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Endocrine Test 2 > Non-Insulin Meds > Flashcards

Non-Insulin Meds Flashcards

1
Q

Secretagogues

A 
SU & Meglitinides
Glyburide
Glipizide
Glimepride
Repaglinide
Nateglinide
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2
Q

Sensitizers

A

Metformin & TZDs
Metformin
Pioglitazone
Rosiglitazone

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3
Q

Glyburide Brand Name

A

Diabeta, Micronase

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4
Q

Glyburide micronized Brand Name

A

Glynase

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5
Q

Glipizide Brand name

A

Glucotrol

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6
Q

Glipizide XL Brand Name

A

Glucotrol XL

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7
Q

Glimipiride Brand Name

A

Amaryl

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8
Q

Glyburide Onset and Duration

A

O: 1-60 minutes
D: 16-24 hr

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9
Q

Glyburide Micronized Onset and Duration

A

O: 15-60 mins
D: 12-24 h

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10
Q

Glipizide Onset and Duration

A

O: 30 min
D: 12-24 h

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11
Q

Glipizide XL Onset and Duration

A

O: 2-3 h
D: 24 h

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12
Q

Glimeprided Onset and Duration

A

O: 2-3 hr
D: 16-24 hr

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13
Q

SU Side Effects and Contraindications

A

Weight gain
Hypoglycemia
Sulfa allergy
Renal and hepatic insufficiency

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14
Q

Efficacy of SU

A

Reduces FASTING and pp levels

Requires working beta cells

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15
Q

Repaglinide Brand Name

A

Prandin

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16
Q

Nateglinide Brand Name

A

Starlix

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17
Q

Repaglinide Onset and Duration

A

O: 30 min
D: <4 hrs

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18
Q

Nateglinide Onset and Duration

A

O: 15 min
D: 4 hrs

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19
Q

Meglitinides Side effects and contraindications

A

Weight gain
Hypoglycemia
Same as SU but no sulfa
Renal and hepatic insuffiency

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20
Q

Efficacy of Meglitinides

A

Reduces postprandial glucose levels

Require working beta cells

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21
Q

Characteristics of a best response for Meglitinide use

A 
PP levels concern
DMT2 <5 yrs
Mild hyperglycemia
No previous insulin
Cost not an issue
Not obese
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22
Q

Characteristics of best response for SU use

A

DMT2 <5 yrs
Mild-moderate hyperglycemia
No previous insulin
Not obese

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23
Q

Metformin Brand Name

A

Glucophage

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24
Q

Metformin Onset and Duration

A

O: Days to 6 weeks
D: Weeks

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25
Metformin side effects and contraindications
Weight loss GI Renal insufficiency, iodinated contrast and heart failure (black box)
26
Metformin Efficicacy
Reduces FASTING
27
Characteristics of best response in metformin use
``` Obese Mild-moderate hyperglycemia Insulin resistance strongly suspected!!! 1st line!! CV risk ```
28
Pioglitazone Brand Name
Actos
29
Rosiglitazone Brand Name
Avandia
30
Pioglitazone Onset and Duration
O: 4 weeks D: 4 weeks
31
Rosiglitazone Onset and Duration
O: weeks D: weeks
32
TZDs side effects and contraindication
Edema/fluid retention Weight gain Hepatic insufficiency CHF (blackbox)
33
TZDs Efficacy
Reduces glucose levels by increase sensitivity
34
Characteristics of best response of TZDs
Mild hyperglycemia Cost not an issue Insulin resistance strongly suspected!!
35
Rosiglitazone Controversies
Increase MI
36
Pioglitazone Controversies
Bladder cancer
37
GI Glucose Absorption Inhibitors
Alpha-Glucosidase Inhibitors Acarbose Miglitol
38
Acarbose Brand Name
Precose
39
Miglitol Brand Name
Glyset
40
AGI MOA
Limits breakdown of complex carbs | Decrease PP levels
41
AGI Side effects and contraindications
GI (gas) | GI disorders
42
AGI Efficacy
Take with food will it decrease PP
43
Characteristics of best response for AGIs
Mild hyperglycemia PP hyperglycemia Treat hypo with glucose
44
Incretin Systems
``` GLP-1 Agonists & DPP-4 Antagonists Exenatide Lirglutide Albiglutide Dularglutide Sitagliptin Saxagliptin Linagliptin Alogliptin ```
45
Exenatide Brand Name
Byetta
46
Exenatide LA Brand Name
Bydureon
47
Liraglutide Brand Name
Victoza
48
Dulaglutide Brand Name
Trulicity
49
Albiglutide Brand Name
Tanzeum
50
Exenatide Onset and Dosing
O: 1-2 hrs D: 12 hrs
51
Exenatide LA Onset and Dosing
O: 2-9 wks D: 7 days
52
Liraglutide Onset and Dosing
O: 8-12 wks D: 24 hrs
53
Albiglutide Onset and Dosing
O: 2-5 days D: 7 days
54
Dulaglutide Onset and Dosing
O: 24-72 hrs D: 7 days
55
GLP-1 Agonists Efficacy
Shorter acting: PP | Longer acting: Fasting + PP
56
Characteristics of best response with GLP-1 Agonists
Weight loss!! SQs acceptable Cost is okay
57
GLP1 Agonists interactions
Slowed gastric emptying
58
GLP-1 Agonists side effects and contraindications
Nausea Hypoglycemia Renal insufficiency, GI disease, acute pancreatitis (black box)
59
Sitaglipitin Brand Name
Januvia
60
Saxagliptin Brand Name
Onglyza
61
Linagliptin Brand Name
Tradjenta
62
Alogliptin Brand Name
Nesina
63
DPP-4 Inhibitors efficacy
Reduces PP
64
Characteristics of best response with DPP-4 inhibitors
With other oral agents
65
DPP-4 Inhibitors side effects and contraindications
Hypersensitivites Hypoglycemia Renal insuffiencies
66
Sodium Glucose Cotransporters 2 Inhibitors
Canagliflozin Dapagliflozin Empagliflozin
67
Canagliflozin Brand Name
Invokana
68
Dapagliflozin Brand Name
Farxiga
69
Empaglifloazin Brand Name
Jardiance
70
Canagliflozin Onset and Duration
O: 1-2 hrs D: 24
71
Dapagliflozin Onset and Duration
O: 2 hrs D: 24 hrs
72
Empagliflozin Onset and Duration
O: 1.5 hrs D: 24 hrs
73
Na-Glc CTI Benefits
Insulin independent mechanisms Weight loss Low risk of hypoglyc Reduces BP
74
Na-Glc CTI AE and Interactions
``` Genitourinary infections Increase potassium Kidney function reduction Monitor K with ACI-I/ARBs CYP inhibitor ```
75
Na-Glc CTI Precautions
Not in T1, severe renal impairment or hypersensitivity
76
Bromocriptin
``` Cycloset Dopamine agonists 2 hrs after waking With food other wise nausea Reducation blood glucose very little High cost ```
77
Colsevelam
``` WelChol Bile acid sequestrant that reduces fastiing High tablet burden Little weight gain Little hypogly ```
78
How to choose an oral agent?
``` Obeses (use metformin or GLP1) Renal insuf (no metformin or glyburide) Hepatic insuf (no TZD or glipizide) Heart failure (no TZD or metformin ```
79
Failure of therapy actions?
Mono therapy failure --> add | Dual therapy failure --> add another or begin insulin
80
Insulin should be added if:
Failing combo oral therapy (keep sensitizers, wean off secretagogues) Insitial presentation is hyperglycemia + weight loss

Endocrine Test 2 (6 decks)

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