Week 7 Meds Flashcards
Diabetes and Thyroid (28 cards)
Metformin
Class: Biguanide
MOA: Decreases hepatic gluconeogenesis, increases insulin sensitivity, decreases intestinal glucose absorption
SE: GI upset (diarrhea, gas), lactic acidosis (rare), B12 deficiency
Need renal dose ajustment to avoid in severe renal impairment
BBW: Lactic acidosis
Linagliptin
Class: DPP-4 Inhibitor
MOA: Inhibits DPP-4 enzyme → ↑ GLP-1 → ↑ insulin release, ↓ glucagon
SE: Nasopharyngitis, headache, pancreatitis (rare), joint pain
BBW: None
Saxagliptin
Class: DPP-4 Inhibitor
MOA: Inhibits DPP-4 enzyme → ↑ GLP-1 → ↑ insulin release, ↓ glucagon
SE: Nasopharyngitis, headache, pancreatitis (rare), joint pain, possible ↑ risk of heart failure
BBW: None
Sitagliptin
Class: DPP-4 Inhibitor
MOA: Inhibits DPP-4 enzyme → ↑ GLP-1 → ↑ insulin release, ↓ glucagon
SE: Nasopharyngitis, headache, pancreatitis (rare), joint pain
BBW: None
“-gliptin”
DPP-4 Inhibitors
Dulaglutide
Class: GLP-1 Receptor Agonist
MOA: Activates GLP-1 → ↑ insulin, ↓ glucagon, slows gastric emptying
SE: Nausea, vomiting, weight loss, pancreatitis, thyroid C-cell tumors
BBW: Thyroid C-cell tumors
Exenatide
Class: GLP-1 Receptor Agonist
MOA: Activates GLP-1 → ↑ insulin, ↓ glucagon, slows gastric emptying
SE:Gi upset, pancreatitis
BBW: Thyroid C-cell tumors
Liraglutide
Class: GLP-1 Receptor Agonist
MOA: Activates GLP-1 → ↑ insulin, ↓ glucagon, slows gastric emptying
SE: Nausea, vomiting, weight loss, pancreatitis, thyroid C-cell tumors
BBW: Thyroid C-cell tumors
Canagliflozin
Class: SGLT2 Inhibitor
MOA: Inhibits SGLT2 in proximal tubule → ↑ urinary glucose excretion
SE: Genital infections, UTI, volume depletion, ↑ LDL, ↑ risk of amputation
BBW: Amputation risk
“-tide”
GLP-1 Inhibitor
“-gliflozin”
SGLT-2 Inhibitor
Dapagliflozin
Class: SGLT2 Inhibitor
MOA: Inhibits SGLT2 in proximal tubule → ↑ urinary glucose excretion
SE: Genital infections, UTI, volume depletion, ↑ LDL, ↑ risk of amputation
Dapaglifozin
Class: SGLT2 Inhibitor
MOA: Inhibits SGLT2 in proximal tubule → ↑ urinary glucose excretion
SE: Genital infections, UTI, volume depletion, ↑ LDL, ↑ risk of amputation
Empagliflozin
Class: SGLT2 Inhibitor
MOA: Inhibits SGLT2 in proximal tubule → ↑ urinary glucose excretion
SE: Genital infections, UTI, volume depletion, ↑ LDL, ↑ risk of amputation, shown to reduce CV mortality
Glimepiride
Class: Sulfonylurea
MOA: Stimulates pancreatic β-cell insulin release (closes K⁺ channels)
SE: Hypoglycemia, weight gain
BBW: None
Glipizide
Class: Sulfonylurea
MOA: Stimulates pancreatic β-cell insulin release (closes K⁺ channels)
SE: Hypoglycemia, weight gain
BBW: None
Glyburide
Class: Sulfonylurea
MOA: Stimulates pancreatic β-cell insulin release (closes K⁺ channels)
SE: Hypoglycemia, weight gain
BBW: None
“-ide”
Sulfonylurea
Pioglitazone
Class: Thiazolidinedione (TZD)
MOA: PPAR-γ agonist → ↑ insulin sensitivity, upregulates genes (GLUT-4) and increases glucose cellular uptake
SE: Weight gain, edema, HF exacerbation, bladder cancer (possible)
BBW: May cause or worsen heart failure
MAJOR CYP3A4 substrate!
What are the rapid acting insulins? What is the onset of action?
LAG
Insulin Lispro, Aspart, and Glulisine
Onset is 15 min
What is a short acting insulin?
Regular insulin
Onset: 30-60 min
What is the intermediate acting insulin and the onset?
NPH
Onset: 1-2H
What are the long acting insulins and the onset/duration?
DDG
Insulin Glargine, Detemir, and Degludec
Onset: 1-2 H
Duration: 24H
Levothyroxine (T4)
Class: Thyroid hormone replacement
MOA: Synthetic T4 converted to active T3
SE: Symptoms of hyperthyroidism if over-replaced
BBW: Not for weight loss
