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Top Drugs PHMD 201A > Quiz 2 Antihyperlipidemics and Antidiabetics > Flashcards

Quiz 2 Antihyperlipidemics and Antidiabetics Flashcards

1
Q

Atorvastatin Brand Name

A

Lipitor

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2
Q

Atorvastatin Class

A

HMG-CoA Reductace Inhibitor

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3
Q

Atorvastatin Indication

A
  1. Hyperlipidemia
  2. Primary and secondary prevention of atherosclerotic cardiovascular disease
  3. Secondary prevention of cardiovascular events in patients with or at high risk for CAD
  4. Familial hypercholesterolemia (homozygous)
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4
Q

Atorvastatin MoA

A

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.

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5
Q

Atorvastatin Pregnancy Category

A

Pregnancy - contraindicated first trimester, and contraindicated for breastfeeding.

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6
Q

Atorvastatin Contraindication

A

Hypersensitivity to atorvastatin, use in breastfeeding, active liver disease, unexplained persistent elevations of serum transaminases

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7
Q

Atorvastatin Black Box Warning

A

N/A

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8
Q

Atorvastatin Counseling points

A

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.

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9
Q

Pravastatin Brand Name

A

Pravachol

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10
Q

Pravastatin Class

A

HMG-CoA Reductace Inhibitor

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11
Q

Pravastatin Indications

A

Cerebrovascular accident (prevention)
Familial hypercholesterolemia
Hyperlipidemia

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12
Q

Pravastatin MoA

A

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.

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13
Q

Pravastatin Pregnancy Category

A

Contraindicated - first trimester

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14
Q

Pravastatin Contraindications

A

Hypersensitivity to pravastatin, do not use in breastfeeding

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15
Q

Pravastatin Black Box Warning

A

N/A

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16
Q

Pravastatin Counseling Points

A

Take in the evening. Avoid concurrent heavy alcohol use. Pravastatin does not take the place of diet and exercise to lower cholesterol levels.

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17
Q

Ezetimibe Brand Name

A

Zetia

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18
Q

Ezetimibe Class

A

Antihyperlipidemic, Cholesterol Absorption Inhibitor

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19
Q

Ezetimibe Indications

A
  1. Familial hypercholesterolemia-homozygous, with atorvastatin or simvastatin
  2. Mixed hyperlipidemia
  3. Primary hypercholesterolemia
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20
Q

Ezetimibe MoA

A

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.

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21
Q

Ezetimibe Pregnancy

A

Pregnancy - limited human data.
Contraindicated breastfeeding

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22
Q

Ezetimibe Contraindication

A

Hypersensitivity to ezetimibe, gallbladder disease, severe hepatic dysfunction, concurrent use with a statin in a pregnant or nursing mother

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23
Q

Ezetimibe Black Box Warning

A

N/A

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24
Q

Ezetimibe Counseling Points

A

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

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25
Q

Fenofibrate Brand Name

A

Antara

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26
Q

Fenofibrate Class

A

Antihyperlipidemic

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27
Q

Fenofibrate Indication

A
  1. Hypercholesterolemia
  2. Hypertriglyceridemia
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28
Q

Fenofibrate MoA

A

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.

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29
Q

Fenofibrate Pregnancy Category

A

Pregnancy - limited human data
breastfeeding - no human data - potential toxicity

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30
Q

Fenofibrate Contraindication

A

Hypersensitivity, gallbladder disease, severe renal or hepatic dysfunction, nursing mothers

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31
Q

Fenofibrate Blackbox warning

A

N/A

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32
Q

Fenofibrate Counseling Points

A

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.

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33
Q

Lovastatin Brand Name

A

Altoprev

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34
Q

Lovastatin Class

A

HMG-CoA Reductace Inhibitor

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35
Q

Lovastatin Indications

A
  1. Coronary arteriosclerosis, hypercholesterolemia, primary andmixed
  2. familial hypercholesterolemia, heterozygous
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36
Q

Lovastatin MoA

A

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.

