Quiz 2 Antihyperlipidemics and Antidiabetics Flashcards
Atorvastatin Brand Name
Lipitor
Atorvastatin Class
HMG-CoA Reductace Inhibitor
Atorvastatin Indication
- Hyperlipidemia
- Primary and secondary prevention of atherosclerotic cardiovascular disease
- Secondary prevention of cardiovascular events in patients with or at high risk for CAD
- Familial hypercholesterolemia (homozygous)
Atorvastatin MoA
HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol also can decrease because of decreased production of VLDL-cholesterol or increased VLDL; removal by LDL receptors.
CLARIFICATION OF WHAT THIS MEANS JUST TO UNDERSTAND THE MECHANISM DEEPER WHATS BELOW WILL EXPLAIN WHAT UP THERE MEANS:
Competitively inhibits the conversion of HMG-CoA to mevalonate
Compensatory increase in low density lipoprotein (LDL) receptors which bind and break down circulating LDL cholesterol and VLDL
Note: LDL and VLDL are both bad cholesterol in liver cells – hepatocytes
Ultimately there is less cholesterol. The LDL is turned into bile, excreted, and recycled.
Note: VLDL is turned into LDL
LDL= Low density lipoprotein
VLDL = Very low density lipoprotein
The reduced intracellular concentrations of cholesterol in hepatocytes secondary to statin use activate the proteases that cleave membrane-bound sterol regulatory element-binding proteins (SREBP), which further migrate to the nucleus and bind to sterol response elements. This binding results in increased transcription of the LDL receptor, which translocates to the liver cell membrane. The LDL and VLDL particles in plasma bind to the LDL receptors and endocytose in hepatocytes, where their cholesterol component gets processed into bile salts, which are then excreted or recycled. This process increases the catabolism of LDL and VLDL cholesterol and results in further reduction of plasma cholesterol concentrations.[3]
Statins reduce the plasma concentrations of total cholesterol, LDL-C, VLDL-C, triglycerides, apo-B, and increase the plasma concentrations of HDL-C.
Atorvastatin Pregnancy Category
Pregnancy - contraindicated first trimester, and contraindicated for breastfeeding.
Atorvastatin Contraindication
Hypersensitivity to atorvastatin, use in breastfeeding, active liver disease, unexplained persistent elevations of serum transaminases
Atorvastatin Black Box Warning
N/A
Atorvastatin Counseling points
Avoid excessive alcohol, grapefruit, and grapefruit juice (>1 L/d) consumption while taking drug. Atorvastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels. Notify prescriber if unexplained muscle tenderness or weakness occurs.
Pravastatin Brand Name
Pravachol
Pravastatin Class
HMG-CoA Reductace Inhibitor
Pravastatin Indications
Cerebrovascular accident (prevention)
Familial hypercholesterolemia
Hyperlipidemia
Pravastatin MoA
HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol decreases because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.
CLARIFICATION OF WHAT THIS MEANS JUST TO UNDERSTAND THE MECHANISM DEEPER WHATS BELOW WILL EXPLAIN WHAT UP THERE MEANS:
Competitively inhibits the conversion of HMG-CoA to mevalonate
Compensatory increase in low density lipoprotein (LDL) receptors which bind and break down circulating LDL cholesterol and VLDL
Note: LDL and VLDL are both bad cholesterol in liver cells – hepatocytes
Ultimately there is less cholesterol. The LDL is turned into bile, excreted, and recycled.
Note: VLDL is turned into LDL
LDL= Low density lipoprotein
VLDL = Very low density lipoprotein
The reduced intracellular concentrations of cholesterol in hepatocytes secondary to statin use activate the proteases that cleave membrane-bound sterol regulatory element-binding proteins (SREBP), which further migrate to the nucleus and bind to sterol response elements. This binding results in increased transcription of the LDL receptor, which translocates to the liver cell membrane. The LDL and VLDL particles in plasma bind to the LDL receptors and endocytose in hepatocytes, where their cholesterol component gets processed into bile salts, which are then excreted or recycled. This process increases the catabolism of LDL and VLDL cholesterol and results in further reduction of plasma cholesterol concentrations.[3]
Statins reduce the plasma concentrations of total cholesterol, LDL-C, VLDL-C, triglycerides, apo-B, and increase the plasma concentrations of HDL-C.
