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Winter Diabetes meds
Oral and Subcut Diabetic drugs
Question | Answer |
---|---|
Catagory: Sulfonylureas ex: glypizide (Glucotrol) | -Simulates insulin release & cellular sensitivity to insulin & binding. -Used alone or in combo drugs.-Metabolized in the liver, peed and pooped out.- hypogly especially w/ beer & exercise. disulfiram(hangover effect) Onset 15-30,works up to 24 hrs. |
Catagory: Incretion enhancer ex: sitagliptin (Januvia) | Newest drug!Stops enzyme that breaks down incretions.like dipeptidyl peptidase 4 (DPP-IV). Metabolized in liver &peed out.May cause headache,diarrhea &resp infect. Increases digoxin levels.bad for Renal failure.Onset 30-60min Peak 1-4 hrs Duration 24 hrs. |
Catagory: Alpha-gludosidase inhibitors ex: acarbose (Precose) | Can be use solo or with sulfonylurea, metformin or insulin.lowers glucose by interfering with carb absorption from GI.Acts in GI to stop enzyme that breaks carbs.Diarrhea,farts, distention,borborygmi(loud stomach), anemia,Hypogly. Onset 1hr, Dur2-4 hrs |
Catagory: Thiazolinides ex: rosiglitazone (Avandia) | restricted for MI.lowers hepatic glucose. up cellular sensitivity.Metabolized by liver, peed out.Risk of Edema and macular edema.Don't give to CHF, liver probs, preg.May up lipid levels.Need base test for liver function. Onset&Peak 1 hr Duration 24hr |
Catagory: Biguanides ex: metformin (Glucophage) | lowers hepatic glucose. up cellular uptake. lowers lipids & promotes weight loss. Ages 10+. N&V, metallic taste, headache, dizzy&tired, LACTIC ACIDOSIS, renal failure.Will not cause hypoglycemia. don't 2 days before or after IV Radiographic contrast test. |
Catagory: Meglitinides ex: repaglinide (Prandin) | Stimulates insulin release from beta cells.Decreases postprandial glucose rise &Hemoglobin A1C.Doesn't effect fasting CBG.Metabolized by liver,no liver,so can be given to renal failure peps.Onset 15-30 mins Peak 1 hr, Duration 4 hrs.Hypogly risk |
isophane (NPH) | Most common Intermediate acting Onset 1-2 hrs Peek 6-12 hrs Cloudy, Roll gently to mix. |
insulin glargine (Lantus) | Long acting for types 1 & 2 onset 1 hr evenly distributed thru 24 hrs no peak |
Regular (Humalin R) | Short acting.30 mins pre-meal cell uptake of glucose, amino acids and K. up protein synthesis, glycogen formation & "triglycerides" storeage. Used as 1therapy for type1 & preg. Used with combo drugs w type2. can be in IV. 100-500u. lipodystrophy bump&ind |
Human insulin (Novalog) | Fast acting. Give when meal is in room. Onset: 5-15 mins Peak: 30-60 mins |
lispro (Humalog) | Fast acting. Give when meal is in room. Onset: 5-15 mins Peak: 30-60 mins Duration: 3-4 hrs |
glucagon (Glucagen) | Emergency use for severe hypoglycemia for unconscious or not swallowing. Increases glycogenolysis for liver stores. After giving, supplement with oral carbs. |
insulin detmir (Levemir) | Long acting Peaks 6-8 hrs Duration 12-24 hrs |