Diabetes Medications

Question 1

What is the mechanism of action for Sulfonylureas?
Diabinese, Tolinase, Orinase
2nd Generation: glyburide, glipizide

Answer 1

Increases insulin production (beta-cell stimulator) and increases the sensitivity of receptor sites for interaction c insulin(endogenous insulin secretion)

Question 2

What is the mechanism of action for meglitinides?

Repaglinide(prandin), and Nateglinide(starlix)

Answer 2

Stimulates release of insulin, it acts more rapidly than sulfonylureas in the presence of glucose.It is a short acting agent that is taken pre prandial to prevent pc glucose elevation

Question 3

What are the second generation names of Sulfonylureas?

Answer 3

Glyburide, glipizide, and the long acting glimepiride

Question 4

What are some special considerations for Glipizides? (Glucotrol, Glucotrol XL)

Answer 4

Take 30 minutes before meal, and you may see some capsule in the stool. This is because the capsule is made of a non-absorbable shell.

Question 5

What is the pt education for Sulfonylureas?

Answer 5

• Adm before meals

- Avoid ETOH

Question 6

What are some generic names for Meglitinides?

Answer 6

repaglinide(Prandin), and Nateglinide(Starlix)

Question 7

Which medication has is faster acting c a shorter half life? Sulfonylureas or Meglitinides?

Answer 7

Meglitinides stimulate the release of insulin and act more rapidly than Sulfonylureas c a shorter half life

Question 8

What are some precautions for Meglitinides? like Repaglinide, and Nateglinide

Answer 8

Not recommended during pregnancy and use cautiously c impaired liver function

Question 9

What is the pt education for Meglitinides? And side effects?

Answer 9

Adm 0-30 min pre prandial,

SE: hypoglycemia, and weight gain

Question 10

What is the function of Biguanides? Metformin (glucophage)

Answer 10

Lowers basal and post meal glucose levels in pts c type 2 DM by reducing hepatic glucose production and reducing tissue sensitivity to insulin

Question 11

What are some generic/trade names of Biguanide?

Answer 11

Metformin hydrochloride(Glucophage), and metformin extended release

Question 12

What are some precautions for Biguanides? metformin (glucophage)

Answer 12

Big one is hold for 48hrs befor nd after administration of contrast material and surgical procedures requiring anesthesia

Question 13

What are some contraindications for Biguanide?Metformin (glucophage)

Answer 13

Contraindicated in:

• impaired renal function
• impaired liver function
• > 80 years old
• Pregnancy
• Hypoxia
• CHF
• ETOH abuse

Question 14

What is the pt education for Biguanides? Side effects? Metformin (glucophage)

Answer 14

Take c 2 largest meals to minimize GI distress
report s&s of fatigue, muscle pain, palpitations, dyspnea, dizziness
SE: diarrhea and nausea

Question 15

What is the function of Alpha-glucosidase inhibitors? Acarbose (precose), and Miglitol (glyset)

Answer 15

Delays CHO absorption from the small intestine by inhibiting the SI enzyme alpha-glucsidase. Also impairs the breakdown of complex sugars in stomach (means lower post prandial glucose)

Question 16

What are some generic and trade names of alpha-glucosidase inhibitors?

Answer 16

acarbose(Precose)

miglitol (Glyset)

Question 17

What pt do you NOT use alpha-glucosidase inhibitor on? Dont use acarbose or miglitol on whom?

Answer 17

Pts c inflammatory bowel disease or any other serious intestinal disorder. Because it acts on the small intestine.

Question 18

What is the pt education for alpha-glucosidase inhibitors? And SE?

Answer 18

• take c first bite of food
• when taken alone it does not cause hypoglycemia
• can be taken in combination c sulfonylureas or metformin
  SE: GI flatulence, diarrhea, and abd discomfort

Question 19

A pt is taking alpha-gluosidase inhibitors (acarbose) and sulfonylurea and they become hypoglycemic. How do you treat them?

Answer 19

You can treat them c glucose tbs, sublingual glucose gel, or low fat milk rather than products that contain cane sugar which cant be digested and absorbed due to the drugs effect

Question 20

What is the mechanism of action for Thiazolidinediones? Rosiglitazone (Avandia), and Pioglitazone (Actos)

Answer 20

Reduces insulin resistance at receptors sites so insulin is more efficient. decreases hepatic glucose production

Question 21

What are some generic and trade names of Thiazolidinediones?

Answer 21

rosiglitzone (Avandia)

pioglitazone (Actos)

Question 22

What are the precautions of using Thiazolidinediones?

Answer 22

use c caution in pts with hepatic disease

Question 23

What is the pt education for someone taking Thiazolidinediones? And what are the SE?

Answer 23

take c main meal of the day to maximize absorption

SE: fluid retention, weight gain, H/A, increases cholesterol

Question 24

Insulin varies according to what 3 factors?

Answer 24

onset of action, peak of action, duration of action

Question 25

What are insulins classified by?

Answer 25

Their onset of action: rapid action, short acting, intermediate acting and long acting

Question 26

What are rapid and short insulin used for?

Answer 26

used to regulate the rises in blood glucose after meals

Question 27

What are intermediate and long acting insulin used for?

Answer 27

to maintain basal insulin levels throughout the dy

Question 28

How fast, what is the peak , and duration of short acting and rapid acting insulin?

Answer 28

Short acting reaches bloodstream in 30"-60", peaks 2-4hrs, and duration of 5-7 Rapid acting rech bloodstream in about 15"; peak 1-3hrs, and duration of 2-5hrs

Question 29

What is the onset peak and duration of long and intermediate acting insulins?

Answer 29

begins to work within1-2hrs, eak of 4-12hrs, and are effective for 18-24hrs

Question 30

What is the most commonly used insulin in the US?

Answer 30

Recombinant DNA human insulin

Question 31

Onset, Peak, and Duration of Rapid Acting insulin? | Lispro, aspart, glulisine.

Answer 31

Onset: 15 minutes Peak Action: 1-2 hrs Duration: 3-4 hours **Inject 5 minutes before meal DO NOT GIVE WITHOUT MEAL TRAY PRESENT

Question 32

Onset, Peak, and Duration of short acting insulin (Regular)? Humilin R and novolin R

Answer 32

Onset: 30-60minutes Peak: 4-10 hours Duration: 5-7 hours **inject 30 minutes before meal

Question 33

Onset, Peak, and Duration of Intermediate acting (NPH) insulin? Humulin N, and Novolin N

Answer 33

Onset: 2-4hrs Peak: -10 hours Duration: 10-16 hours

Question 34

What are some trade names for DPP-4 inhibitor?

Answer 34

sitagliptin phosphate (Januvia) and Saxagliptin (Onglyza)

Question 35

What is the mechanism of DPP-4 inhibitor?

Answer 35

Sitagliptin and saxagliptin prolong activity of proteins tht boost the release of insulin after BS rises. by blocking the enzyme called DPP-4 which breaks down these proteins

Question 36

what do increting mimetics do?

Answer 36

They mimic the glucose-lowering action of naturally ocurring human hormones called incretin. Makes sense right?

Question 37

What is the mechanism of action for Amylin analog?

Answer 37

slows gastric emptying suppresses postprandial glucagon secretion enhances satiety

Question 38

What is the generic and trade name for Amylin analog?

Answer 38

Pramlintide acetate (symlin)