Medications for Diabetes Flashcards
Insulin MOA
initiates glucose uptake into cells that are insulin-dependent
Amylin Analogs MOA
Slows gastric emptying, suppresses glucagon secretion, promotes satiety
GLP-1 receptor agonist MOA
Promotes glucose-dependent insulin secretion, inhibits the post-prandial release of glucagon, slows gastric emptying, suppresses appetite
Acts like endogenous GLP-1, but longer lasting
Biguanides MOA
Increase sensitivity of insulin receptors
Decrease liver gluconeogenesis
Sulfonylureas MOA
Stimulate insulin release (secretagogue)
Meglitinides MOA
Stimulate insulin release (secretagogue)
Alpha-glucosidase inhibitors MOA
Inhibit enzymes at GI brush border –> inhibits absorption of ingested carbohydrates
Thiazolidinediones MOA
insulin sensitizers
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors MOA
slow incretin inactivation by DPP-4 enzyme
Stimulate glucose-dependent insulin release and inhibit postprandial glucagon release
Sodium-glucose linked transporter-2 (SGLT-2) Inhibitors MOA
Reduce the reabsorption of glucose by the kidneys
Levels of hypoglycemia
Level 1: <70
Level 2: <54
Level 3: altered mental and/or physical status
Levels of hypoglycemia
Level 1: <70
Level 2: <54
Level 3: altered mental and/or physical status
U-500 syringes are _____ while U-100 are _____
U-500 syringes are GREEN
U-100 are ORANGE
Rapid Acting Insulin
Aspart
Lispro
Glulisine
Short Acting Insulin
Regular/Human
Intermediate Acting Insulin
NPH
Detemir
Long Acting Insulin
Glargine
Semglee
Detemir
Degludec
What is basal insulin therapy?
Attempts to mimic the natural insulin secretion rhythms of the pancreas
steady, low level of insulin constantly secreted by pancreas
Uses long-acting insulin
What is bolus insulin therapy?
Attempts to mimic the natural insulin secretion rhythms of the pancreas
The spikes in insulin secretion stimulated by glucose ingestion, especially at meals
When is basal insulin given?
At bedtime
What is bolus insulin also called? why?
Nutritional insulin
Requires the person to count carbs ingested and bolus rapid acting insulin according to instructions
What is bolus insulin also called? why?
Nutritional insulin
Requires the person to count carbs ingested and bolus rapid-acting insulin according to instructions
What is allotransplantation? How is it used to treat diabetes?
Islets from the pancreas of a donor are purified, processed, and transferred into another person (usually with T1DM)
Transferred into the liver. infused in the portal vein, become residents in hepatic sinusoids
The person must take immunosuppressive drugs to avoid rejection
What is important to manage while treating diabetes (T2)?
Other comorbidities!
HTN, Dyslipidemia, Obesity
Which classes of medications are injectables?
Insulin
Amylin analogs
GLP-1 receptor agonists
Which classes of medications are oral agents?
Biguanides
Sulfonylureas
Meglitinides
alpha-Glucosidase Inhibitors
Thiazolidinediones (TZDs)
Dipeptidyl Peptidase-4 Inhibitors (DPP-4 Inhibitors)
SGLT2 Inhibitors
GLP-1 Receptor Agonist
S/Sx of Hypoglycemia
Shaking
Sweating
Anxious
Dizzy
Hungry
Fast HR
Weakness
Headache
Irritable
Insulin Pen Precautions
One patient = one pen
Never open the pen and use the insulin cartridge inside as a multi-dose vial
Hold against the skin for 5-10 seconds after depressing the dose button
Insulin pumps practice what type of insulin therapy? How?
Basal/bolus therapy
The pump consistently administers basal short or rapid-acting insulin in small dosing
May also include correction doses
What is the Somogyi effect?
Undetected hypoglycemia followed by rebound hyperglycemia in the morning
What is the dawn phenomenon?
Rise in blood glucose between 2-8 am 2/2 rise in counterregulatory hormones that are normally released
Results in hyperglycemia in the morning
3 AM BG levels indicate:
If hypo –> Somogyi Effect
If hyper –> Dawn Phenomenon
