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TOP 300 > Glucose Lowering Medications > Flashcards

Glucose Lowering Medications Flashcards

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1
Q

generic name

Glucotrol

A

Glipizide

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2
Q

class of glipizide

A

sulfonylureas

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3
Q

indication for glucose lowering medications

A

diabetes

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4
Q

MOA

sulfonylureas

A

stimulates insulin release from pancreatic beta cells

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5
Q

contraindications

sulfonylureas

A
  • hypersensitivity
  • type 1 diabetes
  • diabetic ketoacidosis
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6
Q

common ADRs

sulfonylureas

A
  • hypoglycemia
  • dizziness
  • weight gain
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7
Q

rare but serious ADRs

sulfonylureas

A
  • hemolytic anemia
  • hepatotoxicity
  • disulfiram reaction
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8
Q

key counseling points

sulfonylureas

A
  • take first thing in the morning (30 minutes before breakfast or first meal of the day)
  • avoid alcohol while taking may cause rare disulfiram reactions
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9
Q

other top 300 medications

sulfonylureas

A

brand: amaryl
generic: glimepiride

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10
Q

brand name of meglitinides

A

prandin

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11
Q

generic name of meglitinides

A

repaglinide

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12
Q

MOA

meglitinides

A

stimulates insulin release from pancreatic beta cells

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13
Q

contraindications

meglitinides

A
  • diabetic ketoacidosis
  • type 1 diabetes
  • concurrent use of gemfibrozil
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14
Q

common ADRs

meglitinides

A
  • hypoglycemia
  • headache
  • nausea/vomiting
  • weight gain
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15
Q

rare but serious ADRs

meglitinides

A
  • chest pain
  • ischemia
  • hypersensitivity (SJS)
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16
Q

key counseling points

meglitinides

A
  • needs to be taken with each meal (15-30 minutes before each meal)
  • if patient skips a meal, skip that dose
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17
Q

generic name

biguanides

A

metformin

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18
Q

brand name

biguanides

A

glucophage

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19
Q

MOA

biguanides

A
  • primary: decrease output from the liver (hepatic glucose production)
  • secondary: increase peripheral muscle glucose sensitivity (glucose uptake and utilization)
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20
Q

contraindications

biguanides

A
  • eGFR < 30 mL/min
  • metabolic acidosis
  • use with contrast media
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21
Q

black box warning

biguanides

A

lactic acidosis

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22
Q

common ADRs

biguanides

A
  • GI upset
  • diarrhea
  • nausea/vomiting
  • flatulence
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23
Q

rare but serious ADRs

biguanides

A
  • lactic acidosis
  • hemolytic anemia
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24
Q

key counseling points

biguanides

A
  • take with food to reduce GI upset
  • avoid use within 48 hours of iodinated contrast media
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25
generic name | Actos
pioglitazone
26
class of pioglitazone
thiazolidinediones
27
MOA | thiazolidinediones
* primary: increase peripheral muscle glucose sensitivity (glucose uptake and utilization) * secondary: decrease glucose output from liver (hepatic glucose output)
28
contraindications | thiazolidinediones
New York Heart Association Class III/IV heart failure
29
common ADRs | thiazolidinediones
* edema * weight gain
30
rare but serious ADRs | thiazolidinediones
* congestive heart failure * bladder cancer * fractures * hepatotoxicity
31
key counseling points | thiazolidinediones
* take once daily without regard to meals * monitor for weight gain and/or swelling of legs
32
other top 300 meds | thiazolidinediones
brand: avandia generic: rosiglitazone
33
generic name | tradjenta
linagliptin
34
class of linagliptin
Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
35
MOA | Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
* binds to and inhibits the DPP-4 enzyme, resulting in prolonged incretin hormone levels * incretin hormones regulate glucose metabolism by increasing insuling secretion and release
36
contraindications | Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
* type 1 diabetes * diabetic ketoacidosis * hypersensitivity
37
common ADRs | Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
* nasopharyngitis * hypoglycemia
38
rare but serious ADRs | Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
* pancreatitis * heart failure
39
key counseling points | Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
* take once daily at same time each day * may be taken with or without food
40
other top 300 meds | Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
* brand: onglyza, generic: saxagliptin * brand: januvia, generic: sitagliptin
41
brand name | dapaglifozin
farxiga
42
class of farxiga
sodium glucose cotransporter 2 (SGLT2) inhibitors
43
MOA | sodium glucose cotransporter 2 (SGLT2) inhibitors
* inhibits SGLT2 in the proximal renal tubules which reduces reabsorption of filtered glucose * reabsorption of filtered glucose = increased urinary excretion of glucose
44
contraindications | sodium glucose cotransporter 2 (SGLT2) inhibitors
severe renal impairment (ESRD, dialysis)
45
common ADRs | sodium glucose cotransporter 2 (SGLT2) inhibitors
* dehydration * hypotension * UTI * yeast infection
46
rare but serious ADRs | sodium glucose cotransporter 2 (SGLT2) inhibitors
* euglycemic diabetic ketoacidosis * bone fracture * perineal necrotizing fascitis * acute kidney injury
47
key counseling points | sodium glucose cotransporter 2 (SGLT2) inhibitors
* take once daily in the morning * stay well hydrated while taking
48
other top 300 meds | sodium glucose cotransporter 2 (SGLT2) inhibitors
* brand: invokana, generic: canagliflozin * brand: jardiance, generic: empagliflozin (won't be tested)
49
generic name | trulicity
dulaglutide
50
class of trulicity
glucagon-like peptide-1 (GLP-1) receptor agonists
51
MOA | glucagon-like peptide-1 (GLP-1) receptor agonists
binds to human GLP-1 receptor which augments glucose dependent insulin secretion and slows gastric emptying
52
contraindications | glucagon-like peptide-1 (GLP-1) receptor agonists
personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasisa syndrome type 2 (MEN2)
53
black box warning | glucagon-like peptide-1 (GLP-1) receptor agonists
risk of thyroid c-cell tumors
54
common ADRs | glucagon-like peptide-1 (GLP-1) receptor agonists
* nausea/vomiting * diarrhea * GI upset * weight loss * decreased appetite
55
rare but serious ADRs
* pancreatitis * gallbladder disease * acute kidney injury
56
key counseling point | glucagon-like peptide-1 (GLP-1) receptor agonists
* SQ injection, rotate injection site each week * GI side effects should improve over time
57
other top 300 meds | glucagon-like peptide-1 (GLP-1) receptor agonists
* brand: victoza & saxenda, generic: liraglutide * brand: ozempic & wegovy, generic: semaglutide * brand: byetta &bydureon, generic: exenatide (won't be tested)
58
generic name | lantus
insulin glargine
59
brand name | insulin degludec
tresiba
60
class of lantus & tresiba
basal (long acting) insulin
61
MOA | basal (long acting) insulin
insulin promotes cellular uptake of glucose, fatty acids and amino acids and their conversion to glycogen, triglycerides and proteins
62
contraindications | basal (long acting) insulin
hypersensitivity
63
common ADRs | basal (long acting) insulin
* hypoglycemia * weight gain * injection site reactions
64
rare ADRs | basal (long acting) insulin
* severe hypoglycemia * insulin resistance
65
key counseling points | basal (long acting) insulin
* SQ injection * rotate injection site * use new needle each injection * dosing dial for pens * draw up dose in syringe for vials
66
other top 300 meds | basal (long acting) insulin
1. brand: Toujeo or Basaglar, generic: insulin glargine 2. biosimilar: insulin glargine-aglr (rezvoglar) 3. biosimilar: insulin glargine-yfgn (semglee yfgn)

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