Insulin Secretagogues Flashcards Preview

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Flashcards in Insulin Secretagogues Deck (10)
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1
Q

What are the 2 classes of drugs in this category

A

sulfonylureas and meglitinides

2
Q

What is the mechanism of action

A

Sulfonylureas bind to and inhibit ATP sensitive K+ channels. K+ leads to depolarization of the cells causing influx of Ca+ into the cell –> activates beta cells in pancreas to secrete insulin

3
Q

What is a major contraindication of sulfonylureas and why

A

CKD. Insulin is secreted via the kidneys, someone with kidney injury can’t clear it

4
Q

What are the 4 major side effects

A

1) hypoglycemia
2) weight gain
3) heart attack
4) stroke

5
Q

What are the 3 types of drugs for sulfonylureas and start and max doses

A

1) gliclazide, start: 80mg max: 320mg
2) glimepiride, start: 30mg max: 120mg
3) glyburide, start: 5mg max: 20mg

6
Q

What are the major warnings/contraindications for glyburide

A

Contraindicated with CKD. Warning –> can increase risk of heart attack because it can cause the cardiac K+ channels to close. Also can cause hypoglycemia

7
Q

Who are Meglitinides ideal for

A

people with irregular eating patterns. Fast acting, can work within 1hr and can last for up to 4hrs

8
Q

Which drug is associated with Meglitinides. What do you have to remember when taking this drug.

A

Repaglinide. Take 15min before eating

Start: 0.5mg if A1C <8%, 1-2mg if A1C >8%
Max: 16mg

9
Q

How is Repaglinide excreted

A

Metabolized in liver and can be excreted in poo. Can be used in people with CKD.

10
Q

When is Repaglinide contraindicated. What special precautions is there to take when mixing with ____

A

Liver disease.

Caution when mixing with clopidogrel (Plavix) or gemfibrozil, 8x increase in hypoglycemia