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PHAR 152 > T2D Drugs > Flashcards

T2D Drugs Flashcards

1
Q

What are the drug interactions of metformin

A

Cimetidine
Dolutegravir
Alcohol

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2
Q

What are the AE of metformin?

A

Diarrhea
GI

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3
Q

What are the Less common effects of metformin?

A

Metal taste,
B12 deficiency

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4
Q

What are the precautions and CI of metformin?

A

Lactic Acidosis

Decrease dose if ClCr <60ml/min

1500mg/d 45-59
1000mg/d 30-44

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5
Q

What is the MOA of SUs

A

Enhance the secretion of insulin by binding to SU receptor on beta cells of the pancreas

Stimulate basal and meal stimulated insulin release

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6
Q

What are the three SUs

A

Glyburide, Glicalizide, glimepiride

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7
Q

What is the usual dosage of Glyburide?

A

5m-20mg/d

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8
Q

What is the usual dosage of glicalizide

A

80mg-160mg

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9
Q

What is the usual dosage of Glimepiride

A

1mg-8mg

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10
Q

Which eGFR is glyburide CI in?

A

<60ml/min

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11
Q

Which eGFR is gliclazide and glimepiride in?

A

<30ml/min

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12
Q

Which SU does not cross the placenta?

A

Glyburide

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13
Q

What is the MOA of repaglinide? (Meglitinides)

A

Binds to a site adjacent to the SU receptor, resulting in stimulation of the secretion of insulin from the pancreas

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14
Q

What is the dosing of Repaglinide?

A

◼A1C <8%: initiate at 0.5mg before each meal + titrate up

◼A1C >8%. Initiate at 1-2mg before each meal + titrate up

Max dose: 4mg before each meal (max dose 16mg/d)

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15
Q

What is a possible DI or CI with repaglinide?

A

Grapefruit juice,

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16
Q

What are the two Thiazolidinediones

A

Rosiglitazone, Pioglitazone

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17
Q

What is the MOA of Rosiglitazone, Pioglitazone?

A

Bind to PPAR-γ receptors which are primarily found in adipose tissue. Activation alters genes that influence glucose and lipid metabolism

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18
Q

What was controversial due to Thiazolidinediones?

A

Cardiovascular safety and how they both can promote fluid retention and edema and increase risk of HF

19
Q

What are the GLP-1 receptor agonists (glucagon-like peptide) drugs?

A

Exenatide (Byetta®)
* Liraglutide (Victoza®) ®
* Dulaglutide (Trulicity®)
* Exenatide weekly (Bydureon®)
* Lixisenatide (Adlyxine®)
* Semaglutide (Ozempic® SC, Rybelsus® oral)

-tide is the suffice GLP-1Tide

20
Q

DPP-4 (dipeptidyl peptidase) Inhibitors

A
  • Linagliptin (Trajenta®)
  • Sitagliptin (Januvia®)
  • Saxagliptin (Onglyza®)
  • Alogliptin (Nesina®)

DPP4-iptin

21
Q

Activation of the GLP-1 receptor results in:

A
  • Potent inhibition of gastric emptying
  • Potent inhibition of glucagon secretion
  • Reduction of food intake and body weight
22
Q

Adverse effects and precautions due to DPP4i?

A

headache, nasopharyngitis, URTI

23
Q

What are the short acting GLP1RAs?

A

Exenatide, Lixisenatide

Must be taken before meals

24
Q

What are the long acting GLP1RAs?

A

Liraglutide
Exenatide
Dulugatide
Semaglutide

25
What is the effect on weight with GLP1RA?
Weight loss
26
What renal levels are SGLT2i no longer effective?
<45
27
What are the common AE of SGLT2i?
Urination and thirst
28
What are the CI of SGLT2i?
Elderly, on other diuretics DKA risk
29
Are SGLT2i renal protective?
Yes
30
What is the desired dosing of metformin?
850-1000mg BID
31
What happens when you have Climetidine and metformin DI?
Competes for renal tubular secreiton and increases metofrmins levels by 60%
32
What does Dolutegravir do?
Increases metformin concentration
33
What is the tyipical dosing of repaglinide if the A1C is below 8%?
0.5mg before meal
34
What is the typical dosing of repaglinide if the A1C is above 8%
1-2mg before meal and titrate up to 4mg before mealk
35
What is the typical dosage of acarbose?
25- 50mg OD and go up to 100mg TID is the goal
36
What do TZDs do?
Enhance insulin sensitivity Decreast hepatic glucose production Convert LDL to fluffy LDLs
37
What is the dosage of rosiglitazone (Rosi)(
2-4mg OD and may increase to 4mg BID
38
What is the typical dosage of pioglitazone?
15mg OD and 30-45mg OD
39
What is the only DPP4 inhibitor that does not require dose adjustment due to renal dosing"
Linaglipitin
40
What drugs should be avoided when takling DPP4 inhibitors?
GLP1RA
41
What are the dosages of EL short acting GLP1RAs?
5ug BID (Exenatide) Lixisenatide (10ug to 20ug OD)
42
What is the dosage of Dapa?
5-10mg
43
What is the dosage of Cana? -flozin
100-300mg OD
44
What is the dosage of Empaglifozin?
10-25mg

PHAR 152 (8 decks)

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