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IPC Endocrine Week 1 > Diabetes ORAL Drugs PKPD > Flashcards

Diabetes ORAL Drugs PKPD Flashcards

(85 cards)

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1
Q

What is the MOA of sulfonylureas?

A

-stimulate insulin secretion from beta cells in pancreas

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2
Q

Which drugs are sulfonylureas?

A

-glipizide
-glimeperide
-glyburide

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3
Q

What is the brand name of glipizide?

A

Glucotrol

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4
Q

What is the brand name of glimepiride?

A

Amaryl

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5
Q

What is the brand name of glyburide?

A

-DiaBeta
-Micronase
-Glynase

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6
Q

Which sulfonylureas are on the BEERs List?

A

-glyburide
-glimepiride

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7
Q

Which sulfonylureas do NOT have a contraindication for poor renal function (CrCl<50)?

A

-glipizide (Glucotrol)
-glimepiride (Amaryl)

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8
Q

What are some side effects of sulfonylureas?

A

-HYPOGLYCEMIA
-N/V
-WEIGHT GAIN
-GI upset
-rash
-jaundice
-hemolytic anemia

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9
Q

Which sulfonylurea has the fastest onset of action?

A

glipizide

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10
Q

Sulfonylureas have DDIs with what drugs?

A

-alcohol
-allopurinol
-probenecid
-salicylates

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11
Q

What are the CIs for sulfonylureas?

A

-DKA
-hypersensitivity
-T1DM

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12
Q

Which sulfonylureas are contraindicated in near-term pregnancy?

A

-glipizide
-glyburide

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13
Q

What should you monitor while on sulfonylureas?

A

-FBG
-A1C
-hypoglycemia
-weight gain
-allergies

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14
Q

How long does it take to see the full effects of sulfonylreas?

A

4-6 weeks

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15
Q

What are some important counseling points for sulfonylureas?

A

-take 30 mins before eating, first thin in morning
-avoid alcohol

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16
Q

What is the MOA of meglinitides?

A

-stimulate insulin secretion via Beta cells

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17
Q

What drugs are meglinitides?

A

-repaglinide (Prandin)
-nateglinide (Starlix)

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18
Q

What are some ADE of meglinitides?

A

-hypoglycemia
-weight gain
-GI upset

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19
Q

Which of the following drugs do both nateglinide and repaglinide have DDI with?
A. NPH Insulin
B. Gemfibrozil
C. Mifepristone
D. Pazopanib

A

C. Mifepristone

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20
Q

What DDIs does repaglinide have?

A

-mifepristone
-gemfibrozil
-NPH insulin: increases risk of MI

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21
Q

What are the CIs of meglitinides?

A

-hypersensitivity
-DKA
-T1DM

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22
Q

What are some important counseling points for meglitinides?

A

-take BEFORE meals
-avoid alcohol
-monitor weight gain and hypoglycemia

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23
Q

What should you monitor while on meglitinides?

A

-PPG
-A1C
-hypoglycemia/weight gain

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24
Q

How long does it take to see the full effects of meglitinides?

