Term
| Dipeptidyl-peptidase inhibitor-4 (DPP- 4) inh |
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Definition
Januvia
Tradjenta
Onglyza
MOA: increases level of incretin, increase release and synthesis of insulin and decrease release of glucagon
Dec A1C- 0.6-1.4
-use with metformin and TZD
-tradjenta- no renal adjustment dose |
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Term
| Incretin mimetics (GLP analogue) |
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Definition
Byetta
Victoza
-MOA- increase insulin production in response to increase plasma glucose
-inhibits glucagon release postprandially- decrease appetite
-Dec A1c- 1-2%
-CI in gastroporesis
-hepatic and renal adjustment |
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Term
| Alpha-glucosidase inhibitor |
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Definition
Precose
Glyset
MOA- delays intestinal absorption of carbs by reducing postprandial digestion of starches via enzyme inhibition
-Dec A1C .3-.9%
-taken with first bite of food
-Increase GI s/e, no IBD |
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Term
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Definition
Prandin
Starlix
MOA- short acting insulin secretagogue
Dec A1C- 1-1.5%
-helpful in post prandial glucose
-renal and hepatic adjustment |
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Term
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Definition
Avandia
MOA- insulin sensitizer via muscle, fat and other tissues
Dec A1C- 1-2%
-risk of hepatotoxicity monitor ALT
-Increases edema, no HF
-requires 12 weeks to start working |
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Term
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Definition
Metformin
MOA: reduces hepatic gluconeogenesis, also insulin sensitizer via increased glucose uptake and use
-Dec A1C by 1-2%
-monitor Cr- no RI or CHF
-risk of lactic acidosis |
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Term
| Cr cutoff for metformin use |
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Definition
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Term
| How many hours to hold metformin if getting IV contrast |
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Definition
| day of exam and 48 hours past |
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Term
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Definition
Glipizide Glyburide MOA: insulin secretagogue Dec A1C- 1-2% -adjust dose for renal/hepatic -can cause significant hypoglycemia
can cause pancytopenia |
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Term
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Definition
lantus
levemir
onset: 1 hour
no peak |
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Term
| Intermediate acting insulin |
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Definition
NPH
onset: 1-2h
peak: 6-14h
duration: 16-24h |
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Term
| Short acting, rapid onset of action |
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Definition
humalog- onset: 15m; peak 30min-2.5h
novalog-onset: 10-20m; peak 1-3h
apidra-onset: 10m; peak 1-1.5h |
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Definition
Regular insulin
onset-30m; peak 2-3h |
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Term
| how much long acting insulin to start |
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| Alpha-Glucosidase Inhibitor |
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