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37
Q

Lovastatin Pregnancy Category

A

Contraindicated - first trimester

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38
Q

Lovastatin Contraindication

A

Hypersensitivy to lovastatin, active liver disease, use in breastfeeding, concomitant use with strong CYP3A4/5 inhibitors, and unexplained persistent elevation of liver enzymes

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39
Q

Lovastatin Blackbox

A

N/A

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40
Q

Lovastatin Counseling Point

A

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

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41
Q

Rosuvastatin Brand Name

A

Crestor

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42
Q

Rosuvastatin Class

A

HMG-CoA Reductace Inhibitor

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43
Q

Rosuvastatin Indication

A
  1. Hyperlipidemia
  2. Disorder of cardiovascular system, primary prophylaxis, familial hypercholesterolemia, homozygous, hypertriglyceridemia, mixed dyslipidemia
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44
Q

Rosuvastatin MoA

A

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.

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45
Q

Rosuvastatin Pregnancy Category

A

Contraindicated - first trimester

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46
Q

Rosuvastatin Contraindication

A

Hypersensitivity of rosuvastatin, active liver disease, use in breastfeeding

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47
Q

Rosuvastatin Blackbox Warning

A

N/A

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48
Q

Rosuvastatin Counseling Points

A

Do not drink alcohol. Rosuvastatin does not take the place of diet and exercise to lower cholesterol levels.

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49
Q

Simvastatin Brand Name

A

Zocor

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50
Q

Simvastatin Class

A

HMG-CoA Reductace Inhibitor

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51
Q

Simvastatin Indication

A
  1. Hyperlipidemia
  2. Primary and secondary preventions of atherosclerotic cardiovascular disease
  3. Secondary prevention of cardiovascular events
  4. Familial hypercholesterolemia (homozygous)
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52
Q

Simvastatin MoA

A

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.

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53
Q

Simvastatin Pregnancy Category

A

Contraindicated - first trimester

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54
Q

Simvastatin Contraindication

A

hypersensitivity of simvastatin, active liver disease, use in breastfeeding

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55
Q

Simvastatin Blackbox Label

A

N/A

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56
Q

Simvastatin Counseling Points

A

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.

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57
Q

Dulaglutide Brand Name

A

Trulicity

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58
Q

Dulaglutide Class

A

Antidiabetic Agent, Glucagon-like peptide-1 receptor agonist

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59
Q

Dulaglutide Indication

A

Diabetes mellitus, type 2

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60
Q

Dulaglutide MoA

A

Dulaglutide is an agonist of human glucagon-like peptide-1 (GLP-1) receptor and augments glucose-dependent insulin secretion and slows gastric emptying.

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61
Q

Dulaglutide Pregnancy Category

A

N/A

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62
Q

Dulaglutide Contraindication

A

Family history of medullary thyroid carcinoma, MEN2

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63
Q

Dulaglutide Black Box

A

Risk of thyroid cancers

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64
Q

Dulaglutide Counseling Points

A

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.

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65
Q

Empagliflozin Brand Name

A

Jardiance

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66
Q

Empagliflozin Class

A

Sodium-glucose co-transporter 2 (SGLT2) inhibitors

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67
Q

Empagliflozin Indication

A

Diabetes Mellitus 2

Reduce risk of cardiovascular death in adult patients with Diabetes Mellitus 2 and established cardiovascular disease

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68
Q

Empagliflozin Pregnancy Risk

A

2nd and 3rd trim. risk

69
Q

Empagliflozin Contraindication

A

Severe renal impairment, end-stage renal disease, dialysis
Hypersensitivity

70
Q

Empagliflozin MoA

A

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
71
Q

Empagliflozin Blackbox Warning

A

Risk of thyroid C-cell tumors, contraindicated in family history of Medullary Thyroid Carcinoma (MTC)

72
Q

Empagliflozin Counseling Points

A
  • 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)
73
Q

Glimepiride Brand Name

A

Amaryl

74
Q

Glimepiride Class

A

Second-Generation Sulfonylurea, Antidiabetic

75
Q

Glimepiride Indication

A

Diabetes mellitus, type 2

76
Q

Glimepiride MoA

A

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.

