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Endocrine > Oral Antidiabetic Drugs > Flashcards

Oral Antidiabetic Drugs Flashcards

0
Q

Metformin (Contraindications)

A

SrCr >/= 1.5 (men) or 1.4 (women)
CrCl < 60 mL

REALISTICALLY:
SrCr > 1.8
Half dose when CrCl 30-60
D/C CrCl </= 30

Lactic Acidoses
Iodinated contrast dyes
DKA
Hypoxemia
Dehydration
Sepsis
Surgery
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1
Q

Metformin (Dosing)

A

850-2000 mg QD-BID
ER: 1000-2000 mg QD
IR: 850-1000 mg BID

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2
Q

Metformin (Counseling Points)

A

Take with food
Start low and titrate
Avoid alcohol use

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3
Q

Metformin (Side Effects)

A

GI upset
Weight loss
Lactic acidosis
Vitamin B12 deficiency

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4
Q

TZD: Rosiglitazone (Brand/Dosing)

A

Avandia, 4-8 mg po QD

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5
Q

TZD: Pioglitazone (Brand/Dosing)

A

Actos, 15-45 mg po QD

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6
Q

TZD: Rosiglitazone (Drug Interactions)

A

Insulin!!

Nitrates

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7
Q

TZD: Pioglitazone (Drug Interactions)

A

Oral contraceptives!!

Progestins

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8
Q

TZD: Rosiglitazone/Pioglitazone (Contraindications)

A 
CHF Stage III-IV !!!
T1DM
DKA
ACS
Active Bladder Cancer
ALT > 2.5x normal
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9
Q

TZD: Rosiglitazone/Pioglitazone (Cautions)

A

MI
Edema
Insulin/SU use
CHF Class I-II

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10
Q

TZD: Rosiglitazone/Pioglitazone (Side Effects)

A

Weight gain
May worsen edema
Bone fracture (Pioglitazone)
Increased LDL (Rosiglitazone)

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11
Q

TZD: Rosiglitazone/Pioglitazone (Counseling Points)

A

Take at the same time each day
Report weight gain or swelling of legs
Avoid alcohol use

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12
Q

DPP-4: Sitagliptin (Brand/Dosing)

A

Januvia, 100 mg po QD
CrCl 30-49: 50 mg po QD
CrCl < 30: 25 mg po QD

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13
Q

DPP-4: Linagliptin (Brand/Dosing)

A

Tradjenta, 5 mg po QD

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14
Q

DPP-4: Saxagliptin (Brand/Dosing)

A

Onglyza, 2.5-5 mg

CrCl <50: 2.5 mg po QD

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15
Q

DPP-4: Alogliptin (Brand/Dosing)

A

Nesina, 25 mg po QD
CrCl 30-59: 12.5 mg po QD
CrCl </=29: 6.25 mg po QD

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16
Q

DPP-4: Gliptins (Side Effects)

A

Nasopharyngitis

URI

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17
Q

DPP-4: Gliptins (Contraindications)

A

T1DM

DKA

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18
Q

DPP-4: Gliptins (Counseling Points)

A

Take at same time each day
Take with or without food
Avoid alcohol use

Saxagliptin - contains lactose
Linagliptin - most drug interactions

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19
Q

SU: Glyburide (Brand/Dosing)

A

Diabeta/Micronase/Glynase/Glynase Prestabs, 1.25-20 mg po QD

CONTRAINDICATED CrCl < 50
CONTRAINDICATED Age > 65
PREGNANCY CATEGORY C

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20
Q

SU: Glipizide (Brand/Dosing)

A

Glucotrol, 2.5-20 mg QD-BID
CrCl <50: Half dose
PREGNANCY CATEGORY C

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21
Q

SU: Glimepiride (Brand/Dosing)

A

Amaryl, 1-4 mg po QD

CrCl < 60: caution

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22
Q

SU: Glyburide/Glipizide/Glimepiride (Side Effects)

A

Hypoglycemia
N/V
Weight gain

23
Q

SU: Glyburide/Glipizide/Glimepiride (Contraindications)

A

DKA
Pregnancy
T1DM

24
Q

SU: Glyburide/Glipizide/Glimepiride (Drug Interactions)

A

Alcohol
Allopurinol
Probenecid
Salicylates

25
Q

SU: Glyburide/Glipizide/Glimepiride (Counseling Points)

A

Take 30 minutes before breakfast
Take with food
Avoid alcohol use

26
Q

Meglitinides: Nateglinide (Brand/Dosing)