Pravastatin Pregnancy Category
Contraindicated - first trimester
Pravastatin Contraindications
Hypersensitivity to pravastatin, do not use in breastfeeding
Pravastatin Black Box Warning
N/A
Pravastatin Counseling Points
Take in the evening. Avoid concurrent heavy alcohol use. Pravastatin does not take the place of diet and exercise to lower cholesterol levels.
Ezetimibe Brand Name
Zetia
Ezetimibe Class
Antihyperlipidemic, Cholesterol Absorption Inhibitor
Ezetimibe Indications
- Familial hypercholesterolemia-homozygous, with atorvastatin or simvastatin
- Mixed hyperlipidemia
- Primary hypercholesterolemia
Ezetimibe MoA
Ezetimibe localizes at the brush border of the small intestine and inhibits the absorption of cholesterol, leading to a decrease in the delivery of intestinal cholesterol to the liver. This causes a reduction of hepatic cholesterol stores and an increase in clearance of cholesterol from the blood; this distinct mechanism is complementary to that of statins and of fenofibrate.
Ezetimibe Pregnancy
Pregnancy - limited human data.
Contraindicated breastfeeding
Ezetimibe Contraindication
Hypersensitivity to ezetimibe, gallbladder disease, severe hepatic dysfunction, concurrent use with a statin in a pregnant or nursing mother
Ezetimibe Black Box Warning
N/A
Ezetimibe Counseling Points
Take with or without food and may be taken at the same time as a concurrent statin. In patients receiving a bile acid sequestrant concurrently, ezetimibe should be taken at least 2 h before or 4 h after the bile acid sequestrant is taken.
https://www.verywellhealth.com/what-are-bile-acid-sequestrants-697489
Fenofibrate Brand Name
Antara
Fenofibrate Class
Antihyperlipidemic
Fenofibrate Indication
- Hypercholesterolemia
- Hypertriglyceridemia
Fenofibrate MoA
Fibric acid derivatives activate peroxisome proliferator-activated receptor α (PPARα), which increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein C-III (an inhibitor of lipoprotein lipase activity). The resulting fall in triglycerides produces an alteration in the size and composition of LDL from small, dense particles to large buoyant particles. These larger particles have a greater affinity for cholesterol receptors and are catabolized rapidly.
Fenofibrate Pregnancy Category
Pregnancy - limited human data
breastfeeding - no human data - potential toxicity
Fenofibrate Contraindication
Hypersensitivity, gallbladder disease, severe renal or hepatic dysfunction, nursing mothers
Fenofibrate Blackbox warning
N/A
Fenofibrate Counseling Points
Fenoglide tablets and Lipofen R capsules should be given with food; others can be taken without food. Take 1 h before or 4-6 h after a bile acid binding resin. Products are not interchangeable. Do not use if you have severe kidney disease or liver disease.
Lovastatin Brand Name
Altoprev
Lovastatin Class
HMG-CoA Reductace Inhibitor
Lovastatin Indications
- Coronary arteriosclerosis, hypercholesterolemia, primary andmixed
- familial hypercholesterolemia, heterozygous
Lovastatin MoA
HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol decreases because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.
Lovastatin Pregnancy Category
Contraindicated - first trimester
Lovastatin Contraindication
Hypersensitivy to lovastatin, active liver disease, use in breastfeeding, concomitant use with strong CYP3A4/5 inhibitors, and unexplained persistent elevation of liver enzymes
Lovastatin Blackbox
N/A
Lovastatin Counseling Point
Immediate-release tablets should be taken with the evening meal. Extended-release tablets should be taken at bedtime. Swallow extended-release tablets whole; do not chew, crush, or cut. Avoid alcohol, grapefruit, and grapefruit juice. Report signs/symptoms of rhabdomyolysis, jaundice (yellowing of skin or eyes), or renal failure. There are multiple significant drug-drug interactions with lovastatin. Consult a health-care professional prior to starting any new prescription or OTC medications. Lovastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels
Rosuvastatin Brand Name
Crestor
Rosuvastatin Class
HMG-CoA Reductace Inhibitor
Rosuvastatin Indication
- Hyperlipidemia
- Disorder of cardiovascular system, primary prophylaxis, familial hypercholesterolemia, homozygous, hypertriglyceridemia, mixed dyslipidemia
Rosuvastatin MoA
HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol can also decrease because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.
Rosuvastatin Pregnancy Category
Contraindicated - first trimester
Rosuvastatin Contraindication
Hypersensitivity of rosuvastatin, active liver disease, use in breastfeeding
Rosuvastatin Blackbox Warning
N/A
Rosuvastatin Counseling Points
Do not drink alcohol. Rosuvastatin does not take the place of diet and exercise to lower cholesterol levels.
