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Endocrinology > DM drugs > Flashcards

DM drugs Flashcards

1
Q

What (PO) DM agents are not used as first line?

A

Caution - TZDs and Secretagogues (SFNs/GLNs)

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2
Q

What causes Somogyi phenomenon?

A

Nocturnal hypoglycemia stimulates epinephrine which causes glucose release by liver = elevated 0700 glucose

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3
Q

What class is Apidra?

A

Bolus - Rapid (Ultra short acting) insulin analog

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4
Q

Stimulates insulin release from pancreatice B-cells

A

Secretagogues

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5
Q

What class is Humulin N (NPH)?

A

Basal - Intermediate acting insulin

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6
Q

What class is suffix “-agliflozin” associated with?

A

SGLT-2 inhibitor

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7
Q

What class is suffix “-glinide” associated with?

A

Secretagogues (Meglitinide analogs)

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8
Q

Which (PO) DM agents promote weight loss?

A

GLP-1 Ag and SGLT-2 inhibitors

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9
Q

Which (PO) DM agents ass/w UTIs (esp Fungal) dehydration?

A

SGLT-2 inhibitors

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10
Q

Which (PO) DM agents have an increased risk of hypoglycemia?

A

Insulin and Sulfonylureas

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11
Q

Which (PO) DM agents ass/w N/V?

A

GLP-1 Ag

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12
Q

0200-0300 glucose level of dawn phenonmenon?

A

Mild-severe elevation glucose

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13
Q

Suffix “-gliptin” refers to what class?

A

DPP4 inhibitors

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14
Q

What is 1st line therapy for new DM2 pt?

A

Metformin

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15
Q

GLP-1 Agonist are (PO) or injectables?

A

Injectables

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16
Q

How to TXT Somogyi phenomenon?

A

Reduce bedtime insulin

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17
Q

What (PO) DM agent is considered moderate efficacy?

A

DPP-4 inhibitors

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18
Q

What class is Nateglinide?

A

Megalitinide analogs

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19
Q

What are the complications of pre-breakfast hyperglycemia?

A

Dawn phenomenon Somogyi effect

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20
Q

SGLT-2 inhibitors work on what organ?

A

Kidneys

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21
Q

If pre-lunch blood glucose is high/low

A

Adjust morning bolus insulin dose the next morning

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22
Q

What causes dawn phenomenon?

A

Nocturnal rise in GH and reduced tissue sensitivity 0500-0800

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23
Q

What class is rosiglitazone?

A

TZDs

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24
Q

How to titrate Long acting insulin?

A

1-3 Units every 2-3D

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25
Q

Suppresses hepatic gluconeogensis & increases hepatic insulin sensitivity

A

Metformin

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26
Q

What classes act on Liver (glucose production)?

A

GLP-1 Ag, Metformin, TZDs

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27
Q

What class is Glipizide?

A

2nd generation Sulfonylureas

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28
Q

What classes act on kidney (Glucose reabsorption)?

A

SGLT2-Inhibitors

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29
Q

Which (PO) DM agents cause lactic acidosis?

A

Metformin

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30
Q

What drug should you discontinue if adding insulin?

A

Sulfonylureas

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31
Q

If pre-breakfast glucose is High/Low?

A

Adjust evening basal insulin

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32
Q

What class is suffix “-tide” associated with?

A

GLP-1 agonist (only “-ide” with T in the beginning)

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33
Q

Only add on GLP-1 agonist to what drugs?

A

Metformin or Sulfonylurea

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34
Q

What class is Metformin?

A

Biguanides

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35
Q

Which short acting insulin is useful in DKA?

A

Humulin R

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36
Q

What class is Canagliflozin?

A

SGLT-2 inhibitor

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37
Q

What class is Novolin N (NPH)?

A

Basal - Intermediate acting insulin

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38
Q

What class is Saxagliptin?

A

DPP4 inhibitors

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39
Q

2nd line step when adding insulin and not at goal?

A

Add daytime insulin and adjust via self monitoring

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40
Q

Adding insulin to a (PO) DM agent - what should happen?

A

Continue (PO) DM agent at same dose

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41
Q

How to TXT dawn phenonmenon?

A

Increase bedtime insulin

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42
Q

Which (PO) DM agents promote weight gain?

A

Insulins, Pioglitazone, Sulfonylureas

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43
Q

What class is Humulin R (Regular)?

A

Bolus - Short acting

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44
Q

1st line step when adding insulin?

A

Single bedtime NPH or long acting insulin dose (10U)

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45
Q

What class is Exanatide?

A

GLP-1 agonist

46
Q

Which (PO) DM agents risk of fluid retention, bladder cancer?

A

Pioglitazone

47
Q

If FPG is 120-180 how much should insulin be adjusted?

A

2 units

48
Q

TZDs act on what organ?

A

Liver, Peripheral tissues, Adipose

49
Q

Which DM meds are cheap?

A

Metformin Sulfonylureas Insulin (before all monitoring is taken into consideration)

50
Q

What class is Lente?

A

Basal - Intermediate acting insulin

51
Q

SGLT-2 stands for

A

Selective sodium dependent glucose co-transporter-2 inhibitors

52
Q

What kind of doses dose an insulin pump deliver?

A

Bolus or Basal (programmed and allows for different rates)

53
Q

Prevents degradation of incretins, stablize insulin secretion, and decrease glucagon release

A

DPP4 inhibitors

54
Q

What is the drug of choice for insulin pump?

A

Humalog (Lispro)

55
Q

What class is Humalog?

