seizures, anxiety
Gabapentin name
Neurontin
Gabapentin counseling
Drowsiness/Dizziness
Uncoordinated muscle movements
Promethazine: Antiemetic
q 4-6h prn
TX: Prevents and treats nausea/vomiting
Motion sickness
Allergies
Promethazine brand name
Phenergan
Promethazine counseling
Drowsiness/dizziness
Avoid alcohol
Sun sensitivity
Ondansetron: Antiemetic
q8h prn
Tx: prevent nausea, vomiting
Non-FDA approved for treatment of vomiting
Ondansetron brand names
Zofran
Zofran ODT
Ondansetron counseling
Fatigue
Headache
Constipation/diarrhea
Omeprazole: Acid reflux (OTC)
Once daily
Tx: Acid reflux, indigestion
Prevention and treatment of ulcers
Omeprazole brand name
Prilosec
Omeprazole counseling
Works in 1 day, up to 4 days for full effect
Food delays absorption so take >1 hr before food
Separate from antacids by 2 hours
Famotidine (OTC): Acid reflux
BID
TX: Acid reflux/indigestion
Prevention and tx of ulcers
Famotidine (OTC): Brand
Pepcid AC
Famotidine counseling
Works in 1 hour, up to 1 day for full effect
Can be taken with antacids
Calcium Carbonate (OTC): Acid reflux
Chew 2-4 tabs prn
MAX: 7,500mg/day if used for indigestion
MAX: 2,500 mg/day as supplement
Tx: Calcium supplement
Acute acid reflux/indigestion
Calcium Carbonate OTC name
Tums
Calcium Carbonate Counseling
Constipation
Chew before swallowing
Do not use > 2 weeks for indigestion
Docusate Sodium (OTC): Constipation/Laxatives
Daily
Tx: Stool softener to relieve constipation
Docusate sodium (OTC) name
Colace
Docusate sodium counseling:
Works in 1-3 days
Take with water
Diarrhea, cramps
Polyethylene glycol (PEG) (OTC/Rx): laxatives
MiraLAX: 17g (1 capful) dissolved in 8oz. of liquid po 1d prn
GoLYTELY (colonoscopy prep): Mix w/water to make 1 gallon, drink 8oz every 10 minutes
Tx: Osmotic laxative to relieve constipation
Bowel cleansing for colonoscopy prep
Polyethylene glycol (PEG) (OTC/Rx): Brand names
MiraLAX (OTC)
GoLYTELY (Rx)
Polyethylene glycol (PEG) (OTC/Rx): Counseling
Laxative works in 1-3 days
Do NOT take laxative longer than 1 week w/o MD approval
Colon prep works in 1 hr
Diarrhea, cramps, bloating
Bisacodyl: OTC
Laxative: 5-15 mg PO daily, 10 mg rectally daily
Colonoscopy prep: 30-30mg dose
MAX: 30mg/day
Tx: Stimulant laxative to relieve constipation
Bowel evacuant for colonoscopy prep
Bisacodyl: OTC Brand name:
Dulcolax
Bisacodyl: OTC counesling:
Oral dose works in 8 hrs
Suppository works within 15-60 minutes
Do not take longer than 1 week w/o MD approval
Diarrhea, cramps
Loperamide (OTC): Anti-Diarrheal
2 tabs PO after first loose stool, then 1 tab after each subsequent loose stool
MAX: 8mg/day (OTC), 16mg/day (Rx)
Tx: Slows peristalsis to treat diarrhea
Loperamide: Brand name
Imodium
Loperamide counseling:
Drowsiness
If diarrhea not improved in 2 days, call MD due to dehydration risk