77
Q

Glimepiride Pregnancy Category

A

N/A

78
Q

Glimepiride Contraindication

A

Hypersensitivity to sulfonylureas, diabetic ketoacidosis

79
Q

Glimepiride Blackbox Warning

A

N/A

80
Q

Glimepiride Counseling Points

A

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.

81
Q

Glipizide Brand Name

A

Glucotrol

82
Q

Glipizide Class

A

Second-Generation Sulfonylurea, Antidiabetic

83
Q

Glipizide Indication

A

Diabetes mellitus only type 2

84
Q

Glipizide MoA

A

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.

85
Q

Glipizide Pregnancy Category

A

N/A

86
Q

Glipizide Contraindication

A

Hypersensitivity to sulfonylureas, diabetic ketoacidosis, type 1 diabetes

87
Q

Glipizide Blackbox Warning

A

N/A

88
Q

Glipizide Counseling Points

A

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.

89
Q

Insulin aspart Brand Name

A

Fiasp, Novolog

90
Q

Insulin aspart Class

A

Insulin (FAST ACTING)

91
Q

Insulin aspart Indication

A

Diabetes mellitus 1

92
Q

Insulin aspart MoA

A

Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.

93
Q

Insulin aspart Pregnancy Category

A

Compatible

94
Q

Insulin aspart Contraindication

A

Hypersensitivity

95
Q

Insulin aspart Blackbox Warning

A

Risk of acute bronchospasm with inhaled formulation

96
Q

Insulin aspart Counseling Points

A

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.

97
Q

Insulin degludec Brand Name

A

Tresiba

98
Q

Insulin degludec Class

A

Insulin (LONG ACTING)

99
Q

Insulin degludec Indication

A

Diabetes mellitus 1

100
Q

Insulin degludec MoA

A

Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.

101
Q

Insulin degludec Pregnancy Category

A

None

102
Q

Insulin degludec Contraindication

A

Hypersensitivity

103
Q

Insulin degludec Blackbox Warning

A

Risk of acute bronchospasm with inhaled formulation

104
Q

Insulin degludec Counseling points

A

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.

105
Q

Insulin detemir Brand Name

A

Levemir

106
Q

Insulin detemir Class

A

Insulin (LONG ACTING)

107
Q

Insulin detemir Indication

A

Diabetes mellitus type 1

108
Q

Insulin detemir MoA

A

Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.

109
Q

Insulin detemir Pregnancy Category

A

Compatible

110
Q

Insulin detemir Contraindication

A

Hypersensitivity

111
Q

Insulin detemir Blackbox Warning

A

Risk of acute bronchospasm with inhaled formulation

112
Q

Insulin detemir Counseling Point

A

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.

113
Q

Insulin glargine Brand Name

A

Lantus

114
Q

Insulin glargine Class

A

Insulin (LONG ACTING)

115
Q

Insulin glargine Indication

A

Diabetes mellitus Type 1

116
Q

Insulin glargine MoA

A

Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.

117
Q

Insulin glargine Pregnancy Category

A

Compatible

118
Q

Insulin glargine Contraindication

A

Hypersensitivity

119
Q

Insulin glargine Blackbox Warning

A

Risk of acute bronchospasm with inhaled formulation

120
Q

Insulin glargine Counseling Points

A

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.

121
Q

Insulin LisproBrand Name

A

Amdelog, Humalog

122
Q

Insulin LisproClass

A

Insulin (FAST ACTING)

123
Q

Insulin LisproIndication

A

Diabetes mellitus Type 1

124
Q

Insulin LisproMoA

A

Insulin promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins.

125
Q

Insulin LisproPregnancy Category

A

Compatible

126
Q

Insulin LisproContraindication

A

Hypersensitivity

127
Q

Insulin LisproBlackbox Warning

A

Risk of acute bronchospasm with inhaled formulation

128
Q

Insulin LisproCounseling Points

A

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.

