Diabetes Flashcards
(98 cards)
1
Q
What drugs are in this class:
Biguanide
A
Metformin
2
Q
What drugs are in this class:
Sulfonylureas
A
Glimepiride
Glipizide
Glyburide
3
Q
What drugs are in this class:
Meglitinides
A
Nateglinide
Repaglinide
4
Q
What drugs are in this class:
Thiaxolidinediones (TZD)
A
Pioglitazone
Rosiglitazone
5
Q
What drugs are in this class:
Dipeptidyl peptidase-4 (DPP-4)
A
Alogliptin
Linagliptin
Saxagliptin
Sitagliptin
6
Q
What drugs are in this class:
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors
A
Canagliflozin
Dapagliflozin
Empagliflozin
7
Q
What drugs are in this class:
Alpha-glucosidase inhibitors
A
Acarbose
Miglitol
8
Q
What drugs are in this class:
Glucagon-like peptide-1 (GLP-1) agonists
A
Albiglutide Dulaglutide Exenatide Exenatide ER Liraglutide Lixisenatide
9
Q
What drugs are in this class:
Amylin mimetic
A
Pramlinitide
10
Q
Brand name(s) for Metformin
A
Glucophage, Riomet
ER: Glucophage XR, Glumetza, Fortamet
11
Q
Brand name(s) for Glimepiride
A
Amaryl
12
Q
Brand name(s) for Glipizide
A
Glucotrol
Glucotrol XL
13
Q
Brand name(s) for Glyburide
A
Diabeta
Micronase
14
Q
Brand name(s) for Glyburide, micronized
A
Glynase
15
Q
Brand name(s) for Nateglinide
A
Starlix
16
Q
Brand name(s) for Repaglinide
A
Prandin
17
Q
Brand name(s) for Pioglitazone
A
Actos
18
Q
Brand name(s) for Rosiglitazone
A
Avandia
19
Q
Brand name(s) for Alogliptin
A
Nesina
20
Q
Brand name(s) for Linagliptin
A
Tradjenta
21
Q
Brand name(s) for Saxagliptin
A
Onglyza
22
Q
Brand name(s) for Sitagliptin
A
Januvia
23
Q
Brand name(s) for Canagliflozin
A
Invokana
24
Q
Brand name(s) for Dapagliflozin
A
Farxiga
25
```
Brand name(s) for
Empagliflozin
```
Jardiance
26
```
Brand name(s) for
Acarbose
```
Precose
27
```
Brand name(s) for
Miglitol
```
Glyset
28
```
Brand name(s) for
Albiglutide
```
Tanzeum
29
```
Brand name(s) for
Dulaglutide
```
Trulicity
30
```
Brand name(s) for
Exenatide
```
Byetta
31
```
Brand name(s) for
Exenatide ER
```
Bydureon
32
```
Brand name(s) for
Liraglutide
```
Victoza
33
```
Brand name(s) for
Lixisenatide
```
Adlyxin
34
```
Brand name(s) for
Pramlintide
```
SymlinPen
35
Daily dose for
| Metformin
500mg QD - 1000mg BID
36
Daily dose for
| Glimepiride
1-8 mg QD
37
Daily dose for
| Glipizide
5-40 mg QD
38
Daily dose for
| Glyburide
1.25-20 mg daily dosed QD or BID
39
Daily dose for
| Glyburide,, micronized
1.5-12 mg QD
40
Daily dose for
| Nateglinide
60-120 mg before each meal
41
Daily dose for
| Repaglinide
0.5-4 mg before each meal
| Max of 16 mg/d
42
Daily dose for
| Pioglitazone
15-45 mg QD
43
Daily dose for
| Rosiglitazone
4-8 mg QD
| 2-4 mg BID
44
Daily dose for
| Alogliptin
25 mg QD
45
Daily dose for
| Linagliptin
5 mg QD
46
Daily dose for
| Saxagliptin
5 mg QD
47
Daily dose for
| Sitagliptin
100 mg po QD
48
Daily dose for
| Canagliflozin
100-300 mg QD
49
Daily dose for
| Dapagliflozin
5-10 mg QD
50
Daily dose for
| Empagliflozin
10-25 mg QD
51
Daily dose for
| Acarbose
50-100 mg TID
52
Daily dose for
| Miglitol
25-100 mg TID
53
Daily dose for
| Albiglutide
30-50 mg SQ weekly
54
Daily dose for
| Dulaglutide
0.75-1.5 mg SQ weekly
55
Daily dose for
| Exenatide
5-10 mg SQ BID
56
Daily dose for
| Exenatide ER
2mg SQ weekly
57
Daily dose for
| Liraglutide
0.6-1.8 mg SQ daily
58
Daily dose for
| Lixisenatide
10-20 mg SQ daily
59
Daily dose for
| Pramlintide
Type 1 DM: 15-60 mcg TID before meals
| Type 2 DM: 60-120 mcg TID before meals
60
```
How is this class effective in the treatment of DM
Biguanides
```
Decrease hepatic glucose production
Increase glucose uptake in peripheral tissue
Decrease intestinal glucose absorption
61
```
How is this class effective in the treatment of DM
Sulfonylureas
```
Increase insulin secretion
| Decrease hepatic glucose production
62
```
How is this class effective in the treatment of DM
Meglitinides
```
Increase insulin secretion
| Decrease hepatic glucose production
63
```
How is this class effective in the treatment of DM
Thiaxolidinediones
```
Increase insulin sensitivity
| Decrease hepatic glucose production
64
```
How is this class effective in the treatment of DM
Dipeptidyl peptidase-4 (DPP-4) inhibitors
```
Decrease breakdown of endogenous GLP-1
65
```
How is this class effective in the treatment of DM
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors
