Medication Flashcards
Substitute for ASA
Clopidogrel
What sugars will not work to treat hypoglycaemia when taking Acarbos
Alpha-glucosidase inhibitors inhibit the absorption of carbohydrates from the small intestine.
They competitively inhibit enzymes that convert complex non-absorbable carbohydrates into simple absorbable carbohydrates. These enzymes include glucoamylase, sucrase, maltase, and isomaltase.
If a patient has established cardiovascular disease, what should second agent be?
Invokana , Empagliflozin, victoza
Adjuvant pharmacotherapy for T1DM to insulin?
In Canada adjunctive therapy is not approved for people with type one diabetes. Further research is needed on the benefits of non-insulin anti-hyperglycaemic agents in type 1 diabetes.
At time of Dx, what A1C should medication be added
If A1C is >1.5% above target
Metformin can decrease by 1
Each agent will decrease A1C by 0.5-1.5%
Biguanides
Metformin (Glucophage)
Metformin XR (Glumetza)
- Increase insulin sensitivity in the liver and peripheral tissues (muscle and fat)
- Improve glucose uptake across cell membrane
- impairs glucose production in the fasting and postprandial state
DPP4 Inhibitors
allows GLP-1 (promotes insulin secretion, reduces, glucagon production, delayed gastric, emptying, increases, satiety) and GIP to act longer
Weight neutral
0.5 - 0.7% A1C reduction
GLP1
promotes insulin secretion, reduces, glucagon production, delayed gastric, emptying, increases, satiety
1% A1C reduction
Meds to d/c in pregnancy
Statin
Ace-I/Arb
And all anti-hyperglycaemic agents other than metformin or glyburide or insulin
CV risk factors for deciding on second line agent (GLP-1 RA vs SGLT2 -I)
DYS (LDL > 3.4, TG > 2.3, HDL <1-1.3)
HTN (> 140/95)
Meds for HTN or DYS
Smoking
Stop DPP4i when starting GLP-1 RA
CV Risk factors for consideration to start ACE/ARB
Hypertension
TC >5.2 mmol/L
HDL-C<0.9 mmol/L
Albuminuria (ACR 2-20)
Smoking
