Diabetes Mellitus

Front 1

Brand name for glipizide

Back 1

Glucotrol

Front 2

Brand name for glimiperide

Back 2

Amaryl

Front 3

Brand name for glyburide

Back 3

Diabeta

Front 4

Sulfonylurea that is preferred with kidney dysfunction

Back 4

Glipizide (Glucotrol)

Front 5

Sulfonylurea indicated for use with insulin

Back 5

Glimiperide (Amaryl)

Front 6

What are the insulin secretagogues?

Back 6

Sulfonylureas, Repaglinide, Nateglinide

Front 7

Sulfonylureas and Repaglinide decrease A1C by how much?

Back 7

1 - 2%

Front 8

Nateglinide decreases A1C by how much?

Back 8

0.5 - 1%

Front 9

Side effects of secretagogues

Back 9

Weight gain, nausea vomiting, rare sulfa allergy

Front 10

Can secretagogues cause hypoglycemia?

Back 10

Yes

Front 11

What organ metabolizes 1st generation sulfonylureas?

Back 11

Liver (LFTs are recommended)

Front 12

Brand name for repaglinide?

Back 12

Prandin

Front 13

When should repaglinide and nateglinide be taken?

Back 13

15-30 mins before meal (skip dose if meal is skipped)

Front 14

Main drug interaction for repaglinide

Back 14

Not be taken with Gemfibrozil

Front 15

Brand name for nateglinide

Back 15

Starlix

Front 16

Duration of action of nateglinide

Back 16

Only 2 hours

Front 17

What should be monitored during nateglinide therapy?

Back 17

Liver function tests (use with caution in hepatic disease)

Front 18

Site of action of secretagogues

Back 18

Pancreatic B-cells (increase secretion of insulin)

Front 19

What is a drug in the biguanide class?

Back 19

Metformin (Glucophage)

Front 20

What is the brand name for metformin?

Back 20

Glucophage

Front 21

Site of action of Biguanides

Back 21

Liver
MOA: Decreases hepatic glucose production
Drug: metformin

Front 22

Metformin decreases A1C by how much?

Back 22

1 - 2%

Front 23

Common side effects of metformin

Back 23

Nausea and vomiting

Front 24

Does metformin cause weight loss, weight gain, or weight neutral

Back 24

Weight loss to weight neutral

Front 25

Does metformin cause hypoglycemia

Back 25

No

Front 26

Contraindicated serum creatinine values for metformin

Back 26

Males: SCr > or equal to 1.5 mg/dL
Females: SCr > or equal to 1.4mg/dL

Front 27

When should metformin be taken?

Back 27

With meals

Front 28

Starting metformin dose

Back 28

500 mg BID
- Increase by 500mg every 1-3 weeks

Front 29

1) What is the most effective dose of metformin?
2) What is the max dose of metformin?

Back 29

1) 2000mg/day
2) 2550mg/day

Front 30

Absolute contraindications for metformin

Back 30

-Frequent alcohol use, liver or kidney disease, CHF
-these can all increase risk of lactic acidosis

Front 31

Drug that should be discontinued for 48 hours after radiocontrast dye procedures

Back 31

Metformin

Front 32

MOA of TZDs

Back 32

Enhance tissue response to insulin / decreases tissue resistance to insulin

Front 33

TZDs decrease A1Cs by how much

Back 33

0.9-1.6%

Front 34

TZDs - weight gain, weight neutral or weight loss?

Back 34

Weight gain (dose related) + edema (dose related)

Front 35

Main risk with rosiglitazone

Back 35

Increased cardiovascular morbidity

Front 36

Brand name of pioglitazone

Back 36

Actos

Front 37

Brand name of rosiglitazone

Back 37

Avandia

Front 38

This class of drugs has added benefit of increasing HDL

Back 38

TZDs

Front 39

What tests should be performed on patient before starting TZDs?

Back 39

-Liver function tests
-If patient is above 2.5 times the upper limit of normal, TZDs should be avoided
-If patient is above 3 times the upper limit, drug should be discontinued

Front 40

What drugs are contraindicated in class III and class IV heart failure

Back 40

TZDs (Avandia and Actos)