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22 Cards in this Set
- Front
- Back
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metformin
mech action adv |
mech- activates AMP kinase
Act- dec. liver glucose making + intestinal absorpt inc. insulin action adv- no hypoglycemia, weight gain disadv- lactic acidosis GI issues |
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sulfonureas
mech action adv disadv |
mech- close K-ATP channels on B cell
act- incr. insulin secretion adv- well tolerated disadv- hypoglycemia, weight gain |
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meglinitides
drugs mech action adv disadv |
repaglinide
nateglinide mech- closes K-atp B cell act- incre. insulin secretion adv- accents effex around meal time disadv- hypoglyc, weight gain |
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thiazolidinediones
(glitazones) mech action disadv/adv |
mech- activates PPAR-Y
act- incr insulin sensitivity adv- no hypoglycemia disadv- weight gain, bone fractures, HF, edema |
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alpha- glucosidase inhib
drugs mech action adv disadv |
acarbose
miglitol mech- inhib. intestinal alpha glucosidase action- slows down abs of carbohydrate digestion adv- dec postprandial glucose disadv- GI issues |
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GLP-1 receptor
incretin mimetics drugs? mech? action? adv/disadv |
exenatide
liraglutide mech-activates GLP on B cell act- inc insulin secretion, dec glucagon secretion, slows gastric emptying, incr. satiey adv-weight loss, improved Bcell fxn disadv- pancreatitis, injectable, |
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DPP-4 inhibitors
incretin enhancers drugs? mech? action? adv/disadv? |
sitagliptin
saxagliptin linagliptin inhibit Dpp, prolongs endogenous incretin act-incr. insulin sec. dec glucagon secretion adv-no hypoglycemia, weight neutral |
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criteria for diagnosis of diabetes
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A1C > OR = 6.5%
FPG >126 ( no intnake x 8H) 2H plasma gluc>200 during gluc. tolerance test-put 75g of glucose in water |
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when to test for diabetes in asymptomatic pts
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overweight or BM1>25% + 1 or > RF (inactive, weird chol. levels)
if no RF can test at age >45- if normal test q 3 years |
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ways to prevent type 2 DM
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if AIC 5.7-6.4- can do weight loss of 7%, walk 150min/wk
metformin tx in DM2 is ok (espically pts <60 n fat) |
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how often to do SMBG
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3 or more if on insulin
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how often to do A1c checks
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at least 2 times a yr in stable pts
quarterly if unstable |
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tx for type 2DM
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start metformin
consider mono insulin if unstablized add second agent to metformin if mono insulin doesnt work |
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immunizations recc
how often n which ones |
influenza annually once >6 months old
pneumococcal for >2 years old revaccinate if >64 yo and got vaccine when <64 hepB recc also |
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HTN goals for DM
ways to help HTN |
<130/<80
DASH diet dec. alcohol intake start ACEI |
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HTN goals for pregnant pts w/ DM
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110-130/ 65-79
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how often to measure lipid panel
whats goal |
annually
LDL <100 hdl> 50 TG <150 can repeat q 2 years |
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when to recc aspirin
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if increased CV risk of 10% over 10 years
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meds to tx CHD w DM
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ACEI + statin
BB- if post MI |
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ways to screen for nephropathy
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urine albumin excretion (UAE)
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BG range for critically ill
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start insulin at 180, goal is 140-180
require an IV insulin protocol |
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non critically ill BG goal
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if treated with insulin, premeal BG targets <!40
subcutaneous is preferred method |