129
Q

Metformin Brand Name

A

Glucophage

130
Q

Metformin Class

A

Biguanide, Hypoglycemic

131
Q

Metformin Indication

A

Diabetes mellitus type 2

132
Q

Metformin MoA

A

Metformin is a biguanide antihyperglycemic agent. It does not affect insulin secretion; rather, it reduces hepatic glucose production and enhances glucose utilization by muscle.

133
Q

Metformin Pregnancy Category

A

Pregnancy - Low risk

134
Q

Metformin Contraindication

A

Hypersensitivity to metformin, contrast media, eGFR <30 mL/min/1.73 m2, metabolic acidosis

135
Q

Metformin Blackbox Warning

A

Lactic acidosis

136
Q

Metformin Counseling Point

A

Take with meals. Drink plenty of liquids to improve elimination of metformin. Avoid alcohol; this increases the risk of lactic acidosis.

137
Q

Metformin;Sitagliptin Brand Name

A

Janumet

138
Q

Metformin;Sitagliptin Class

A

Antidiabetics, Biguanides/Dipeptyl Peptidase-IV Inhibitors

139
Q

Metformin;Sitagliptin Indication

A

Diabetes Mellitus Type 2

140
Q

Metformin;Sitagliptin MoA

A

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.

141
Q

Metformin;Sitagliptin Pregnancy Category

A

Caution advised

142
Q

Metformin;Sitagliptin Contraindication

A
  • DM1
  • Severe renal impairment (eGFR > 30 mL / min / 1.73 m^2)
  • Acidosis
  • Ketoacidosis
  • Dehydration
  • Liver disease
  • Hypersensitivity to Janumet, sitagliptin, or metformin
143
Q

Metformin;Sitagliptin Blackbox Warning

A

May cause lactic acidosis

144
Q

Metformin;Sitagliptin Counseling Points

A
  • 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.
145
Q

Liraglutide Brand Name

A

Victoza

146
Q

Liraglutide Class

A

Glucagon-Like Peptide-1-Receptor Agonist

147
Q

Liraglutide Indication

A
  1. Diabetes mellitus type 2
  2. Chronic weight management
148
Q

Liraglutide MoA

A

Analog of glucagon-like peptide-1, which increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, slows gastric emptying, and increases satiety.

149
Q

Liraglutide Pregnancy Category

A

N/A

150
Q

Liraglutide Contraindication

A

Hypersensitivity, multiple endocrine neoplasia syndrome type 2, history or family history of medullary thyroid carcinoma

151
Q

Liraglutide Blackbox Warning

A

Increased risk of thyroid cancer

152
Q

Liraglutide Counseling Points

A

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.

153
Q

Pioglitazone Brand Name

A

Actos

154
Q

Pioglitazone Class

A

Thiazolidinedione Antidiabetic

155
Q

Pioglitazone Indication

A

Diabetes mellitus type 2

156
Q

Pioglitazone MoA

A

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.

157
Q

Pioglitazone Pregnancy Category

A

N/A

158
Q

Pioglitazone Contraindication

A

Hypersensitivity to pioglitazone, NYHA III/IV heart failure

159
Q

Pioglitazone Blackbox Warning

A

Heart failure risk

160
Q

Pioglitazone Counseling Points

A

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.

161
Q

Sitagliptin Brand Name

A

Januvia

162
Q

Sitagliptin Class

A

Dipeptidyl Peptidase-4 Inhibitor, Antidiabetic

163
Q

Sitagliptin Indication

A

Diabetes mellitus type 2 (prolly lolz)

164
Q

Sitagliptin MoA

A

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.

165
Q

Sitagliptin Pregnancy Category

A

N/A

166
Q

Sitagliptin Contraindication

A

Hypersensitivity to sitagliptin

167
Q

Sitagliptin Blackbox Warning

A

N/A

168
Q

Sitagliptin Counseling Points

A

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.

169
Q
A

Top Drugs PHMD 201A (9 decks)

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