Term
| Primary MOA: increases/replaces insulin secretion |
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Definition
| insulin, SUs, meglitinides |
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Term
| Primary MOA: decreases heaptic glucose output |
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Definition
|
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Term
| Primary MOA: decreases glucagon, which decreases glucose production |
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Definition
| GLP-1, DPP-4, pramlintide |
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Term
| Primary MOA: slows gastric emptying, which increases satiety |
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Definition
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Term
| Primary MOA: Increases glucose excretion |
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Definition
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Term
| Primary MOA: Increases insulin sensitivity |
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Definition
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Term
|
Definition
| Immunne destruction of beta cells --> No insulin production --> No muscle uptake of glycogen --> Fat production --> Keytone production --> DKA |
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Term
|
Definition
| Damged beta cells --> Decreased insulin production |
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Term
| Describe HYPERglycemia symptoms |
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Definition
3 polys (polyuria, polydypsia, polyphagia)
blurry vision
fautigue
unexplained weight loss |
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Term
| Describe HYPOglycemia symptoms |
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Definition
| Shaky, Irritable, HA, Hunger, Confusion, Weak, Sleepy, Dizzy, Sweaty, Tachcardia |
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Term
|
Definition
FPG: 100-125
2Hr Plasma Glucose after 75mg OGTT: 140-199
A1C: 5.7-6.4 |
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Term
|
Definition
FPG: ≥ 126
2Hr Plasma Glucose after 75mg OGTT: ≥ 200
A1C: ≥ 6.5 |
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Term
|
Definition
A1C: < 7%
preprandial glucose: 80-130
postprandial glucose: < 180 |
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
| SCr: 1.5 males | 1.4 females |
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Term
|
Definition
| 2000-2550 depending on the dosing form |
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Term
| Metformin causes ____ deficency. |
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Definition
|
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Term
|
Definition
GI upset; less with ER; will improve with time
Ghost tablet in stool with ER
Stop before/after contrast dye (48h) |
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Term
| Does metformin have hypoglycemia risk? |
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Definition
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Term
| Meglitinides brand/generic (2 drugs) |
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Definition
repaglinide (Prandin)
nateglinide (Stralix) |
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Term
| Take meglitinides __________ |
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Definition
| 30 min before meals (like insulin) |
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Term
| Solfnyureas: brand/generic (3 drugs) |
|
Definition
glipizide (Glucotrol)
glimepiride (Amaryl)
glyburide (Glynase) |
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Term
|
Definition
Take @ breakfast
Take glipizide (Glucotrol IR) before meals
Sulfa-based
2C9 substrates |
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Term
| Thiazolidinedones: brand/generic |
|
Definition
pioglitazone (Actos)
rosiglitazone (Avandia) |
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Term
| Thiazolidinedones: pearls |
|
Definition
TZDs are 2C8 substrates (rifampin/gemfibrozil)
S/E: edema, weight gain
Cause: liver fail, bone density loss, HF |
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Term
| Sodium Glucose Co Transporter (SGLT2): brand/generic (3 drugs) |
|
Definition
canagliflozin (Invokana)
dapagliflozin (Farxiga)
empagliflozin (Jardiance) |
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|
Term
| Sodium Glucose Co Transporter (SGLT2): pearls |
|
Definition
Similar action to diurectics
SGLT2s are flozin the sugar out!
