Pharm- Diabetes

Question 1

Metformin- AE/ CI

Answer 1

• Nausea
• Diarrhea
• IV contrast
• Lactic acidosis
• Low creatinine
• Vit B12 absorption

Question 2

Metformin- MOA

Answer 2

• Decrease hepatic glucose production
• Decrease insulin resistance, improves insulin sensitivity
• Moderate LDL reduction

Question 3

Glucosidase inhibitors- MOA

Answer 3

Blocks digestion of carbohydrate in gut

Question 4

Glucosidase inhibitors- CI/AE

Answer 4

• Major GI side effects

- Pregnant, lactating, GI or liver disease

Question 5

Glucosidase inhibitors- Ed

Answer 5

• Take with first bite of meal
• Must treat with glucose tabs to treat hypoglycemia
• Monitor prandial values

Question 6

TZDs- MOA

Answer 6

• Decrease insulin resistance

- Decrease hepatic glucose production

Question 7

TZD- AE/CI

Answer 7

• Cardiac- CHF, edema, fractures, CVD
• Hepatotoxicity
• Weight gain
• Increased fertility
• HA, anemia

Question 8

GLP-1 incretin- MOA

Answer 8

• Gut hormones- enhance insulin secretion in response to food
• Slows gastric emptying
• Glucose dependent insulin secretion- beta cells

Question 9

DDP-4 Inhibitors- MOA

Answer 9

• Increase and prolong the action of GLP-1
• Incretin enhancer- increased insulin release in response to meals
• Increased secretion of glucagon

Question 10

GLP-1- RoA

Answer 10

Injection, daily or weekly

Question 11

DDP-4- RoA

Answer 11

Oral

Question 12

GLP-1- AE/CI

Answer 12

• Weight loss
• Nausea
• ESRD, dialysis, gastroparesis
• Hypoglycemia with SU
• Delayed med absorption- abx, BCP, warfarin
• dizziness, HA, jittery

Question 13

GLP-1- Ed

Answer 13

• Refrigerate pens
• Inject in thigh, abd, arm
• Not insulin substitute
• New needle with each use

Question 14

DPP-4- AE/ CI

Answer 14

• Type 1, children
• URI, nasopharyngitis
• HA
• Low hypoglycemia
• Ok to use in CKD, ESRD

Question 15

SGLT 2 inhibitor- Name

Answer 15

Invokana

Question 16

SGLT 2 inhibitor- MOA

Answer 16

• Blocks reabsorption of glucose in the renal tubules

- Blocks 90% glucose reabsorption at SGLT

Question 17

SGLT 2 inhibitor- CI/AE

Answer 17

• Decreased renal function

- UTI due to glucose uresis

Question 18

Sulfonylureas- Names

Answer 18

Glyburide, glipizide, glymeperide

Question 19

Sulfonylureas- MOA

Answer 19

• Stimulate insulin release from beta cells
• Reduce hepatic glucose reproduction
• Increase insulin sensativity

Question 20

Sulfonylureas- Duration of action

Answer 20

12-24 hrs

Question 21

Sulfonylureas- AE/CI

Answer 21

• Wt gain
• Hepatic/ renal insufficiency
• Glyburide may be used in pregnancy

Question 22

Meglinatide analogs- Names

Answer 22

• Glindes
• Nonsulfonylurea insulin stimulators
• Repaglinide

Question 23

Meglinatide analogs- MOA

Answer 23

• Bind to potassium channels and initiate release of insulin from beta cells

Question 24

Meglinatide analogs- Peak & Duration

Answer 24

• Rapid onset, short duration of action

Question 25

Meglinatide analogs- Indications

Answer 25

Postprandial glucose regulation.

Question 26

Meglinatide analogs- AE/CI

Answer 26

• Hypoglycemia
• weight gain
• Caution in hepatic impariment

Question 27

Metformin- Indications

Answer 27

• DOC for all type 2 diabetics

Question 28

TZDs- Names

Answer 28

pioglitazone (Actose)

Question 29

Alpha glucosidase inhibitors- Names

Answer 29

Acarbose (Precose)

Question 30

Alpha glucosidase inhibitors- MOA

Answer 30

• Delay ingestion of carbohydrates

- Taken at beginning of meals

Question 31

Alpha glucosidase inhibitors- AE/ CI

Answer 31

• Flatulence, diarrhea, abd cramping

- IBD, ulcers, obstruction

Question 32

DPP-4- Indications

Answer 32

• Adjunct therapy with metformin

Question 33

SGLT2 Inhibitors- Indications

Answer 33

• Improvement of glycemic control