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diabetic meds/

mod 5 pharm

QuestionAnswer
What 5 hormones does the pancreas secrete? insulin islet amyloid polypeptide (amylin) glucagon somatostatin pancreatic peptide
What type of diabetes is insulin dependent? Type 1
What is the most common type of diabetes? Type 2
Gestational diabetes is what type of diabetes? Type 4
Name rapid acting insulin? Insulin lispro, Insulin aspart (Novolog, Humalog)
What is the onset of Novolog? rapid acting, 5-15 min duration 3-5 hrs
What is the onset of Regular insulin? 30 min. (duration 5-8 hrs)
What type of insulin is Novolin R? Short-acting (Regular insulin)
What combinations are found in 70/30? rapid or short acting combined with intermediate or long acting
What type of insulin is never mixed? Long acting (Lantus)
Hypoglycemia is most common with what type of insulin? Long acting
What is an intermediate insulin? NPH
What is the onset and durantion of Humulin N? Humulin N and Novolin N are intermediate insulin. onset 1-2 hrs, duration 4-12 hours
Name 2 long acting insulins? Lantus(insulin glargine), Levenir (insulin detemir)
What is the difference between Novolog, Novolin R, and Novolin N? Novolog is rapid acting Novolin R (Regular) is short acting Novolin N (NPH) is intermediate acting
Which insulin has the longest duration: Humalog, Humulin R, or Humulin N? Humulin N (NPH) intermediate acting insulin *but long acting insulin is insulin glargine (Lantus) or insulin detemir (Levemir)
Name 5 oral anti-diabetic categories. 1. insulin secretagogues 2. biguanides 3. thiazolidinediones 4. dipeptidyl-peptidase IV inhibitors (DDP-IV) 5. alpha-glucosidase inhibitors
Insulin secretagogues include what medications? sulfonylureas 1st and 2nd generation
What is the most common sulfonylurea used in the US? 2nd generation: glyburide, glipizide, glimepiride (less adverse reactions and drug interactions)
What is the pregnancy risk category of sulfonylureas? C
What is the generic name of Diabeta? glyburide
What is the brand name of Glucotrol? glipizide
What is the brand name of glimepiride? Amaryl
What two sulfonylureas SALAD? glyburide (Diabeta) and glipizide (Glucotrol)
Which sulfonylurea's max dose is 40mg? glipizide
What is the starting dose of glipizide? 5mg
What is the usual dose of glipizide? 10-15mg
What is the maximum dose of glyburide? 20mg (divided dose)
What is the starting dose of glyburide? 2.5 - 5 mg with breakfast
What are the adverse effects of glyburide? abd pain, diarrhea, N/V, heartburn (dose related)
What are adverse effects of glipizide? N/V, diarrhea (dose-related)
What are adverse effects of glimepiride? dizziness, headache, N/V
What is the starting dose of glimepiride? 1-2mg once daily
What is the max dose of glimepiride? 8mg once daily
What is the mechanism of action of sulfonylureas? increase insulin secretion from pancreas
What is the mechanism of action of biguanides? -stimulate glycolysis, with increased removal of glucose from blood -reduce hepatic and renal gluconeogenesis -slows glucose absorption from GI -reduces plasma glucagon
What is the name brand of metformin? Glucophage
Metformin is what class of medication? biguanide anti-diabetic medication
What is the advantage of using a biguanide over a sulfonylurea? the risk of hypoglycemia
What is the starting dose of metformin? 500mg BID
What is the max dose of metformin? 2500mg (over 2000mg, divide into 3 doses)
What is the pregnancy risk class of metformin? B
What are common adverse reactions to metformin? anorexia, N/V, abd discomfort, dyspepsia, flatulence, diarrhea, metallic taste
What can reduce the GI side effects of metformin? take with meals
What is the mechanism of action of thiazolidinediones? -enhance insulin sensitivity in adipose tissue, skeletal muscles and liver -decrease hepatic glucose output and improve lipid profile preserve beta cell function
What type of patient should thiazolidinediones be used cautiously? heart failure due to increase of edema/heart failure
What class of medication are pioglitazone and rosiglitazone? thiazolidinediones
What is the brand name of pioglitazone? Actos
What is the brand name of rosiglitazone? Avandia
What is the initial dose of pioglitazone? 15-30mg daily
What is the maximum dose of pioglitazone? 45mg
What is the pregnancy risk category of thiazolidinediones? C
What is the initial dose of rosiglitazone? 4mg daily
What is the maximum dose of rosigliazone? 8mg divided dose
What are the adverse effects of pioglitazone? myalgia, pharyngitis, h/a, edema ?hyperglycemia
What are the adverse effects of rosiglitazone? edema,back pain, diarrhea, fatigue, h/a, sinusitis, ?hyperglycemia
What is DDP-IV? Dipeptidyl peptidase-IV Inhibitor
What is the mechanism of action of DDP-IV? -increase insulin release -decrease glucagon in circulation -slowing inactivation of incretin hormone (GLP-1) -slows glucose release after meals
What is an DDP-IV? sitagliptin (Januvia)
What is the brand name of sitagliptin? Januvia
What is the dosage of sitagliptin? 100mg
Can sitagliptin be given with sulfonylureas? Yes, but may need to decrease dose of sulfonylurea to avoid hypoglycemia
What are adverse effects of sitagliptin? nasopharyngitis, URI, h/a
Discuss alpha-glucosidase inhitors. -acarbose, miglitol -starch blocker: slows digestion of complex carbohydrates -25-300mg with meals -pregnancy risk B -SE:bloating, nausea, diarrhea, excess gas, abd pain
What medication is an incretin mimetic:GLP-1? exenatide (Byetta)
Exenatide should be given with what other medications? adjunct with metformin, sulfonylureas, or combo of metformin/sulfonulureas NOT given with insulin
How is exenatide administered? sub-cut injection (pre-filled syringes) BID within 60 min before morning and evening meals
What is the pregnancy risk category of exenatide? C
What is the most common adverse effect of exenatide? hypoglycemia (especially with sulfonylurea)
What drug interaction is most important with all anti-diabetic medications? Beta blockers mask symptoms of hypoglycemia (rapid HR, sweaty palms)
What post-market reports have occured with exenatide? acute pancreatitis
What is the max dose of exenatide? 10mg BID
Created by: Tabble
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