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Diabetes Mell: Pharmacotherapy
Dr. Lehman 2-4-09
21
Health Care
Professional
02/13/2009

Additional Health Care Flashcards

 


 

Cards

Term
What does HbA1c stand for and what does it measure?
Definition

Glycosolated hemoglobin

 

Over the 120 day life-span of the red blood cells, glucose combines with hemoglobin to form the glycated form.  A uncontrolled diabetic in a prolonged state of hyperglycemia will have more glycated hemoglobin!  Target is around 6%

Term

Biguanides Class

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Metformin (drug of choice for T2DM)

2.  MOA- Primarily acts on liver to decrease glucose output but also increases insulin sensitivity in muscle. 

3.  Advantages:  No Hypoglycemia and no Weight Gain

4.  Gastrointestinal Problems (Explosive Diarrhea)

-METALLIC-A Taste in their mouth

Term

Thiazolidinedions (TZDs)Class

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Pioglitazone (Actos)

2.  Primarily acts in the muscle and FAT to increase insulin sensitivity but also decreases glucose production in liver.

3.  Doesn't cause hypoglycemia and favorable lipid effects (other drug could cause heart attack!)

4.  Edema and fluid retention, weight gain, heart failure, and osteopenia in old women.

Term

Sulfonylureas Class

 

 

1.  Generic Name (brand)

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Glipizide (Glucotrol)

2.  Act on pancreas to stimulate insulin

3.  Dosed once a day

4.  Chance of hypoglycemia

Term

Glinides Class

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Repaglinide (Prandin)

2.  Works directly on pancreas to secrete insulin

3.  Taking 3 times a day with meals (reduces chances of hypoglycemia with skipped meals)

4.  Chance of hypoglycemia

-weight gain

Term

Alpha-Glucosidase Inhibitors

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Acarbose (precose)

2.  Alpha-glucosidase is inhibited in the small intestine causing delay of carbohydrate absorption.

3. 

4.  Gastrointestinal Issues (farts and rrhea)

-Not go-to medication...tough on patient

-Don't take oral sucrose! AGI stops sucrose to glucose hydrolysis

Term

Incretin Mimetic Class

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Exenatide (Byetta)

2.  GLP-1 (Glucagon Like Peptide) stimulates pancreas to release insulin (only in hyperglycemic state)

3.  Weight loss!

4.  Nausea, hypoglycemia, and warning to impaired renal function.  Slows extent and rate of absorption of other meds...wait an hour before taking other drugs.

Term

Dipeptidyl Peptidase IV (DDP-4) Inhibitor

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Sitagliptin (Januvia)

2.  Inhibits DDP-4 which normally breaks down

GLP-1, the glucagon like peptide that stimulates insulin release

3.  No hypoglycemia and limited drug interactions

4.  Hypersensitivity Reaction

Term

Amylinomimetic Class

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Pramlintide (symlin)

2.   Mimics amylin by inhibiting carbohydrate absorption and glucose release by the GI tract

3.  Weight loss

4.  Hypoglycemia, nausea, vomiting

-same drug interactions as exenatide

Term

Colesevelam

 

 

1.  Generic Name?

2. MOA

3.  Advantages

4.  Adverse Effects

Definition

1.  Colesevelam (Wechol)

2.  Unknown (sequesters bile acid)

3.  No Hypoglycemia, Favorable lipid action

4.  Constipation, DRUG INTERACTIONS

-have to take other drugs 4hrs beforehand

Term
Name the four fast acting insulins
Definition

1. Lispro (Humalog)

2.  Aspart (Novolog)

3.  Inhaled (Exubera)

4.  Glulisine (Apidra)

 

They all peak at 30-90 minutes except aspart which is 1-3 hours

Term
Name the short acting insulin
Definition
Regular (peaks at 2-4 hours)
Term
Name the intermediate acting insulin
Definition

NPH (peak at 4-10 hours)

Detemir (levemir) (peak at 6-8 hours)

Term
Name the long acting insulin and its peak
Definition

Glargine (lantus)

 

Peakless

Term
Which drugs are known to have drug interactions?
Definition

1.  Incretin Memetic (Exenatide)

2.  Amylinomimetic (Pramlinitide)

3.  Colesvalem.

 

Pretty much any of the mimetics or that mess with digestion and nutrient absorption.

Term
What drugs are known to have the potential for hypoglycemia?
Definition

1.  Sulfonylureas (Glucotrol)

2.  Glinides (Repaglinide)

3.  Amylinomimetic (Pramlintide)

 4.  Incretin Mimetic

5.  Alpha glucosidase inhibitors (Acarbose)

(USE DEXTROSE TO TREAT HYPOGLYCEMIA)

Term
Which drugs DON'T cause hypoglycemia?
Definition

TZD's (Pioglitazone)

Dipeptidyl Peptidase IV Inhibitor (Sitagliptin)

Biguanides (Metformin)

Term
What is the drug of choice for T2DM?
Definition
Biguanides (Metformin)
Term

What drugs stimulate insulin release from the pancreas?

Definition

Sulfonylureas (Glipizide, Glucotrol)

Glinides (Repaglinide)

 

Term
What drugs increase insulin sensitivity in muscle and reduce glucose output from liver?
Definition

Biguanides (Metformin)

TZD's (Piaglitizone)

Term
What drug prevents the rapid degradation of Glucagon Like Protein?
Definition
DDP-4 Inhibitor (Sitagliptin, Januvia)
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