Type2 Flashcards

1
Q

Biguanides

A

Metformin

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2
Q

Alpha-glucosidase inhibitors

A

acarbose (precose), miglitol (glyset)

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3
Q

Meglitinide agonists

A

Repaglinide (Prandin)

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4
Q

D-Phenylalanine derivative

A

Nateglinide (Starlix)

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5
Q

Sulfonylureas

A

Glimepride (amaryl), glyburide (diabeta, micronase, glynase), glipizide (glucotrol, gluctrol XL)

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6
Q

Thiazolidinediones

A

Pilgitazone (actos), Rosiglitazone (avandia)

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7
Q

GLP-1 receptor agonists (injectable)

A

exenatide (Byetta), liraglutide (victoza)

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8
Q

DPP-4 inhibitors

A

Sitagliptin (Januvia), Saxagliptin (onglyza), linagliptin (tradjecta)

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9
Q

Metformin C/I

A

GFR less than 30, less than 80 yrs

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10
Q

Metformin mechanism

A

improves insulin action at LIVER

MUSCLE glucose uptake

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11
Q

Metformin S/E

A

GI upset; metallic taste (usually transient)

Lactic acidosis = RARE

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12
Q

Metformin renal dosing

A

GFR less than 30 – do NOT use
30-45 – if on metformin, decrease dose
30-45 – not on metformin, dont start

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13
Q

Metformin drug interaction

A

cimetidine

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14
Q

Metformin advantages

A

No hypoglycemia
Decreases microvascular and CVD events
Lack of weight gain – potential weight reduction
Improves lipid profile (decreases TG and LDL)

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15
Q

Sulfonylureas (second generation preferred) MOA

A

stimulates beta cell secretion of insulin

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16
Q

Sulfonylureas disadvantages

A

Higher risk of hypoglycemia; weight gain

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17
Q

Avoid in early stages of typical DM2

A

sulfonylureas

18
Q

risk for lactic acidosis

A

metformin

19
Q

TZD MOA

A

more focus on glucose uptake in muscle and adipose tissue

20
Q

Slow onset (2-3 months)

A

TZD

21
Q

Advantage of Pioglitazone (actos)

A

favorable response in lipid

22
Q

Disadvantage of TZD

A

weight gain
Edema due to increased plasma volume
AVOID in CHF patients
avoid in liver dysfunction

23
Q

Moderate bone loss

A

TZD

24
Q

Alternative to metformin

A

TZD

25
Q

Usually used in combo except very early in diagnosis of DM2

A

TZD

26
Q

DPP-IV Inhibitors MOA

A

prevents breakdown of GLP-1

27
Q

Mainly lowers post-prandials

A

DPP-4 Inhibitors

28
Q

DPP-4 Inhibitors increased risk of heart failure

A

Saxaglipton

Alogliptin

29
Q

No increased risk of MACE (DPP-4)

A

Sitagliptin, Linagliptin

30
Q

GLP-1 Agonists MOA

A

mimics GLP-1 (increases insulin release, decreases glucagon release)
does NOT impair normal glucagon response to hypoglycemia

31
Q

GLP-1 Agonists S/E

A

Slows gastric emptying (GI effects)
Increases HR
Small risk – acute pancreatitis

32
Q

GLP-1 Agonists CI

A

Gastroporesis

severe renal impairment (Byetta, Bydureon)

33
Q

Daily (short acting) GLP-1 Agonists

A

exenatide

liraglutide

34
Q

Weekly (long acting)

A

albiglutide
dulaglutide
exenatide

35
Q

GLP-1 primarily targeting PPG (usually BOTH FBG and PPG)

A

exenatide (byetta)

albiglutide (tanzeum)

36
Q

GLP-1 advantages

A

no hypoglycemia
weight loss
decreases some CV risk factors
decreases postprandial glucose excursions

37
Q

SGLT-2 Inhibitors MOA

A

upregulates SGLT-2 –> renal threshold for glucose reabsorption increased

38
Q

SGLT-2 (FBG or PPG?)

A

targets FBG primarily

39
Q

SGLT-2 Advantages

A

no hypoglycemia
weight loss
decreases BP slightly

40
Q

SGLT-2 Disadvantages

A

GU infections – UTI most common
increases LDL
volume depletion/dizziness
BONE LOSS potential