pharmaceutical care for diabetes Flashcards
1
Q
biguanides
A
- taken gradually to minimise risk of GI side effects
- increased weekly by 500mg
- taken with food
- cautions in renal impairment
- side effects diarrhoea - anorexia
2
Q
pioglitazone
A
- useful in renal failure as a substitute for metformin
- low risk of hypoglycaemia
- causes weight gain
- contradicted in patients with: heart failure, fractures, haematuria
3
Q
gliptins
A
- used in mono/dual/triple therapy
- takes time to exert effect
- alternative to a TZD when weight gain is a problem or glitazone contraindicated or poorly tolerated
4
Q
sodium glucose co-transporter 2 inhibitors
A
- weight loss
- BP reduction
- no hypos
- can take time to exert effect
- polyuria
- genital infections
- cannot be given to >85
- cannot be used if eGFR <45
5
Q
meglitinides
A
- can be used as mono therapy or with metformin
- weight gain
- increased risk of hypoglycaemia
- expensive
6
Q
GLP-1 therapy
A
- third line therapy
- BMI >35
- HbA1c >58 mmol/mol
- diagnosis < 10 years
or - BMI <35
- cant tolerate insulin
7
Q
hypoglycaemia signs + symptoms
A
- sweaty
- hungry
- cold
- pounding heartbeat
- tingling lips
- can lose consciousness
- dizzy/faint/tired/confused/irritable
8
Q
hypoglycaemia management
A
- eat/drink something immediately containing sugar
- followed up by longer acting CHO - sandwiches, fruit, biscuits, milk
- should feel better after 5-10 mins
- eat a normal meal as soon as possible
9
Q
diabetic nephropathy
A
- monitor annually - foot care
- confirmed by abnormal ACR 2/3 tests
- ACE inhibitor or ARB
- titrate to maximum tolerated dose
- target BP <130/80 mmHg
10
Q
suspect renal disease rather than nephropathy if:
A
- no retinopathy
- BP particularly high or resistant to treatment
- heavy proteinuria when previously normal
- sig haematuria
- GFR worsened rapidly
- patient systemically ill
