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Clinical medicine A > DM meds > Flashcards

DM meds Flashcards

1
Q

Biguanides meds

A

metformin

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2
Q

biguanides MOA

A

Inhibits hepatic gluconeogenesis
Decreases intestinal absorption of glucose
Improved insulin sensitivity
Increase glucose uptake and utilization by peripheral tissue

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3
Q

biguanides SE

A

Anorexia
Metallic taste
NVD
B12 deficiency
BBW: Lactic acidosis
Weight loss/neutral

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4
Q

biguanides CI

A

CKD (Serum Cr 1.4+[F]/1.5+[M], GFR <30)
Liver failure
Alcoholism
Acidosis
CHF
Radiocontact

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5
Q

fisrt line for T2DM

A

biguanides

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6
Q

TZD Meds

A

Rosiglitazone(avandia)
Pioglitazone(Actos)

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7
Q

TZDs MOA

A

Binds to nuclear receptor (PPAR-G), affects gene expression for glucose metabolism
Allows muscle/fat cells utilize glucose easily
Improved insulin sensitivity
Decreased gluconeogenesis
Increased adipogenesis

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8
Q

TZDs SE

A

Weight gain
Peripheral and macular edema
fracture risk
anemia
Bladder cancer(pioglitazone)
better lipids (pioglitazone)
worse lipids (rosiglitazone)
BBW:CHF, MI(for rosiglitazone)

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9
Q

TZD CI

A

CHF
Caution: osteoporosis risk
Liver disease

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10
Q

which meds have no hypoglycemic associations

A

TZD
A-glucosidase inhibitors
SGLT2 inhibitors
DPP-4 inhibitors

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11
Q

sulfonylureas meds

A

Glimepiride(Amaryl)
Glipizide(Glucotrol)
Glyburide(Diabeta, micronase)

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12
Q

Meglitinides meds

A

Repaglinide(Prandin)
Nateglinide(Starlix)

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13
Q

Sulfonylureas MOA

A

Binds
Stimulates pancreas to increase production of insulin to ATP-sensitive K- channels on B-cells causing insulin release

Works quickly

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14
Q

Meglitinides MOA

A

Binds
Stimulates pancreas to increase production of insulin to ATP-sensitive K- channels on B-cells causing insulin release

Works quickly

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15
Q

sulfonylureas SE

A

Weight gain
Hypoglycemia

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16
Q

meglitinides SE

A

Weight gain
Hypoglycemia

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17
Q

sulfonylureas CI

A

Allergy to sulfa drugs
DKA
Caution: Liver/renal disease

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18
Q

meglitinides CI

A

DKA
Caution: Liver/renal disease

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19
Q

A-glucosidase inhibitors meds

A

Acarbose(precose)
Miglitol(glyset)

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20
Q

A-glucosidase inhibitors MOA

A

Prevents breakdown of starches in intestine
Competitively inhibits enzymes that digest starches and sucrose
Delayed carb absorption
Decreased postprandial glucose rate

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21
Q

A-glucosidase inhibitors SE

A

Weight loss
Hypoglycemia (if w sulfonylureas or insulin)
Increased LFT’s
Flatulence
“WHIF”

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22
Q

A-glucosidase inhibitors CI

A

DKA
Cirrhosis
Major GI disease
Caution: CKD
Liver disease
No hypoglycemia association

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23
Q

SGLT2 inhibitors meds

A

SGLT2 inhibitors
Canagliflozin(invokana)
Dapagliflozin(farxiga)
Empagliflozin(Jardiance)
Ertugliflozin(Steglatro)

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24
Q

SGLT2 inhibitors MOA

A

Stops renal glucose reabsorption
Increase glucose excretion by inhibiting protein that functions 90% of glucose reabsorption in kidney
Acts on proximal tubule

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25
Q

SGLT2 inhibitors SE

A

UTI, genital mycotic infections
Increased LDL
Decreased GFR
Intravascular volume contraction, dehydration, hypotension
Ketoacidosis(can mask DKA)
Weight loss
Dapagliflozin
Breast,bladder cancer
Canagliflozin
Bone fractures, amputations

26
Q

SGLT2 inhibitors CI

A

Moderate-severe CKD
Caution: osteoporosis risk
Mild CKD
No hypoglycemia association
Can improve CKD in non-DM pts