A

Starlix, 60-120 mg po ac meals

27
Q

Meglitinides: Repaglinide (Brand/Dosing)

A

Prandin, 0.5-16 mg po ac

28
Q

Meglitinides: Nateglinide/Repaglinide (Side Effects)

A

Hypoglycemia

GI Upset

29
Q

Meglitinides: Nateglinide/Repaglinide (Drug Interactions)

A

Mifepristone (do not use within 14 days)
Nateglinide - pazopanib
Repaglinide - gemfibrozil

30
Q

Meglitinides: Nateglinide/Repaglinide (Contraindications)

31
Q

Meglitinides: Repaglinide (Cautions)

A

NPH insulin - MI risk

32
Q

Meglitinides: Nateglinide/Repaglinide (Counseling Points)

A

Take 30 minutes before meals
Skip a meal, skip a dose
Avoid alcohol use

33
Q

a-Glucosidase Inhibitors: Acarbose (Brand/Dosing)

A

Precose, 25 mg po ac meals

34
Q

a-Glucosidase Inhibitors: Miglitol (Brand/Dosing)

A

Glyset, 25 mg po ac meals

35
Q

a-Glucosidase Inhibitors: Acarbose/Miglitol (Contraindications)

A 
DKA
cirrhosis 
IBS
Colonic ulceration
Intestinal obstruction
36
Q

a-Glucosidase Inhibitors: Acarbose/Miglitol (Counseling Points)

A

Start low and go slow
Take with first bite of each meal
Skip a meal, skip a dose

37
Q

SGLT-2: Canagliflozin (Brand/Dosing)

A

Invokana, 300 mg po QD

eGFR 45-60: 100 mg po QD

38
Q

SGLT-2: Dapagliflozin (Brand/Dosing)

A

Farxiga, 5-10 mg po QAM

eGFR 30-59 or CrCl <30: CONTRAINDICATED

39
Q

SGLT-2: Canagliflozin/Dapagliflozin (Side Effects)

A

Yeast infections
Weight loss
UTI
Nasopharyngitis

40
Q

SGLT-2: Canagliflozin/Dapagliflozin (Contraindications)

A

Dialysis

End stage renal disease

41
Q

SGLT-2: Canagliflozin/Dapagliflozin (Cautions)

A

Hypotension
Hyperkalemia
LDL increase

42
Q

SGLT-2: Canagliflozin/Dapagliflozin (Counseling Points)

A

Take at the same time each day

Yeast infections and shit

43
Q

GLP-1: Exenatide IR (Brand/Dosing)

A

Byetta, 5 mcg BID x 30 days (starting dose) then 10 mcg BID

CrCl <30 CONTRAINDICATED

44
Q

GLP-1: Exenatide ER (Brand/Dosing)

A

Bydureon, 2 mg Q Week

CrCl <30 CONTRAINDICATED

45
Q

GLP-1: Liraglutide (Brand/Dosing)

A

Victoza, 0.6 mg QD x 7 days then 1.2-1.8 mg QD

46
Q

GLP-1: Albiglutide (Brand/Dosing)

A

Tanzeum, 30-50 mg Q Week

47
Q

GLP-1: Exenatide/Liraglutide/Albiglutide (Side Effects)

A

Hypoglycemia
Weight loss
N/V
GERD

48
Q

GLP-1: Exenatide/Liraglutide/Albiglutide (Contraindications)

A

GI Disease

ESRD

49
Q

GLP-1: Exenatide/Liraglutide/Albiglutide (Counseling Points)

A

Store in refrigerator before initial use

Store anywhere after initial use

50
Q

Amylin Analog: Pramlintide (Brand/Dosing)

A

Symlin, 15-60 mcg sc ac meals (T1DM) 60-120 mcg sc ac meals (T2DM)

51
Q

Amylin Analog: Pramlintide (Contraindications)

A

A1C > 9%
Cresol hypersensitivity
Gastroparesis
Hypoglycemia unawareness

52
Q

Amylin Analog: Pramlintide (Side Effects)

A

Hypoglycemia
Weight loss
N/V
Arthralgia

53
Q

Amylin Analog: Pramlintide (Drug Interactions)

A

Potassium salts

Anti-cholinergics

54
Q

Amylin Analog: Pramlintide (Counseling Points)

A 
Decrease meal-time insulin by 50%
Do not mix with insulin
Give immediately before meals
Skip meal, skip dose
Discard 28 days after opening

Endocrine (1 decks)

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