Meglitinides DI Flashcards Preview

PHM 602- Diabetes > Meglitinides DI > Flashcards

Flashcards in Meglitinides DI Deck (22)
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1
Q

Meglitinides (GLN) MoA

A

Same as sulfonylureas- stimulate insulin release from beta cells!

(They’re just shorter-acting versions of SUs)

2
Q

Meglitinides site of action

A

Beta cells

3
Q

GLN products

A

Nateglinide (Starlix), repaglinide (Prandin)

4
Q

Brand name for nateglinide

A

Starlix

5
Q

Brand name for repaglinide

A

Prandin

6
Q

Nateglinide (Starlix) dosing

A

60-120mg PO before meals

7
Q

Repaglinide (Prandin) dosing

A

If A1C <8%- 0.5mg PO before meals
If A1C >8%- 1-2mg PO before meals

MDD- 4mg/dose or 16mg/day

8
Q

If a patient isn’t going to eat/skips a meal, should they still take their GLN?

A

Nope. Skip a meal, skip the dose.

9
Q

GLN side effects

A

Hypoglycemia (less than SUs), GI disturbances, weight gain, headache

10
Q

Nateglinide drug interactions

A

Mifepristone- don’t use within 14 days

Pazopanib (whatever this drug is idk)

11
Q

Repaglinide drug interactions

A

Mifepristone- don’t use within 14 days
Gemfibrozil- increased repaglinide levels
NPH insulin- NEVER USE TOGETHER, increased risk of MI

12
Q

GLNs CI

A

hypersensitivity, T1DM, DKA

13
Q

GLNs precautions

A

Severe renal disease, impaired liver function, use with insulin

14
Q

GLN counseling points

A

Administered before meals (repaglinide- 15-30 minutes prior, nateglinide- 1-30 minutes prior)

Skip a meal, skip the dose

Avoid alcohol use

15
Q

What should you ask about at every GLN refill?

A

Hypoglycemia and weight gain

16
Q

GLN A1C lowering

A

Low (0.6-1%)

17
Q

GLN effects on CKD, HF, ASCVD

A

Neutral

18
Q

Renal dosing for GLN

A

Not required

19
Q

GLN monitoring

A

PPG, hypoglycemia, A1C, weight gain

20
Q

Peak effect of GLN

A

4-6 weeks

21
Q

ADA guidelines on GLN

A

GLNs are nowhere in the guidelines

22
Q

AACE guidelines on GLN

A

Lumped in with SUs (last-line option for monotherapy, somewhere in the middle for dual and triple therapy)