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Flashcards in Diabetes Drugs Deck (30):
1

Insulin toxicity

Hypoglycemia

2

Rapid acting insulins

Aspart
Glulisine
Lispro

3

Intermediate acting insulin

NPH

4

Long acting insulin

Detemir
Glargine

5

Biguanides (Metformin) action

Decreased gluconeogenesis
Increased glycolysis
Increased peripheral glucose uptake (increased insulin sensitivity)

6

Use for Metformin

Oral
First line therapy in type 2 DM; causes modest weight loss
Can be used in patients without islet function

7

S/E of Metformin

GI upset
Lactic acidosis (C/I in renal insufficiency)

8

Sulfonylureas

First gen - Chlorpropamide, Tolbutamide
Second gen - Glimepiride, Glipizide, Glyburide

9

Sulfonylureas mechanism

Closes K+ channel in Beta cell membrane --> cell depolarizes and insulin is released via increased Calcium influx

10

Use for Sulfonylureas

Type 2 DM - require some islet function

11

S/E of Sulfonylureas

Hypoglycemia risk increases in renal failure
First gen - Disulfiram like effects
Second gen - Weight gain, hypoglycemia

12

Glitazones/Thiazolidinediones mechanism

Increased insulin sensitivity in peripheral tissue (binds to PPAR-gamma nuclear transcription regulator) --> increased synthesis and translocation of GLUT4

13

When is Metformin C/I?

Any condition that precipitates lactic acidosis
Liver dysfunction, CHF, sepsis, alcoholism

14

S/E of Glitazones

HEPATOTOXICITY, HF, increased risk of fractures

15

GLP-1 Analogs

Exenatide
Liraglutide

16

Exenatide, Liraglutide mechanism

GLP 1 analogs that increase insulin and decrease glucagon release

17

S/E of GLP 1 analogs

Pancreatitis, N/V

18

DPP-4 Inhibitors

Linagliptin, Saxagliptin, Sitagliptin

19

DPP-4 inhibitors mechanism

DPP4 usually inactivates GLP-1; inhibition causes increased insulin and decreased glucagon release

20

Amylin analogs mechanism (Pramlintide)

Decreased gastric emptying and decreased glucagon

21

Amylin analog

Pramlintide

22

SGLT-2 Inhibitors (Canagliflozin)

Block reabsorption of glucose in PCT

23

S/E of Canagliflozin (SFLT-2 inhibitor)

Glucosuria
UTis
Vaginal yeast infections

24

Alpha-glucosidase inhibitors

Acarbose, Miglitol

25

Alpha-glucosidase inhibitors mechanism

Inhibit intestinal brush border alpha-glucosidases --> delay carbohydrate hydrolysis and glucose absorption --> decrease postprandial hyperglycemia

26

S/E of propylthiouracil and methimazole

Agranulocytosis, aplastic anemia
Hepatotoxicity (Propylthiouracil)
Methimazole is teratogen in first trimester

27

Conivaptan, Tolvaptan

ADH antagonists used for SIADH

28

Uses for Somatostatin

Acromegaly
Carcinoid syndrome
Gastrinoma
Glucagonoma
Esophageal varices

29

Demeclocycline

ADH antagonist used for SIADH (Tetracycline family so it causes nephrogenic DI, photosensitivity, bone/teeth abnormalities)

30

Cinacalcet

Sensitizes Ca sensing receptor in parathyroid gland to circulating Ca --> causes decreased PTH
-Used for Hypercalcemia due to primary or secondary hyperparathyroidism
-S/E is hypocalcemia