GROUP 10

Question 1

What are the indications for Alteplase (tPA), and how does it work?

Answer 1

Indications: Dissolve clots following acute MI, PE, and ischemic stroke.

MOA: Promotes the conversion of plasminogen to plasmin, which digests the fibrin matrix of clots, initiating fibrinolysis.

Question 2

What are the side effects, adverse effects, and contraindications of Alteplase (tPA)?

Answer 2

Side Effects: Bleeding.
Adverse Effects: Intracerebral hemorrhage, stroke, atrial or ventricular dysrhythmias.

Contraindications: Internal bleeding, recent CVA, surgery, trauma, bacterial endocarditis, severe liver dysfunction, uncontrolled hypertension.

Question 3

What are Sodium-Glucose Co-transporter 2 (SGLT-2) Inhibitors, and how do they function?

Answer 3

SGLT-2 Inhibitors: A class of medications used to treat type 2 diabetes by inducing glucosuria.

Mechanism of Action: They inhibit the SGLT-2 protein in the renal tubules, reducing glucose reabsorption in the kidneys, leading to glucose excretion in the urine. This process is independent of insulin secretion and also enhances insulin sensitivity and reduces gluconeogenesis.

Question 4

What are some common examples of SGLT-2 inhibitors?

Answer 4

Empagliflozin (Jardiance)
Canagliflozin (Invokana)
Dapagliflozin (Farxiga)

Question 5

What are the indications and contraindications for SGLT-2 inhibitors?

Answer 5

Indications: Treatment of type 2 diabetes mellitus, often used to improve glycemic control, and reduce the risk of cardiovascular events.

Contraindications:
Type 1 Diabetes Mellitus
Diabetic Ketoacidosis (DKA)
Severe renal disease (GFR < 30 mL/min)
Patients on hemodialysis (HD)

Question 6

What are the common adverse effects of SGLT-2 inhibitors?

Answer 6

Hyperkalemia
Mycotic infections (e.g., genital yeast infections)
Urinary Tract Infections (UTIs)
Renal insufficiency
Hypotension

Question 7

What is the recommended dosing for Empagliflozin (Jardiance)?

Answer 7

Initial Dose: 10 mg PO in the morning.

Titration: Increase to 25 mg if needed

Discontinue: If GFR is persistently below 45 mL/min.

Question 8

How is Dapagliflozin (Farxiga) dosed for patients?

Answer 8

Initial Dose: 5 mg PO daily.
Titration: Can increase to 10 mg daily.
Discontinue: If GFR falls below 60 mL/min.

Question 9

What is the dosing recommendation for Canagliflozin (Invokana)?

Answer 9

Initial Dose: 100 mg PO daily before the first meal.
Titration: Increase to 300 mg daily for patients with normal renal function (GFR > 60 mL/min).