A

4-6 weeks

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25
What is the MOA of biguanides?
1. decrease HGP 2. increase peripheral glucose uptake
26
What renal dose adjustment must be made for metformin if eGFR = 30-45?
-half dose -max 1000 mg/day
27
Below what eGFR value is metformin contraindicated?
30
28
What are some important side effects of metformin?
-GI upset (N/V/D) -WEIGHT LOSS -lactic acidosis
29
What is the onset of action of metformin?
several days
30
What DDIs does metformin have?
-DOFETILIDE -radiopaque contrast dyes -corticosteroids -lamotrigine
31
What CIs does metformin have?
-hypersensitivity -DKA -iodinated contrast -surgery -sepsis
32
What should be monitored while on metformin?
-RENAL FUNCTION (eGFR) -ADE -FBG/PPG -A1C
33
How long does it take to see the full effects of metformin?
6-8 weeks
34
What are some important counseling points for metformin?
-take with food -start low, go slow -avoid alcohol -GI upset should decrease over time
35
What is the MOA of TZDs?
1. increase peripheral glucose uptake (muscles) 2. decrease HGP (liver)
36
What agents are TZDs?
-rosiglitazone (Avandia) -pioglitazone (Actos)
37
What are some important ADR of TZDs?
-EDEMA -WEIGHT GAIN -BLADDER CANCER -FRACTURES -hepatic toxicity
38
What DDIs does rosiglitazone have?
-insulin -nitrates
39
What DDIs does pioglitazone have?
-OCs -progestins -pazopanib
40
What DDIs does nateglinide have?
-mifepristone -pazopanib
41
What are the CIs of TZDs?
-NYHA Class III-IV HF -hypersensitivity -DKA -T1DM -acute coronary syndrome (ACS) -active bladder cancer
42
What blackbox warning does rosiglitazone have?
DO NOT USE IN PATIENTS WITH MI. DON'T DO ITTTTTT
43
What blackbox warning do TZDs have?
CHF. TZDs can exacerbate CHF
44
What needs to be monitored while a patient is on a TZD?
-LFTs -edema -weight gain -FBG/PPG -A1c
45
How long does it take to see the full effects of TZDs?
6-8 weeks
46
What are some important counseling points for TZDs?
-take same day each day -report ADE -avoid alcohol
47
What is the MOA of alpha-glucosidase inhibitors (AGIs)?
-decrease breakdown of sucrose and complex carbs in brush border of the SI -reduces rate of digestion of complex carbs, decreasing absorption of glucose
48
What agents are AGIs?
-Acarbose -Miglitol
49
What are some ADR of AGIs?
-GI upset (pain, diarrhea, bloating)
50
What are some CIs of AGIs?
-hypersensitivity -DKA -cirrhosis -IBS -Crohn's disease -Colonic ulceration -intestinal obstruction -SCr > 2.0
51
What are some important counseling points for AGIs?
-always take with first bit of each meal -monitor GI ADE -start low, go slow
52
What should we monitor while on AGIs?
-PPG -A1C -GI intolerance
53
How long does it take to see the peak effect of AGIs?
4-6 weeks
54
What is the MOA of Gliptins (DPP4-is)?
-potentiate the effects of incretin hormones 1. suppress glucagon secretion 2. slow gastric emptying 3. reduce food intake 4. promote insulin secretion
55
What is the brand name of sitagliptin?
Januvia
56
What is the brand name of linagliptin?
Tradjenta
57
What is the brand name of saxagliptin?
Onglyza
58
What is the brand name of alogliptin?
Nesina
59
Which DPP4-i does NOT require renal dose adjustments?
linagliptin
60
What are some ADE of gliptins?
-NASOPHARYNGITIS -URI -GI: N/V/D -hypoglycemia -HF/pancreatitis (saxagliptin, alogliptin)
61
What are some DDIs for Onglyza?
conivaptan
62
What are DDIs for Tradjenta?
-carbamazepine -efavirenz -phenytoin -rifampins -St. John's Wort
63
Which gliptins do NOT have DDIs?
-sitagliptin -alogliptin
64
What are some CIs for gliptins?
-hypersensitivity -DKA -T1DM
65
In patients with heart failure or history of pancreatitis, use ____ and ____ with caution.
Saxogliptin and alogliptin
66
What should we monitor while on gliptins?
-FBG/PPG -A1C -ADE
67
How long does it take to see the full effects of gliptins?
6-8 weeks
68
What are some important counseling points for gliptins?
-avoid alcohol -take once a day same time each day -take with or without food
69
What is the MOA of SGLT2i?
-inhibits the reabsorption of filtered glucose at proximal renal tubules
70
What is the brand name of canagliflozin?
Invokana
71
What is the brand name of empagliflozin?
Jardiance
72
What is the brand name of dapagliflozin?
Farxiga
73
What is the brand name of ertugliflozin?
Steglatro
74
What is the brand name of sotagliflozin?
Inpefa
75
True or false: SGLT2i need renal dose adjustments.
True
76
Under what eGFR are SGLT2i contraindicated for?
eGFR <30
77
What are some of the ADE of SGLT2i?
-UTIs -hypotension -weight loss -Fournier's gangrene -increased urination
78
What ADEs are exclusive to canagliflozin?
-lower limb amputation/bone fractures -hyperkalemiaW
79
What ADE is exclusive to dapagliflozin (compared to other SGLT2is)?
bladder cancer
80
What DDIs do SGLT2i have?
-UGT enzyme inducers -rifampin -ritonavir -phenytoin -phenobarbital -may alter digoxin levels
81
What CIs do SGLT2is have?
-dialysis -renal failure -ESRD
82
What needs to be monitored while on SGLT2i?
-FBG/PPG -A1C -eGFR -ADE -BP -weight
83
How long does it take to see the full effect of SGLT2is?
4-6 weeks
84
What are some important counseling points for SGLT2is?
-stay hydrated -discuss ADE -take once a day, same time of the day
85

IPC Endocrine Week 1 (7 decks)

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