Glucose excretion --> UTIs + yeast infections
Leg/foot amputations |
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Term
| Glucagon like peptide 1 agonist: brand/generic (5 drugs) |
|
Definition
exantide (Byetta/Bydureon)
liraglutide (Victoza)
dulaglutide (Trulicity)
albiglutide (Tanzeum)
Lixisenatide (Adlyxin) |
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|
Term
| Pramlintide brand/generic |
|
Definition
|
|
Term
|
Definition
DI due to MOA (slowing gastric emptying): Antibiotics / Contraception
S/E: N/V/D, HA, (decreases over time)
SQ inj
Stomach pain = pancrease problem = STOP
Not for folks with self/fam thyroid cancer |
|
|
Term
| Exantide (Byetta): pearls |
|
Definition
BID; AM/PM before meals
60 doses per pen = 30days |
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Term
| Exantide (Bydureon): pearls |
|
Definition
| Inject immediately after mixing powder/liquid |
|
|
Term
| Liraglutide (Victoza): pearls |
|
Definition
|
|
Term
| Bydureon, Trulicity, Tanzeum dosing interval? |
|
Definition
|
|
Term
|
Definition
Separate from insulin by 3hrs
Decrease insulin meal time dosing by 50% to prevent hypoglycemia |
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Term
| DDP4 inhibitors brand/generic (4 drugs) |
|
Definition
Sitagliptin (Januvia)
Saxagliptin (Onglyza)
Linagliptin (Tradjenta)
Alogliptin (Nesina) |
|
|
Term
|
Definition
DDP4s are glucagon-free gliptin tea
linagliptin + saxagliptin are 3A4 and Pgp substrates
Qday dosing - Food does not matter
Stomach pain = pancrease problem = STOP
Saxagliptin + algogliptin --> HF; trouble breathing = STOP |
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Term
| Rapid acting insulin: brand/generic (4 drugs) |
|
Definition
Aspart (Novolog)
Glusine (Apidra, Solostar)
Lispro (Humalog) **kwikpen = 200u/mL
Afrezza ***inhaled |
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Term
| Regular insulin: brand/generic (2 drugs) |
|
Definition
Humlin R,
Humlin R U-500 *500u/mL
Novolin R |
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Term
| Intermediate "basal" insulin: brand/generic (2 drugs) |
|
Definition
| NPH (Humlin N, Novolin N) |
|
|
Term
| long-acting "basal" insulin: brand/generic (3 drugs) |
|
Definition
Detemir (Levimir)
Glargine (Lantus, Basaglar, Toujeo)
Degludec (Tresiba) |
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Term
| Mixed insulin: brand/generic (4 drugs) |
|
Definition
Novolog Mix 70/30 = 70% protamine, 30% aspart
Novolin Mix 70/30 = 70% NPH, 30% Humlin
Humalog Mix 75/25 =75% protamine, 25% lispro
Humalog Mix 50/50 =50% protamine, 50% lispro |
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|
Term
| Most insulin product are ___units/mL. What are 4 exceptions? |
|
Definition
most products = 100u/mL
Humalog kwikpen = 200u/mL
Humulin R U-500 = 500u/mL
Tresiba = 200u/mL
Toujeo Solostar = 300u/mL |
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|
Term
| Most insulin pens are ___mL, with one exception _________ . |
|
Definition
Most pens are 3mL
Toujeo = 1.5mL |
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Term
| Most insulin pens have _____ unit increments, with two exceptions _____________, _____________ . |
|
Definition
Most pens; 1 increment = 1 unit
Humulin R u-500; 1 increment = 5 units
Tresiba Flextouch; 1 increment =2 units |
|
|
Term
| What types of insulin is used in insulin pumps? |
|
Definition
|
|
Term
| When converting between insulin brands reduce dosage by |
|
Definition
|
|
Term
| How to dose insulin? (3 steps) |
|
Definition
1. 0.6u/kg/day = Total Daily Dose (TDD)
2. Divide TDD by 2 to determine Total basal dose and total bolus dose
3. Further divide total bolus dose by 3 to determine meal-time dosing |
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Term
| Describe the rule of 450 and 500 |
|
Definition
Determines the insulin to carb ratio.
500/TDD = g of carb covered by 1U of rapid acting insulin
450/TDD = g of carb covered by 1U or regular insulin |
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|
Term
| Describe the rule of 1800 and 1500 |
|
Definition
1800/TDD = corr. factor for rapid acting insulin
1500/TDD = corr. factor for regular insulin
(BG Now - Target BG)/corr. factor = corr. dose |
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Term
| When mixing insulin which type is drawn up first? |
|
Definition
1rst Clear (regular)
2nd Cloudy (NPH)
****These are the ONLY types of insulin that can be mixed**** |
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Term
|
Definition
BG ≤ 70.
TX with 15-20g SIMPLE carbs repeat Q15min PRN |
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|
Term
| Drugs that cause hypoglycemia |
|
Definition
linezolid
lorcaserin (Belviq)
Octreotide
pentamidine
Propanolol
Quinine
Quinolones |
|
|
Term
| Drugs that cause hyperglycemia |
|
Definition
B blockers
diuretics
immunosuppressents
naicin
Pis
Quinolones
2nd gen AP
Statins
Steroids
Azole AF |
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