Simvastatin Brand Name
Zocor
Simvastatin Class
HMG-CoA Reductace Inhibitor
Simvastatin Indication
- Hyperlipidemia
- Primary and secondary preventions of atherosclerotic cardiovascular disease
- Secondary prevention of cardiovascular events
- Familial hypercholesterolemia (homozygous)
Simvastatin MoA
HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol also can decrease because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.
Simvastatin Pregnancy Category
Contraindicated - first trimester
Simvastatin Contraindication
hypersensitivity of simvastatin, active liver disease, use in breastfeeding
Simvastatin Blackbox Label
N/A
Simvastatin Counseling Points
Avoid excessive alcohol. There are multiple significant drug-drug interactions with simvastatin. Consult a health-care professional prior to starting any new medications, including OTC and herbal drugs. Simvastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels.
Dulaglutide Brand Name
Trulicity
Dulaglutide Class
Antidiabetic Agent, Glucagon-like peptide-1 receptor agonist
Dulaglutide Indication
Diabetes mellitus, type 2
Dulaglutide MoA
Dulaglutide is an agonist of human glucagon-like peptide-1 (GLP-1) receptor and augments glucose-dependent insulin secretion and slows gastric emptying.
Dulaglutide Pregnancy Category
N/A
Dulaglutide Contraindication
Family history of medullary thyroid carcinoma, MEN2
Dulaglutide Black Box
Risk of thyroid cancers
Dulaglutide Counseling Points
Inject subcutaneously into the upper arm, thigh, or abdomen; use a different injection site each week. Administer once weekly on the same day each week, without regard to meals or time of day. Administration day can be changed as long as at least 3 d have passed. If using concomitantly with insulin, administer as separate injections (do not mix); may inject in the same body region as insulin, but do not administer both agents directly adjacent to one another. Keep refrigerated, but is stable at room temperature for 14 d. Be aware of symptoms of thyroid cancer (lump in neck, trouble breathing or swallowing) and kidney problems (decreased urination, blood in urine) and report to HCP.
Empagliflozin Brand Name
Jardiance
Empagliflozin Class
Sodium-glucose co-transporter 2 (SGLT2) inhibitors
Empagliflozin Indication
Diabetes Mellitus 2
Reduce risk of cardiovascular death in adult patients with Diabetes Mellitus 2 and established cardiovascular disease
Empagliflozin Pregnancy Risk
2nd and 3rd trim. risk
Empagliflozin Contraindication
Severe renal impairment, end-stage renal disease, dialysis
Hypersensitivity
Empagliflozin MoA
Empagliflozin works by inhibiting the sodium-glucose co-transporter-2 (SGLT-2) found in the proximal tubules in the kidneys. Through SGLT2 inhibition, empagliflozin reduces renal reabsorption of glucose and increases urinary excretion of glucose
- Lower plasma glucose levels by blocking renal reabsorption of filtered glucose, which falls as plasma levels fall.
- Reduction in blood glucose without stimulating insulin release
Empagliflozin Blackbox Warning
Risk of thyroid C-cell tumors, contraindicated in family history of Medullary Thyroid Carcinoma (MTC)
Empagliflozin Counseling Points
- If signs / symptoms of ketoacidosis (nausea, vomiting, abdominal pain, tiredness, and labored breathing) occur, seek medical attention.
- Contact healthcare provider if signs of HTN occur. Dehydration may increase risk of HTN so pt must maintain adequate fluid intake.
- Concurrent use with sulfonylureas or insulin may increase risk of hypoglycemia.
- Necrotizing infections of perineum and vaginal / penile yeast infections may occur. (Gyat damn bruh)
Glimepiride Brand Name
Amaryl
Glimepiride Class
Second-Generation Sulfonylurea, Antidiabetic
Glimepiride Indication
Diabetes mellitus, type 2
Glimepiride MoA
Sulfonylureas enhance insulin secretion from pancreatic β-cells and potentiate insulin action on several extrahepatic tissues. Long-term sulfonylureas increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase the sensitivity and/or number of peripheral insulin receptors.
Glimepiride Pregnancy Category
N/A
Glimepiride Contraindication
Hypersensitivity to sulfonylureas, diabetic ketoacidosis
Glimepiride Blackbox Warning
N/A
Glimepiride Counseling Points
Monitor blood glucose in frequent intervals (2-4 times per d); if <70 mg/dL, eat candy or sugar and contact prescriber. Take with food or milk in the morning. Use a sunscreen and avoid sunlamps and tanning beds. Do not drink alcohol; may cause a disulfiram reaction.