27
Q

what drugs have a SE of pancreatitis

A

GLP-1 receptor agonists
DPP-4 inhibitors

28
Q

BBW thyroid cancer

A

GLP-1 receptor agonists

29
Q

GLP-1 receptor agonist meds

A

Exenatide(byetta/bydureon)
Liraglutide(Victoza, saxenda)
Lixisenatide(adlyxin)
Dulaglutide(trulicity)
Semaglutide(ozempic, rybelsus)
Tirzepatide(mounjaro)

natide
patide
glutide

30
Q

GLP-1 receptor agonist MOA

A

mimics incretin GLP-1

Slows gastric emptying
Stimulates insulin release
Inhibits glucagon release
increases satiety

31
Q

GLP-1 receptor agonists SE

A

Hypoglycemia(if taking insulin secretagogues)
NVD(dose dependent)
Pancreatitis
Weight loss, low appetite
BBW: thyroid cancer

Tirzepatide
Increased GI SE, weight loss, decreased BG

32
Q

GLP-1 receptor agonists CI

A

PMHX/FMHX of medullary thyroid carcinoma or MEN 2
Caution: gastroparesis, use w/o other rx that decrease GI motility

33
Q

SE of nasopharyngitis

A

DPP-4 inhibitors

34
Q

bone fractures and amputations SE

A

Canagliflozin
(SGLT2 inhibitor)

35
Q

flatulence as SE

A

A-glucosidase inhibitors

36
Q

peripheral and macular edema SE

A

TZDs

37
Q

BBW lactic acidosis

A

biguanides

38
Q

Urticaria SE

A

DPP4-inhibitors

39
Q

DPP-4 INHIBITORS meds

A

Sitagliptin(januvia)
Saxagliptin(onglyza)
Linagliptin(Tradjenta)
Alogliptin(nesina)

40
Q

DPP-4 inhibitors MOA

A

Prolongs effect of endogenous incretin GLP-1 by inhibiting enzyme that degrades it
Increase insulin release, satiety, B-cell proliferation
Decrease glucagon release, gastric emptying

41
Q

DPP-4 inhibitors SE

A

NVD(less than GLP-1)
Nasopharyngitis, URI
Pancreatitis
Urticaria(hives)
Angioedema
Increase risk of arthralgias
Weight neutral
Alogliptin, Saxagliptin
Increased risk of HF

42
Q

DPP-4 inhibitors CI

A

allergy

43
Q

BBW hypoglycemia

A

amylin anaglogs

44
Q

amylin analogs meds

A

pramilintide (symlin)

45
Q

amylin analogs MOA

A

Mimics effects of amylin
Decrease glucagon release, gastric emptying
Increase satiety

46
Q

Amylin analogs SE

A

NV
Anorexia
Weight loss
BBW: Hypoglycemia

47
Q

Amylin analogs CI

A

Gastroparesis
Unaware hypoglycemia
Caution: rx that decrease GI motility

48
Q

angioedema SE

A

DPP-4 inhibitors

49
Q

Bile acid sequestrants meds

A

colesevelam (welchol)

50
Q

SE of bile acid sequestrants

A

Constipation
Dyspepsia
Increased TG
Lowers LDL

51
Q

dopamine receptor agonists meds

A

bromocriptine

52
Q

dopamine receptor agonist SE

A

NV
Dizziness
HA

53
Q

look at slides 60-62 and figure out what the hell is goin on

A

mmmmk

54
Q

glucagon MOA

A

Mimics endogenous glucagon
Increases glycogenolysis and gluconeogenesis

55
Q

glucagon SE

A

NV
HTN
Tachycardia
Anaphylaxis

56
Q

glucagon CI

A

Pheo
Insulinoma
Glucagonoma

57
Q

Dextrose MOA

A

Provides monosaccharides for fuel

58
Q

Dextrose SE

A

Hyperosmolar syndrome
HypoK
Dehydration
Edema

59
Q

Dextrose CI

A

Allergy to corn
Diabetic coma
CNS hemorrhage
Dehydration
DTs(delirium tremors)

60
Q

CI allergy to corn

A

Dextrose

Clinical medicine A (32 decks)

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