Week 1 - Diabetes Pharm Flashcards
What are Biguanide (Metformin) and TZDs (Rosiglitazone)?
insulin sensitizers
What do insulin sensitizers do?
help cells take in insulin at the receptor level in muscle, fat cells and liver
Do insulin sensitizers lower or raise BS?
lower - bring it into the cell, decrease glycogenolysis, decrease glucose release from the liver
what is an adverse effect of metformin?
lactic acidosis b/c it acts on the liverw
what are 4 adverse effects of TZD?
- upper resp. tract infections
- headache
- sinitus
- HF b/c of fluid retention so BP goes up and increases afterload and thus workload of the heart
What three drug classes do not cause hypoglycemia?
- insulin sensitizers
- Incretin agents
- Glucose wasters
what two medications do cause hypoglycemia?
Insulin secretagogues
Sulfonylureas (glyburide)
meglitinides (repaglinide)
what are the 2 adverse effects of DPP4 inhibitors (Sitagliptin)
- pancreatitis
- hypoglycemia when with sulfonylureas (glyburide)
What are the 4 adverse effects of GLP 1 receptor agonists
- GI issues
- anaphalayxis
- pancreatitis
- thyroid cancers (maybe)
what drugs are glucose dependant?
Incretin agents
What are the adverse effects of insulin secretagogues?
hypoglycemia b/c kicks pancreas into high gear regardless of food
Is glyburide basal or bolus?
basal - think glidinggggg (slow)
is repaglinide basal or bolus?
bolus - think rapidddd fast
when should someone take repaglinide?
within 30 min of a meal
what meds must be given with food?
insulin secretagogues
glyburide & repaglinide
What does SGLT 2 inhibitor (canagliflozin) do?
less glucose reabsorption in the kidneys so more come out in urine
what does alpha-glucosidase inhibitors (acarbose) ?
delays glucose absorption in GI and no glucose is absorbed in the stomach so more gets pooped out
who should not have alpha-glucosidase inhibitors (acarbose)
type 1 diabetic b/c no glucose is absorbed in the stomach
What are 5 adverse effects of alpha-glucosidase inhibitors (acarbose)
- Gi issues
- distention
- hyperactive bowel sounds
- anemia (malabsorption)
- liver dysfunction
what are adverse effects of SGLT2 inhibitors?
- UTI
- Yeast infection
- postural hypotension (b/c of fluid loss due to glucose in urine)
- hyponatremia
Short & rapid acting insulin
- lispro (humalog)
- aspart (novalog)
Which insulins are used for sliding scale the most?
lispro
aspart
short acting insulin
Regular insulin (humalin R, Novolin R, toronto)
long acting insulins
- glargine (lantus)
- detemir (levemir)
ultra long acting insulin
degludec (tresiba)
intermediate insulin
NPH (humulin N and Novolin N)
what can intermediate insulin be mixed with?
short or rapid insulins
which insulin is cloudy?
intermediate NPH
when do we administer lispro (humalog)?
15 min before/after meals
when do we administer aspart (novalog ) ?
5-10 min before meals
when do we administer regular insulin?
30 min before a meal
