Oral Hypoglycemics

Question 1

Chlorpropamide (Diabenese)

Answer 1

First gen sulfonylureas

• Stimulates insulin secretion
• Reduces glucose output from liver by decrease glycogenolysis
• Increases insulin sensitivity in cells

Question 2

Tolbutamide (Orinase)

Answer 2

First gen sulfonylureas

• Stimulates insulin secretion
• Reduces glucose output from liver by decrease glycogenolysis
• Increases insulin sensitivity in cells

Question 3

Glyburide (DiaBeta, Micronase)

Answer 3

Second gen sulfonylureas

• Stimulates insulin secretion
• Reduces glucose output from liver by decrease glycogenolysis
• Increases insulin sensitivity in cells

Question 4

Glipizide (Glucotrol)

Answer 4

Second gen sulfonylureas

• Stimulates insulin secretion
• Reduces glucose output from liver by decrease glycogenolysis
• Increases insulin sensitivity in cells

Question 5

Sulfonylureas*

Answer 5

*Sulfa allergies, thiazide diuretic, renal/hepatic disease

Question 6

Metformin (Glucophage, Glumetza)

Answer 6

Biguanides*

• v hepatic glucose production, intestional glucose absorption, increases tissue sensitivity to insulin
• Lactic acidosis, renal insufficiency, CHF, alcoholics
• *Cimetidine (Tagamet), digoxin (Lanoxin), vancomycin (^ concentration due to renal tubular secretion competition)/herbals (hypoglycemia)

Question 7

Repaglinide (Prandin)

Answer 7

Meglitinides

• Stimulate insulin secretion (quick insulin burst - 20 min)
• Good for renal patients

Question 8

Nateglinide (Starlix)

Answer 8

Meglitinides

• Stimulate insulin secretion (quick insulin burst - 20 min)
• Good for renal patients

Question 9

Acarbose (Precose)

Answer 9

Alpha-glucosidase inhibitors

-Delayed absorption of carbs by inhibiting glucosidase in small intestine

Question 10

Miglitol (Glyset)

Answer 10

Alpha-glucosidase inhibitors

-Delayed absorption of carbs by inhibiting glucosidase in small intestine

Question 11

Biguanides*

Answer 11

• Lactic acidosis, renal insufficiency, CHF, alcoholics
• *Cimetidine (Tagamet), digoxin (Lanoxin), vancomycin (^ concentration due to renal tubular secretion competition)/herbals (hypoglycemia)

Question 12

Alpha-glucosidase inhibitors*

Answer 12

<18 years, hiatal hernias, digestive disease

Question 13

Rosiglitazone (Avandia)

Answer 13

Thiazolidinediones

-Reduces insulin resistance, inhibit hepatic gluconeogensis

Question 14

Pioglitazone (Actos)

Answer 14

Thiazolidinediones

-Reduces insulin resistance, inhibit hepatic gluconeogensis

Question 15

Thiazolidinediones*

Answer 15

Hepatic pts, CHF, decrease level of oral contraceptives

Question 16

Sitagliptin (Januvia)*

Answer 16

Dipeptide Peptidase-4 Inhibitor (DP-4)*

• Inhibits DP4, protects incretin hormones, reduces hepatic glucose production
• Digoxin, sulfonylureas (to prevent hypoglycemia)

Question 17

Vildagliptin (Galvus)

Answer 17

Dipeptide Peptidase-4 Inhibitor (DP-4)

-Inhibits DP4, protects incretin hormones, reduces hepatic glucose production

Question 18

Exenatide (Byetta)

Answer 18

GLP-1 Agonists

-Synthetic incretin mimetic, decreases blood glucose levels

Question 19

Exenalide (Bydureon)

Answer 19

GLP-1 Agonists

-Synthetic incretin mimetic, decreases blood glucose levels

Question 20

Liraglutide (Victoza)

Answer 20

GLP-1 Agonists

-Synthetic incretin mimetic, decreases blood glucose levels

Question 21

Pramlintide (Symlin)

Answer 21

Amylin Analogue

-Slows gastric emptying, postprandial glucose metabolism, use with insulin

Question 22

Canagliflozin (Invokana)

Answer 22

SGLT-2 Inhibitor

-Blocks kidney rebasorption of glucose

Question 23

Farxiga (Dapagliflozin)

Answer 23

SGLT-2 Inhibitor

-Blocks kidney rebasorption of glucose