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Flashcards in DM Deck (17)
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1

Insulin Lispro
+2

type

PK

Aspart and glulisine

Human insulin analogs (no PD changes)

rapid acting and short duration

2

Regular insulin S.C vs I.V

PK

difference

rapid onset short duration

S.C-slowly releases becuase with Zn

IV-crisis situations

3

Isphane NPH
PK
special

intermediate acting
takes 2-5 hours to work beucase has to get rid of postive binding

highly unpredictable

4

Glargine (+2)
-PK
-vs others

Long actin-slow onset and long duration-flat profile

glargine (shorttest)>Detemir>Delude (longest)

5

Afrezz
-PK
-side fx

Inhalable
-rapid acting with quick peak

cough, thraot pain, hypoglycemia

6

Glyburide
+2
type+mech
difference
side fx
met

oral

Glipizide and glimepiride

sulfonylureas=stim insulin secretion from B cells, and decrease glucagon in cirlcation (need working B cells to use)

Glip short t1/2, glimepridie longest T1/2

weight gain and hypoglycemia/NV
-gly liver and kideny met
-glim liver met

7

Repaglinide
+1 (and difference)
mech
contraindicated

oral

Netaglinide (quicker onset and shorter duration, but only liver)
-can give @ very reduced renal fxn

samne mech as sulonylureas but newer versions (better control)

hypoglycemia

Hypersens or DKA

8

Metformin
-type
-mech (2)
-side fx 3
-contraindicated2

oral

biguanide

Decrease hepatic glucose output and increase insulin sensitivity

Lactic acidosis (if patient is dehydrated), GI disturbances, B12 def

low GFR, ALCOHOLISM

9

Exenatide
-type
-+4 and timing
-side fx
-contraindication

GLP1 agonist (GLP stimultaes inuslin secretion and is inactivated by DPP4)

Exenatide (1x daily)Liraglutide Daily), lixisenatide (daily), dulaglutide (weekly), albiglutide (weekly)

NVD and hypoglycmia when used with sullonylureas

kidney problems

10

Sitagliptin
-type
+3
-metabolism

DPP inhibitors (DPP4 inactivates GLP1 inhibiting inuslin secretion and also supresses glucagon prod)

saxagliptin, linagliptin, alogliptin

renal excretion

11

Canagliflozin
-type
+2
use
3 side fx

SGLT inhibitors-inhibit resorption of glucose

Dapaglifozin and empagliflozin\

only DM1

icnrease DKA risk ,vaginal yeast infection, UTI

12

Pramlintide
-type
-use
-side fx
-contraindication

amylin agonists (hormone secreted by beta cells)->slows gastric emptying and reduices glucagon prod

use as adjuct

N and hypoglycemia

contraindicated in GI motility d/o

13

Pioglitazone
-type
+1
side fx 2
contra indications 2

oral

Thiazolidinediones
-increase peripheral insulin sensitivity
-reduce gluconeogensis
-wiork via PPARgamma->REGULATED TRANSCRIPTION OF GENES INVOLVED IN GLUCOSE UTILZIATION

Rosiglitazone=>CHF!!!!

modest weight gain and liver damge

CYP3a4/CHF

14

acarbose
-type
+1
side fx/contra

oral

alpha glucosidase inhibitors-competitve inhibitor of alpha glucosidase-cant digest carbs to absorbale monosacs (no abosrptioN)

miglitol

GI distrub, IBD

15

Colesevelam
-what is it
-mech
-side fx

bile acid binding resin

modest efficacy (DM2)-unclear mech

GI, incrase plasma TAGs

16

bromocriptine
-what is it
-use

D2 receptor agonist

DM2 modest efficacy

17

general insulin side fx (4)

hypoglycemia-GI, tachy, swating, coma, convusions

weight gain

lipodystriphy where inject

rarely allergic