Glipizide Brand Name
Glucotrol
Glipizide Class
Second-Generation Sulfonylurea, Antidiabetic
Glipizide Indication
Diabetes mellitus only type 2
Glipizide MoA
Sulfonylureas enhance insulin secretion from pancreatic β-cells and potentiate insulin action on several extrahepatic tissues. Long-term sulfonylureas increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase the sensitivity and/or number of peripheral insulin receptors.
Glipizide Pregnancy Category
N/A
Glipizide Contraindication
Hypersensitivity to sulfonylureas, diabetic ketoacidosis, type 1 diabetes
Glipizide Blackbox Warning
N/A
Glipizide Counseling Points
Monitor blood glucose in frequent intervals (2-4 times per d); if <70 mg/dL, eat candy or sugar and contact prescriber. Use a sunscreen and avoid sunlamps and tanning beds. Do not drink alcohol; may cause a disulfiram reaction. Take 30 min before morning meal. Do not chew or crush extended-release formulation.
Insulin aspart Brand Name
Fiasp, Novolog
Insulin aspart Class
Insulin (FAST ACTING)
Insulin aspart Indication
Diabetes mellitus 1
Insulin aspart MoA
Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
Insulin aspart Pregnancy Category
Compatible
Insulin aspart Contraindication
Hypersensitivity
Insulin aspart Blackbox Warning
Risk of acute bronchospasm with inhaled formulation
Insulin aspart Counseling Points
Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
Insulin degludec Brand Name
Tresiba
Insulin degludec Class
Insulin (LONG ACTING)
Insulin degludec Indication
Diabetes mellitus 1
Insulin degludec MoA
Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
Insulin degludec Pregnancy Category
None
Insulin degludec Contraindication
Hypersensitivity
Insulin degludec Blackbox Warning
Risk of acute bronchospasm with inhaled formulation
Insulin degludec Counseling points
Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
Insulin detemir Brand Name
Levemir
Insulin detemir Class
Insulin (LONG ACTING)
Insulin detemir Indication
Diabetes mellitus type 1
Insulin detemir MoA
Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
Insulin detemir Pregnancy Category
Compatible
Insulin detemir Contraindication
Hypersensitivity
Insulin detemir Blackbox Warning
Risk of acute bronchospasm with inhaled formulation
Insulin detemir Counseling Point
Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
Insulin glargine Brand Name
Lantus
Insulin glargine Class
Insulin (LONG ACTING)
Insulin glargine Indication
Diabetes mellitus Type 1
Insulin glargine MoA
Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
Insulin glargine Pregnancy Category
Compatible
Insulin glargine Contraindication
Hypersensitivity
Insulin glargine Blackbox Warning
Risk of acute bronchospasm with inhaled formulation
Insulin glargine Counseling Points
Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
Insulin LisproBrand Name
Amdelog, Humalog
Insulin LisproClass
Insulin (FAST ACTING)
Insulin LisproIndication
Diabetes mellitus Type 1
Insulin LisproMoA
Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.
Insulin LisproPregnancy Category
Compatible
Insulin LisproContraindication
Hypersensitivity
Insulin LisproBlackbox Warning
Risk of acute bronchospasm with inhaled formulation
Insulin LisproCounseling Points
Monitor blood glucose in frequent intervals (2-4 times/d); if <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Store unopened vials in refrigerator. Keep open vials at room temperature if it is painful to inject cold insulin. Dispose needles in sharps container. Do not share needles (risk of transmission of infectious diseases). Rotate injection sites.
Metformin Brand Name
Glucophage
Metformin Class
Biguanide, Hypoglycemic
Metformin Indication
Diabetes mellitus type 2
Metformin MoA
Metformin is a biguanide antihyperglycemic agent. It does not affect insulin secretion; rather, it reduces hepatic glucose production and enhances glucose utilization by muscle.
Metformin Pregnancy Category
Pregnancy - Low risk
Metformin Contraindication
Hypersensitivity to metformin, contrast media, eGFR <30 mL/min/1.73 m2, metabolic acidosis
Metformin Blackbox Warning
Lactic acidosis
Metformin Counseling Point
Take with meals. Drink plenty of liquids to improve elimination of metformin. Avoid alcohol; this increases the risk of lactic acidosis.