A

Bolus - Rapid (Ultra short acting) insulin analog

56
Q

What classes act on Pancreatic ? cells (Insulin secretion)?

A

DPP4-Inhib, GLP-1 Ag, SFN/GLNs

57
Q

What class is Glargine?

A

Basal - Long acting insulin analog

58
Q

What class is Novolin R (Regular?

A

Bolus - Short acting

59
Q

GLP-1 agonist are what based therapy?

A

Incretin based therapy

60
Q

Which (PO) DM agents are weight neutral?

A

Metformin and DPP-4 Inhibitors

61
Q

If pre-supper blood glucose is high/low

A

Adjust morning basal insulin and/or pre-lunch bolus dose the next day

62
Q

What (PO) DM agents are not used in combo w/ Metformin?

A

Caution - TZDs, Secretagogues (SFNs/GLNs), Basal insulin

63
Q

Basal insulin used to control?

A

Fasting hyperglycemia

64
Q

What class is suffix “-glitazone” associated with?

A

TZDs

65
Q

What two drugs are incretin based therapies used to increase increatin effects?

A

DPP4 inhibitors GLP - 1 agonist

66
Q

DPP4 - inhibitors act on what organs

A

Pancreatic ? cell (stabilizes) Intestines (Increases incretin)

67
Q

Insulin injection sites?

A

Abdomen - Not w/in 2in of navel Thighs - medial,anterior, lateral Upper arms - near tricep/deltoid

68
Q

Which is more severe for hypoglycemia risk SFNs or GLNs secretagogues?

A

Sulfonylureas

69
Q

GLP-1 agonist stands for

A

Glucagon-like peptide 1 receptor agonist

70
Q

Stimulates glucose-dependent insulin release, reduces glucagon, and slows gastic emptying

A

GLP-1 agonist

71
Q

Delays carb absorption affecting glucose absorption

A

?-glucosidase inhibitors (AGI)

72
Q

What class is Liraglutide?

A

GLP-1 agonist

73
Q

What classes act on the peripheral tissues (Glucose uptake)?

A

AGIs and TZDs

74
Q

AGIs act on what organs?

A

Peripheral tissues

75
Q

Bolus insulin used to control?

A

Post-prandial hyperglycemia

76
Q

What class is suffix “-ide” associated with?

A

Secretagogues (Sulfonylureas)

77
Q

Which SGLT-2 inhibitor is approved for reducing CV risk?

A

Empagliflozin

78
Q

What insulin is useful for bedtime?

A

Basal - long acting

79
Q

What class is Empagliflozin?

A

SGLT-2 inhibitor

80
Q

The dawn phenonmenon is more common in what type DM?

A

DM1

81
Q

What class is Tolbutamide?

A

1st generation Sulfonylureas

82
Q

What class is Pioglitazone?

A

TZDs

83
Q

TZDs stand for

A

Thiazolidinediones

84
Q

DPP4 inhibitors stands for

A

Dipeptidyl peptidase-4 inhibitor

85
Q

DPP4 inhibitors are what based therapy?

A

Incretin based therapy

86
Q

Secretagogues (SFNs/GLNs) act on what organ

A

Pancreatic B-cells

87
Q

GLP-1 agonist act on what organs?

A

Intestines, pancreatic A/B-cells, Liver

88
Q

What class is Sitagliptin?

A

DPP4 inhibitors

89
Q

What class is Detemir?

A

Basal - Long acting insulin analog

90
Q

0200-0300 glucose level of Somogyi phenonmenon?

A

Low glucose

91
Q

Intermediate acting onset/peal?

A

2-4h onset / 9 hr peak

92
Q

What dose AGIs stand for

A

?-glucosidase inhibitors

93
Q

What classes act on Intestines (incretin effect)?

A

DPP4-Inhib and GLP-1 Ag

94
Q

What classes act on Pancreatic ? cells (Glucagon secretion)?

A

GLP-1 Ag

95
Q

Sensitizies peripheral tissues to insulin

A

TZDs

96
Q

What two classes fall under secretagogues?

A

Sulfonylureas and Meglitinide analogs

97
Q

How to differentiate Dawn phenomenon vs Somogyi effect?

A

Glucose check at 0200-0300

98
Q

If FPG is >180 how much should insulin be adjusted?

A

4 units

99
Q

What class is Acarbose?

A

AGIs

100
Q

What classes act on adipose (Lipolysis)?

A

TZDs

101
Q

Reduces reabsorption of filtered glucose and lowers renal threshold for glucose allowing for its excretion

A

SGLT-2 inhibitor

102
Q

What class is Novolog?

A

Bolus - Rapid (Ultra short acting) insulin analog

103
Q

Entry A1C of <7.5% should be TXT how?

A

Monotherapy to start

104
Q

If pre-bedtime blood glucose is high/low

A

Adjust supper rapid/reg insulin dose the next day

105
Q

If 2-hour post-prandial glucose is high/low

A

Adjust pre-meal rapid/reg insulin dose the next day

106
Q

Saxenda is another name for what drug used for what?

A

Liraglutide but used for obesity TXT

107
Q

What class is Repaglinide?

A

Megalitinide analogs

108
Q

Entry A1C of >7.5% should be TXT how?

A

Dual therapy to start

109
Q

If 0300 blood glucose is high/low

A

Adjust evening basal insulin dose the next day

110
Q

What class is miglitol?

A

AGIs

111
Q

Which (PO) DM agents ass/w pancreatitis?

A

GLP-1 Ag and DPP-4 inhibitors

Endocrinology (5 decks)

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