Diabetes meds Flashcards Preview

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Flashcards in Diabetes meds Deck (101):
1

One time, I got an old lady's blood in my eye, and the ED doc said I'm at risk of catching her diabetes.

Don't be like that doc.

2

Glipizide: class

Sulfonylurea

3

Glipizide: MOA

Increases beta cell insulin secretion

4

Glipizide: indication

T2DM

5

Glipizide: side effects

Hypoglycemia, wt gain

6

Glipizide: contraindications

Sulfa allergy; T1DM

7

Glipizide: Dx-Dx

Beta blockers may mask hypoglycemic sxs

8

Do not exceed this daily dose of Glipizide...

20mg

9

You're Pt's on Glipizide. What are you expecting to happen one day?

B-cell burnout.

10

Repaglinide: class

Meglitinide

11

Repaglinide: MOA

Binds adjacent to the sulfonylurea receptor in increases B-cell insulin secretion.

12

Repaglinide: indication

T2DM with a sulfa allergy

13

Repaglinide: side effects

Hypoglycemia, seizures with OD

14

Repaglinide: contraindication

Advanced renal/hepatic disease; T1DM

15

Repaglinide: Dx-Dx

Multiple (CYP3A4 substrate)

16

Let's compare Repaglinide to Glipizide...

Repaglinide has a faster onset and shorter duration.

17

How do you take Repaglinide?

PO TID 15 mins before meals

18

Metformin: class

Biguanide

19

Metformin: MOA

Decr hepatic glucose production
Decr insulin resistance
Slows intestinal glucose absorption

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Metformin: indication

DOC for T2DM

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Metformin: side effects

GI upset; possible lactic acidosis

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Metformin: contrainidcations

Renal/hepatic disease

23

Metformin: Dx-Dx

IV contrast, etoh, diuretics

24

Actos: class

TZD

25

Actos: MOA

Decr insulin resistance by activating nuclear PPAR-y.

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Actos: indication

T2DM

27

Actos: side effects

Edema, may incr Fx risk in women

28

Actos: contraindication

Pregnancy, diabetic retinopathy

29

Actos: Dx-Dx

Competes with CYP3A4 substrates

30

What does Actos require in order to work?

Insulin

31

Actos may stimulate...

Ovulation

32

Precose: class

Alpha-glucosidase inhibitor

33

Precose: MOA

Inhibits conversion of polysaccharides to monosaccharides

34

Precose: indication

T1DM, T2DM

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Precose: side effects

GI upset

36

Precose: contraindication

IBD, IBS

37

How do you take Precose?

PO before each meal

38

Januvia: class

DPP-4 inhibitor

39

Januvia: MOA

DPP-4 inhibition reduces GLP-1 degredation

40

Januvia: indication

T2DM

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Januvia: side effects

diarrhea, nasopharyngitis

42

You're old enough now. It's time we talked about...

Insulin

43

Rapid-acting insulin

Humalog

44

Humalog: onset/peak/duration

Onset: 5-15 min
Peak: 1-1.5 hrs
Duration: 3-5 hrs

45

Short-acting insulin

Humulin-R

46

Humulin-R: onset/peak/duration

Onset: 30-60 min
Peak: 2-4 hrs
Duration: 5-8 hrs

47

Intermediate-acting insulin

Humulin-N

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Humulin-N: onset/peak/duration

Onset: 2-4 hours
Peak: 4-10 hours
Duration: 10-24 hours

49

Long-acting insulin

Lantus

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Lantus: onset/peak/duration

Onset: 2-4 hours
Peak: none
Duration: 20-24 hours

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Is it okay to mix other insulins with your Lantus in the same syringe?

No, no it isn't.

52

In what two concentrations is Lantus available?

100u/mL
300u/mL

53

Afrezza: class

Oral inhalation rapid acting insulin

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Afrezza: MOA

Inhaled insulin

55

Afrezza: indication

T1DM, T2DM
Use with a long-acting insulin

56

Afrezza: side effects

May decr FEV1

57

Afrezza: contraindication

Smoking w/in 6 months

58

Symlin: class

Amylin analog

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Symlin: MOA

Decr gastric emptying, glucagon secretion, appetite

60

Symlin: indication

T1DM, T2DM
Use with a long-acting insulin

61

Symlin: side effects

anorexia, hypoglycemia

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Symlin: contraindication

Gastroparesis

63

When do you take Symlin?

15 mins before meals

64

Can you mix Symlin with insulin?

No....I'm beginning to be concerned about your obsession with mixing things into your insulin....get a hobby already.

65

Byetta: class

Incretin mimetic: GLP-1

66

Byetta: MOA

Incr insulin secretion
Decr glucagon secretion
Slows gastric emptying
Decr appetite

67

Byetta: indication

T2DM with Metformin, +/- Sulfonylurea

68

Byette: side effects

Necrotizing hemorrhagic pancreatitis

69

Oh, you have necrotizing hemorrhagic pancreatitis?

Come back when you've got real problems.

70

How do you take Byette?

SQ BID 60 mins before meals

71

T1/2 of Byette?

2.5 hours

72

Victoza: class

Incretin mimetic: GLP-1

73

Victoza: MOA

Incr insulin secretion
Decr glucagon secretion
Slows gastric emptying
Decr appetite

74

Victoza: indication

T2DM with Metformin, +/- Sulfonylurea

75

Victoza: side effects

Necrotizing hemorrhagic pancreatitis AND

HTN....okay now you have problems

76

How do you take Victoza?

With a side of necrotizing hemorrhagic pancreatitis plase

77

Okay, how do you really take Victoza?

SQ BID before meals

78

Victoza: t1/2

13 hours

79

Invokana: class

SGLT2 inhibitor

80

Invokana: MOA

Inhibits glucose resorption in proximal renal tubule

81

Invokana: indication

T2DM adjunct therapy

82

Invokan: side effects

Vulvovaginitis, UTI

83

Invokana: contraindications

GFR below 30

84

Invokana: Dx-Dx

Ace-I/ARBs
Steroids
K+ sparing diuretics
SSRIs

85

Welchol: class

Bile acid sequesterant

86

Welchol: MOA

Unknown in DM

87

Welchol: indication

Adjunct to Metformin, Sulfonylureas, insulin in T2DM

88

Welchol: side effects

Constipation, abd pn, incr triglycerides

89

Welchol: contraindication

Bowel obstruction

90

Welchol: Dx-Dx

May inhibit absorption of other drugs

91

D/C Welchol if triglycerides exceed

500

92

Desmopression: class

Vasopressin receptor agonist

93

Desmopressin: MOA

Incr renal H2O resoprtion

94

Desmopressin: indication

Diabetes insipidus

95

Desmopressin: side effects

BP changes
decr plasma osmalality

96

Desmopressin: contraindication

Hyponatremia

97

Desmopressin: Dx-Dx

Lithium, SSRIs, NSAIDs, etoh

98

Okay, let's talk about A1c

Okay, let's.

99

What drug classes lower A1c by ~0.5-1.0%?

GLP-1
Meglitinide
Alpha-glucosidase
DPP-4 inhibitor
Amylin analog
SGLT2 inhibitor
Bile acid sequestrant

100

What drug classes lower A1c ~1-1.5%?

Sulfonylurea
Biguanide
TZD

101

What drug class lowers A1c ~1.5-3.5%?

Insulin