```
Inhibits SGLT-2
| Increases urinary glucose excretion
66
```
How is this class effective in the treatment of DM
Alpha-glucosidase inhibitors
```
Delay digestion of carbohydrates
67
```
How is this class effective in the treatment of DM
Glucagon-like peptide-1 (GLP-1) agonists
```
Stimulate GLP-1 receptors resulting in GLUCOSE-DEPENDENT insulin secretion
Decreased postprandial glucagon secretion
Decreased gastric emptying rate
Early satiety
68
```
How is this class effective in the treatment of DM
Amylin mimetic
```
Amylin analog resulting in
Decreased postprandial glucagon secretion
Decreased gastric emptying rate, early satiety
69
Common side effects of
| Biguanide
Diarrhea
N/V
Abdominal pain/bloating
Low B12
70
Common side effects of
| Sulfonylureas
Hypoglycemia
| Weight gain
71
Common side effects of
| Meglitinides
Hypoglycemia
| Weight gain
72
Common side effects of
| Thiazolidinediones
Weight gain
| Edema
73
Common side effects of
| Dipeptidyl peptidase-4 (DPP-4) inhibitors
Nasopharyngitis
Upper respiratory tract infections
HA
UTI
74
Common side effects of
| Sodium-glucose co-transporter 2 (SGLT-2) inhibitors
```
Hypotension
Dehydration
Weight loss
Genital mycotic infections
UTI
Hyperkalemia (canagliflozin)
Increase in LDLs
Increased hematocrit (dapa, empa)
```
75
Common side effects of
| Alpha-glucosidase inhibitors
```
Flatulence
GI upset
Abdominal pain/bloating
Diarrhea
Increase in LFTs and bilirubin
```
76
Common side effects of
| Glucagon-like peptide-1 (GLP-1) agonists
N/V/D
HA
Weight loss
77
Common side effects of
| Amylin mimetics
Hypoglycemia
N/V/D
HA
Anorexia
78
Contraindications of
| Biguanide
eGFR < 30
Unstable, symptomatic HF
Hepatic impairment
79
Contraindications of
| Sulfonylureas
Caution in elderly patients
| Avoid use of glyburide b/c of increased risk of hypoglycemia
80
Contraindications of
| Meglitinides
Do not administer repaglinide with gemfibrozil
81
Contraindications of
| Thiazolidinediones
```
Bladder cancer (pioglitazone)
HF
Hepatic impairment
Ischemic heart disease
MI (rosiglitazone)
Risk of bone fracture
```
82
Contraindications of
| Dipeptidyl peptidase-4 (DPP-4) inhibitors
Pancreatitis
83
Contraindications of
| Sodium-glucose co-transporter 2 (SGLT-2) inhibitors
Canagliflozin - eGFR <45
Empagliflozin - eGFR <45
Dapagliflozin - eGFR <60
84
Contraindications of
| Alpha-glucosidase inhibitors
```
Inflammatory Bowel Disease (IBD)
Ulcerative colitis
Crohn's disease
Partial intestinal obstruction
Short bowel syndrome
Renal impairment (SCr >2 or CrCl < 25)
```
85
Contraindications of
| Glucagon-like peptide-1 (GLP-1) agonists
Gastroparesis
Pancreatitis
Multiple endocrine neoplasia syndrome type 2
Personal or family history of medullary thyroid carcinoma
86
Contraindications of
| Amylin mimetics
```
Severe, recurrent hypoglycemia
Hypoglycemic unawareness
Gastroparesis
ESRD
Poor adherence to insulin regimen
Poor adherence to self-monitoring blood glucose
```
87
True/False
| You can cut/crush/chew metformin ER
False
88
Sulfonylureas have a long/short duration of action? Why is this important?
Long
| Patients need to eat in regular intervals to avoid hypoglycemic episodes
89
Which have a longer duration of action sulfonylureas or meglintinides
Sulfonylureas
90
True/False
| If you skip a meal you should skip your dose of Meglitinide
True
91
Can you use Meglitinides and Sulfonylureas together? Why?
No!
| They both increase insulin release so this can lead to hypoglycemia
92
Which thiazolidinedioine (TZD) needs to be dispensed with a medication guide?
Rosiglitazone
93
Dose adjustment for DPP-4 inhibitors
Saxagliptin (Onglyza): CrCl \<50 - 2.5 mg/d
| Sitagliptin (Januvia): CrCl 30-50 - 50 mg/d; CrCl <30 - 25 mg/d
94
Which DPP-4 does NOT need a dose adjustment?
Linagliptin (Tradjenta)
95
What pt populations should SGLT-2 inhibitors be used with caution
Pts taking diuretics and elderly
96
True or False
| Alpha-glucosidase inhibitors are recommended for use by the ADA
False
97
Dose adjustment GLP-1 agonists
Albiglutide , Dulaglutide (Trulicity), Liraglutide (Victoza): no adjustment necessary
Exenatide (Byetta): CI CrCl <30
Lixisenatide (Adlyxin): CI CrCl<15
98
When initiating an amylin mimetic, how much should you reduce mealtime insulin by and why?
50% to avoid hypoglycemia
