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PTx 3 > Non-Insulin Drug Products > Flashcards

Non-Insulin Drug Products Flashcards

(46 cards)

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1
Q

Which drug is classified as a biguanide?

A

Metformin

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2
Q

What is metformin’s effect on body weight?

A

weight loss

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3
Q

_______ is first line for any Type 2 diabetic w/o contraindications and can tolerate it.

A

Metformin

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4
Q

How do you titrate Metformin?

A
  1. 500 QD or BID –> 1000QD - BID

2. 850QD –> 850 BID

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5
Q

What are absolute CI for metformin use?

A
  1. Renal disease (CrCl less than 60 ml/min)
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6
Q

What are some common ADR of Metformin?

A
  1. N/D

2. Lactic Acidosis (rare;weak correlation)

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7
Q

What are the 3 2nd gen sulfonylureas?

A
  1. Glimiperide
  2. Glyburide
  3. Glipizide
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8
Q

What is the most common ADR with SU?

A

hypoglycemia

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9
Q

Which SU has the highest risk of hypoglycemia?

A

Glyburide

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10
Q

What is the initial dose of Glimepiride? Max Dose?

A

Initial: 1-2mg/d (1mg if hepatic/renal disease)
Max: 8mg/d

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11
Q

What is the initial dose of Glyburide? Max Dose?

A

Initial: 2.5-5mg/d
Max: 20mg/d
**Adjust dose for hepatic disease and CrCl

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12
Q

What is the initial dose of Glipizide? Max Dose?

A

Initial: 5-10mg/d
Max: 40mg/d (marginal benefit >20mg/d)

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13
Q

SU work better in pts w/ high C-peptide levels…What does this mean for the efficacy and duration of SU Tx?

A

High C-peptide levels mean the pt is still making insulin in which case the SU upregulates the release into the blood; efficacy wains over time b/c insulin production decreases as DM progresses.

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14
Q

D-D interactions are possible when taking abx b/c…

A

SU are metabolized by p450 enzymes

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15
Q

Which drugs are considered Thiazolidinediones (TZDs)?

A
  1. Pioglitazone (Actos)

2. Rosaglizazone (not available to public)

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16
Q

What are the initial and max doses of pioglitazone?

A

Initial: 15mg/d
Max: 45mg/d

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17
Q

What are some ADR of TZDs?

A
  1. hepatotoxicity (D/C if >3x ULN
  2. fluid retention (wt gain 1.5-4kg)
  3. increased risk of bone fracture
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18
Q

What are some contraindications to pioglitazone?

A
  1. HF class 3-4
  2. hepatic failure
  3. bladder cancer
    Relative: HF class 1-2
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19
Q

How often should you monitor LFTs in a pt taking pioglitazone?

Study These Flashcards
A

Q2months x1year then annually

20
Q

What drugs are in the DPP4 inhibitor class?

Study These Flashcards
A
  1. sitagliptin (Januvia)
  2. satagliptin (Onglyza)
  3. linagliptin (Trajenta)
  4. alogliptin (Nesina)
21
Q

What are the ADRs of DPP4 inhibitors?

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A
  1. nasopharyngitis
  2. URTI
  3. HA
  4. angioedema
    * *linagliptin - nasopharyngitis only**
22
Q

Which patients should not be on a DPP4 inhibitor?

Study These Flashcards
A

pt w/ HF or pancreatitis

23
Q

Which drugs are considered SGLT2 inhibitors?

Study These Flashcards
A
  1. canagliflozin (Invokana)
  2. dapagliflozin (Farxiga)
  3. empagliflozin(Jardiance)
24
Q

What are some ADRs of SGLT2 inhibitors?

Study These Flashcards
A
  1. gential fungal infection (11% occurance in females; 4% in males)
  2. UTI
  3. increased urination/dehydration
25
Renal adjusted dosing for sitagliptin...
CrCl = 30-49 -- 50mg/d (1/2 dose) | CrCl less than 30 -- 25mg/d (1/4 dose)
26
What is the dose for sitagliptin in a pt w/out renal impairment?
100mg/d
27
What is the dose for satagliptin in a pt w/out renal impairment?
2.5-5mg/d
28
What is the renal adjusted dosing for satagliptin?
CrCl less than 50ml/min -- 2.5mg/d
29
Which DPP4 does not require renal adjustments?
linagliptin
30
What is the dose for alogliptin in a pt w/out renal impairment?
25mg/d
31
What is the renal adjusted dosing for alogliptin?
CrCl = 30-59 -- 12.5mg/d | CrCl less than 30ml/min -- 6.25mg/d
32
All _____ inhibitors are weight neutral
DPP4
33
GLP1 agonists include...
1. exenatide 2. liraglutide 3. albiglutide 4. dalaglutide
34
What are some common ADRs of GLP-1 agonists?
1. N/V/D 2. wt loss 3. acute pancreatitis
35
What are some CI to taking GLP-1 agonists?
1. Type 1 DM | 2. renal failure (CrCl less than 30ml/min)
36
What are the two brand names of exenatide and how do they differ?
1. Byetta - dose 5mcg BIDx1mo then 10mcg BID | 2. Bydureon - 2mg Qweek
37
What may deter some pts away from Bydureon?
pt must manually reconstitute the powder suspension
38
What are some special instructions for Byetta?
1. must inject w/in 60min of your first bite of food (for that meal) 2. refrigerate until 1st injection then the pen is good for 30d at room temp.
39
What is the titration schedule for liraglutide(Victoza)?
0. 6 mg SQ QD x1week --> increase to 1.2mg SQ QD | * *max dose 1.8mg, assume increase after another week**
40
What is a unique ADR attributed to liraglutide(Victoza)?
C-cell hyperplasia of thyroid
41
What is a unique ADR for Albiglutide?
URTI
42
What is the therapeutic dose of albiglutide? What is the max dose?
1. 30mg SQ QWeek | 2. 50mg SQ QWeek if insufficient response
43
For the once weekly GLP-1 agonists, all must be given at least ___ days apart except for ________ which has to be given at least ___ days apart.
1. 3 days 2. albiglutide (Tazneum) 3. 4 days
44
_______ takes about 15 min to reconstitute in a self contained device but is viable at room temp. for up to 8h.
albiglutide (Tazneum)
45
What is the therapeutic and max dose of dulaglutide (Trulicity)?
1. 0.75mg SQ QWeek | 2. 1.5mg SQ QWeek if insufficient response
46
How long is dulaglutide (Trulicity) good for at room temp?
14 days

PTx 3 (4 decks)

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