Metformin;Sitagliptin Brand Name
Janumet
Metformin;Sitagliptin Class
Antidiabetics, Biguanides/Dipeptyl Peptidase-IV Inhibitors
Metformin;Sitagliptin Indication
Diabetes Mellitus Type 2
Metformin;Sitagliptin MoA
Combination of Metformin and Sitagliptin
Metformin is a biguanide antihyperglycemic agent. It does not affect insulin secretion; rather, it reduces hepatic glucose production and enhances glucose utilization by muscle.
Stagliptin phosphate is a DPP-4 enzyme inhibitor that inhibits the degradation of incretin hormones by DPP-4, and enhances the function of GLP-1 and GIP to increase insulin release and decrease glucagon levels in the circulation in a glucose-dependent manner.
Metformin;Sitagliptin Pregnancy Category
Caution advised
Metformin;Sitagliptin Contraindication
- DM1
- Severe renal impairment (eGFR > 30 mL / min / 1.73 m^2)
- Acidosis
- Ketoacidosis
- Dehydration
- Liver disease
- Hypersensitivity to Janumet, sitagliptin, or metformin
Metformin;Sitagliptin Blackbox Warning
May cause lactic acidosis
Metformin;Sitagliptin Counseling Points
- Take with meals.
- Swallow whole. Do not break or crush.
- If you miss a dose, take as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not take 2 doses of JANUMET at the same time.
- Call your doctor for instructions if you are dehydrated, plan to have surgery, or are going to get an injection of dye / contrast agent for x-ray procedure.
Liraglutide Brand Name
Victoza
Liraglutide Class
Glucagon-Like Peptide-1-Receptor Agonist
Liraglutide Indication
- Diabetes mellitus type 2
- Chronic weight management
Liraglutide MoA
Analog of glucagon-like peptide-1, which increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, slows gastric emptying, and increases satiety.
Liraglutide Pregnancy Category
N/A
Liraglutide Contraindication
Hypersensitivity, multiple endocrine neoplasia syndrome type 2, history or family history of medullary thyroid carcinoma
Liraglutide Blackbox Warning
Increased risk of thyroid cancer
Liraglutide Counseling Points
Monitor blood glucose periodically (typically daily, more frequently if administered with sulfonylurea or insulin). If <70 mg/dL, eat non–sugar-free candy, glucose tablets, or drink a glass of juice and contact prescriber. Administer in upper arm, thigh, or abdomen. Change needle for each injection; do not share pens, even if needle is changed. If also using insulin, administer with separate injection in a nonadjacent area. Can be injected without regard to meals.
Pioglitazone Brand Name
Actos
Pioglitazone Class
Thiazolidinedione Antidiabetic
Pioglitazone Indication
Diabetes mellitus type 2
Pioglitazone MoA
Pioglitazone is a thiazolidinedione antihyperglycemic and a potent peroxisome proliferator-activated receptor-𝛾 (PPAR-𝛾) agonist used to improve insulin sensitivity in patients with diabetes mellitus type 2. Insulin-dependent glucose disposal in skeletal muscle is improved and hepatic glucose production is decreased; both actions contribute to pioglitazone’s glucose-lowering effects.
Pioglitazone Pregnancy Category
N/A
Pioglitazone Contraindication
Hypersensitivity to pioglitazone, NYHA III/IV heart failure
Pioglitazone Blackbox Warning
Heart failure risk
Pioglitazone Counseling Points
Monitor blood glucose in frequent intervals (2-4 times per d). May take without regard to food. May require several weeks for maximum effect. Seek care for bone pain, yellowing of skin or eyes, eye pain, or shortness of breath.
Sitagliptin Brand Name
Januvia
Sitagliptin Class
Dipeptidyl Peptidase-4 Inhibitor, Antidiabetic
Sitagliptin Indication
Diabetes mellitus type 2 (prolly lolz)
Sitagliptin MoA
Stagliptin phosphate is a DPP-4 enzyme inhibitor that inhibits the degradation of incretin hormones by DPP-4, and enhances the function of GLP-1 and GIP to increase insulin release and decrease glucagon levels in the circulation in a glucose-dependent manner.
Sitagliptin Pregnancy Category
N/A
Sitagliptin Contraindication
Hypersensitivity to sitagliptin
Sitagliptin Blackbox Warning
N/A
Sitagliptin Counseling Points
Monitor blood glucose in frequent intervals (2-4 times/d). Take with morning meal if once-daily dosing. Take with morning and evening meal if twice-a-day dosing. When used in combination with insulin or sulfonylureas, risk of hypoglycemia may be increased.
