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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
Q

What is the effect on weight with GLP1RA?

A

Weight loss

26
Q

What renal levels are SGLT2i no longer effective?

A

<45

27
Q

What are the common AE of SGLT2i?

A

Urination and thirst

28
Q

What are the CI of SGLT2i?

A

Elderly, on other diuretics
DKA risk

29
Q

Are SGLT2i renal protective?

A

Yes

30
Q

What is the desired dosing of metformin?

A

850-1000mg BID

31
Q

What happens when you have Climetidine and metformin DI?

A

Competes for renal tubular secreiton and increases metofrmins levels by 60%

32
Q

What does Dolutegravir do?

A

Increases metformin concentration

33
Q

What is the tyipical dosing of repaglinide if the A1C is below 8%?

A

0.5mg before meal

34
Q

What is the typical dosing of repaglinide if the A1C is above 8%

A

1-2mg before meal and titrate up to 4mg before mealk

35
Q

What is the typical dosage of acarbose?

A

25- 50mg OD and go up to 100mg TID is the goal

36
Q

What do TZDs do?

A

Enhance insulin sensitivity
Decreast hepatic glucose production
Convert LDL to fluffy LDLs

37
Q

What is the dosage of rosiglitazone (Rosi)(

A

2-4mg OD and may increase to 4mg BID

38
Q

What is the typical dosage of pioglitazone?

A

15mg OD and 30-45mg OD

39
Q

What is the only DPP4 inhibitor that does not require dose adjustment due to renal dosing”

A

Linaglipitin

40
Q

What drugs should be avoided when takling DPP4 inhibitors?

A

GLP1RA

41
Q

What are the dosages of EL short acting GLP1RAs?

A

5ug BID (Exenatide)

Lixisenatide (10ug to 20ug OD)

42
Q

What is the dosage of Dapa?

A

5-10mg

43
Q

What is the dosage of Cana? -flozin

A

100-300mg OD

44
Q

What is the dosage of Empaglifozin?

A

10-25mg

PHAR 152 (8 decks)

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