Type 2 Diabetes Meds

Question 1

Insulin Rapid Acting examples

Answer 1

1. Aspart
2. Gluisine
3. Lispro

Question 2

Insulin Short Acting examples

Answer 2

Insulin regular (Humulin-R, Novolin-ge Toronto)

Question 3

Insulin Basal Intermediate-acting examples

Answer 3

Insulin NPH

Question 4

Insulin Basal Long-acting examples

Answer 4

Insulin detemir, insulin glargine

Question 5

Biguanide + dose

Answer 5

Metformin - effective, hypoglycaemia rare, no weight gain/CV risks, GI SEs, rare lactic acidosis in renal/hepatic failure patients
250-500mg OD (max 1000 mg BID)

Question 6

Alpha-glucosidase Inhibitor + dose

Answer 6

Acarbose - modest A1c lowering, GI SEs, multiple daily dosing (post-prandial)
50-200mg TID with each meal

Question 7

Insulin secretagogue

Answer 7

1. Long-acting sulfonylureas (-ide: Glyburide, Gliclazide, Glimepiride)
2. Short-acting sulfonylureas (-glinide: Repaglinide, Nateglinide)
   hypoglycaemia, initial dramatic drop in A1c, WEIGHT GAIN`

Question 8

Glyburide dose

Answer 8

2.5-5mg OD, max 10mg BID

Question 9

Glimepiride dose

Answer 9

1-2mg OD, max 8mg OD

Question 10

Gliclazide dose

Answer 10

80mg OD, max 160 BID

Question 11

Gliclazide MR dose

Answer 11

30mg OD, max 120OD

Question 12

Thiazolidinediones

Answer 12

PPAR-gamma activators: (-glitazone: Rosiglitazone, Pioglitazone)
durable/effective, weight gain, edema, CHF exacerbation, distal femur fractures
ONLY FOR men with no CV risk

Question 13

Thiazolidinedione dose

Answer 13

Rosiglitazone: 4-8mg OD
Pioglitazone: 15-45mg OD

Question 14

Incretin-mediated agents

Answer 14

1. DPP-4 Inhibitors (-gliptin: Saxagliptin, Alogliptin, Sitagliptin, Linagliptin)
   - oral, fairly safe, Saxa and Alo have some CV risk, physiological
2. GLP-1 Agonists (-tide: Liraglutide, Lixisenatide, Exentide, Dulaglutide, Semaglutide)
   - IM, reduces appetite, WEIGHT LOSS, nausea/vomiting at higher doses, pharmacological

Question 15

Saxagliptin dose

Answer 15

5mg OD

Question 16

Sitagliptin dose

Answer 16

100mg OD

Question 17

Linagliptin dose

Answer 17

5mg OD

Question 18

SGLT-2 Inhibitors

Answer 18

-fozin: Canaglifozin, Dapaglifozin, Empaglifozin
CV benefit for Empaglifozin, WEIGHT LOSS, lowers BP, LOW risk of hypoglycaemia, effective
Polyuria, volume depletion, hyperkalemia, possible DKA if insulin stopped

Question 19

Canaglifozin dose

Answer 19

100-300mg OD

Question 20

Dapaglifozin dose

Answer 20

5-10mg OD

Question 21

Empaglifozin dose

Answer 21

10-25mg OD

Question 22

Medications that do NOT cause hypoglycemia

Answer 22

Metformin
SFLT-2 Inhibitors
Incretin-mediated agents 
Alpha-glucosidase inhibitors 
Thiazolidinediones

Question 23

Medications that DO cause hypoglycemia

Answer 23

Insulin
Insulin secretagogues (long and short acting)

Question 24

Weight gain

Answer 24

Thiazoledinediones

Insulin secretagogues

Question 25

Weight loss

Answer 25

SGLT2 inhibitors | GLP-1 agonist

Question 26

CV benefit

Answer 26

Empaglifozin (SGLT-2 inhibitor) | Liraglutide and Semaglutide (GLP-1 agonists)

Question 27

CV Risk

Answer 27

Alogliptin and saxogliptin (DPP4 inhibitors) | Thiazoledinediones