Shared Flashcard Set

Details

Therapeutics Diabetes in Elderly Lynch
Final Exam
17
Business
7th Grade
12/10/2009

Additional Business Flashcards

 


 

Cards

Term
Diabetes and Alzheimer's
Definition
  • Multiple epidemiologic studies show strong relationship between these two diseases
  • Type 2 Diabetes is being considered a plausible risk factor for development of Alzheimer's
  • These diseases also share clinical and biochemical features suggesting common pathogenic mechanisms
Term
Drug Induced Diabetes Type 2: Risk Factors
Definition

Shares same risk factors as T2DM:

  1. HTN
  2. Hyperlipidemia
  3. Family History
  4. History of GDM
  5. Obesity
  6. Physical Inactivity
Term
How do you treat Drug Induced Diabetes?
Definition
  • Change offending agent if possible
  • Drug therapy is typically Metformin + SU or Insulin
Term
Medications commonly associated with Drug Induced Diabetes mimicking T2DM
Definition
  1. Glucocorticoids
  2. Anti-Psychotics (Clozapine, Olanzapine, Aripiprazole, Ziprasidone)
  3. Nucleoside Reverse Transcriptase Inhibitors
  4. Human Growth Hormone

Less common:

  1. Beta-agonists
  2. Beta Blockers
  3. Diuretics
  4. Megestrol Acetate
  5. Niacin

 

 

Term
Glucocorticoids are associated with:
Definition

Type 2 Drug Induced Diabetes

  • High doses and long term use increase risk
  • Increases gluconeogenesis, increases insulin resistance, increases weight gain
  • Much lower incidence for inhaled products
  • May account for > 50% of all DID
Term
Antipsychotics and weight gain
Definition
  • Sedentary lifestyle and poor food choices are components of psychosis - a risk factor for diabetes
  • Weight gain does not appear to be dose related
  • Different agents have different weight profiles (Clozapine>Olanzapine>Aripiprazole>Ziprasidone)
  • Hyperglycemia can occur regardless of weight gain status
  • Most weight gain is fat, not muscle or water (compliance issues)
Term
Nucleoside Reverse Transcriptase Inhibitors are associated with:
Definition

Type 2 Drug Induced Diabetes

  • Increase insulin resistance, increase weight gain
  • Rarely permanent due to concurrent pancreatitis
Term
Growth Hormone
Definition

Type 2 Drug Induced Diabetes

  • Increase insulin resistance
  • Increase weight gain
Term
Pentamide can cause:
Definition

Drug Induced Diabetes Mimicking Type 1

  • often concurrent with pancreatitis
  • may be irreversible
  • directly toxic to pancreatic beta cells
Term
Tacrolimus can cause:
Definition

Drug Induced Diabetes Mimicking Type 1

  • decreased insulin secretion with or without beta cell death
  • difficult to differentiate from steroid-induced diabetes
Term
Cyclosporine can cause:
Definition

Drug Induced Diabetes Mimicking Type 1

  • less common than with tacrolimus
  • less likely irreversible than with tacrolimus
Term
Phenytoin can cause:
Definition

Drug Induced Diabetes Mimicking Type 1

  • Rarely occurs
  • Reversible
Term
Interferons can cause:
Definition

Drug Induced Diabetes Mimicking Type 1

  • Rare, but irreversible beta-cell death due to antibody formation
Term
Gatifloxacin can cause:
Definition

Drug Induced Diabetes Mimicking Type 1

  • unknown mechanism (fast onset with insulinopenia)
  • reversible
  • cipro can inhibit glyburide metabolism and cause hypoglycemia
Term
Strategies to avoid Drug Induced Diabetes
Definition
  1. Obtain baseline FPG before starting agents likely to cause DID
  2. Monitor FPG again at 1 month and q 3-6 months thereafter
  3. Monitor body weight at each visit - greater than 5 kg weight gain is a strong risk regardless of changes in FPG
  4. Inquire about symptoms of hyperglycemia at each visit - symptoms often lag after FPG
Term
Pentamide can cause:
Definition

Drug Induced Hypglycemia

  • short-term insulin spike ante pancreatic failure (insulin dump)
Term
Aspirin can cause:
Definition

Drug Induced Hypglycemia

  • but only in little kids (< 2 years) or in rare cases of extreme overdose (suicide attempts)
Supporting users have an ad free experience!