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NMT200 > Pharm-diabetes > Flashcards

Pharm-diabetes Flashcards

1
Q

What drugs can cause dysglycemia? (6)

A
  1. beta blockers
  2. corticosteriods
  3. HMG coA reductase inhibitors
  4. Thiazide/ loop diuretics
  5. Protease antiviral meds
  6. 2nd-gen antipsychotics
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2
Q

What is rapid onset insulin best for?

A

postprandial insulin injection
OR
use with insulin pump (continuous infusion)

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3
Q

What is long acting insulin best for?

A

Basal insulin infusion

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4
Q

Adverse effects of insulin injection (3)?

A
  1. hypoglycemia (most common) (due to missed meal or increase in exercise)
  2. localized fat atrophy
  3. allergic reactions
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5
Q

Which drug lowers hepatic glucose production?

A

Metformin
(Biguanides)

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6
Q

Which drug is the 1st choice for new + uncomplicated diabetes?

A

Metformin
(Biguanides)

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7
Q

Which drug inhibits intestinal alpha-glucosidases → delayed digestion (starches, disaccharides) → ↓ postprandial glucose levels
(AND must be taken w/ meal)

A

Acarbose
(Alpha-Glucosidase inhibitors)

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8
Q

Which drug Inhibits enzyme responsible for degradation of GLP-1 & other active peptides in glucose homeostasis
Indirectly: incretin mimetic

A

Sitagliptin
(Dipeptidyl peptidase-4 Inhibitors)

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9
Q

Which drugs: Incretin mimetics → act on GLP-1 R
↑ insulin secretion, suppresses postprandial glucagon secretion, slows gastric emptying, ↑ satiety

A

Semaglutide + Liraglutide
(Glucagon-like peptide-1 R agonists)

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10
Q

Which drugs is protective against CVD events

A

Semaglutide + Liraglutide
(Glucagon-like peptide-1 R agonists)

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11
Q

Which drug: Insulin secretagogue → stimulates both basal & meal-stimulated insulin release

A

Glyburide
(Sulfonylureas)

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12
Q

Which drug is considered an add on therapy to metformin?

A

Glyburide
(Sulfonylureas)

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13
Q

Insulin secretagogue → stimulate insulin release

A

Repaglinide
(Meglitinides)

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14
Q

Difference between glyburide + repaglinide?

A

Repaglinide has shorter activity

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15
Q

Which drug: Precent glucose reabsorption in kidneys → enhanced glucose excretion

A

Canagliflozin
(Na-glucose cotransporter 2 inhibitors)

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16
Q

Which drug: Reduced risk of CV mortality , small ↓ bp, slows progression of nephropathy

A

Canagliflozin
(Na-glucose cotransporter 2 inhibitors)

17
Q

Which drug: Agonist at peroxisome proliferator-activated R gamma (PPARG) R located on cell nucleus (adipose tissue) → influences gene expression (upregulation of GLUT-4 + lipoprotein lipase) → enhances glucose reabsorption + hydrolysis of circulating TGs

↑ peripheral glucose uptake
Enhanced fat cell sensitivity to insulin
↓ hepatic glucose output

A

Pioglitazone
(Thiazolidinediones)

18
Q

Which drugs lower HbA1c by 1-1.5% (4)?

A
  1. metformin
  2. Semaglutide + liraglutide
  3. Glyburide
  4. Pioglitazone
19
Q

Nausea, diarrhea, abdominal discomfort, anorexia, metallic taste
CI: hepatic/ renal disease → lactic acidosis
Vitamin B12 deficiency (long term use)
Risk of hypoglycemia is ↓ when monotherapy

A

Metformin
(Biguanides)

20
Q

Flatulence, diarrhea, abdominal pain, cramps, nausea
May reduce metformin availability
CI: IBS, IBD
Hypoglycemia pts should be tx w/ glucose not sucrose

A

Acarbose
(Alpha-Glucosidase inhibitors)

21
Q

Nasopharyngitis, hypersensitivity reactions
Rare: pancreatitis + severe joint pain
Low potential for drug interactions (does not inhibit cytochrome P450)
Low risk of hypoglycemia

A

Sitagliptin
(Dipeptidyl peptidase-4 Inhibitors)

22
Q

Nausea upon initiation + GI adverse effects (common)
Rare: Acute pancreatitis
Caution: heart rhythm disturbances + renal impairment
CI: Pregnancy & family hx of medullary thyroid carcinoma OR multiple endocrine neoplasia syndrome type 2

A

Semaglutide + Liraglutide
(Glucagon-like peptide-1 R agonists)

23
Q

Weight gain, prolonged hypoglycemia
Risk of hypoglycemia greater w/ gliclazide + glimepiride (esp. elderly or patients w/ renal impairment)
beta blockers may mask hypoglycemia symptoms

A

Glyburide
(Sulfonylureas)

24
Q

Similar risks to sulfonylureas but ↓ risk of hypoglycemia
More extensive metabolic drug interactions

A

Repaglinide
(Meglitinides)

25
Q

↑ risk genitourinary infections
↓ intravascular volume results in hypotension
(Use w/ loop diuretics ↑ risk of hypotension)
Hyperkalemia
Risk of diabetic ketoacidosis
Does not cause weight gain (causes weight loss)

A

Canagliflozin
(Na-glucose cotransporter 2 inhibitors)

26
Q

Weight gain
↑ incidence of heart failure → must obtain written consent from pts for prescription
↑ risk of fractures (hip + waist)
Worsen macular edema

A

Pioglitazone
(Thiazolidinediones)

NMT200 (8 decks)

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