Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
47 Cards in this Set
- Front
- Back
|
Acarbose (Prescose) Dosing
|
Max: 100 mg with each meal CrCl < 25 mL/min or Scr > 2: avoid |
|
|
Miglitol (Glyset) Dosing
|
Max: 100 mg with each meal CrCl < 25 mL/min or Scr > 2: avoid |
|
|
Metformin (Glucophage) Dosing
|
Max: 2000 -- 2550 daily (with meals) Scr > 1.4 (F) or > 1.5 (M) or severe hepatic impairment: avoid |
|
|
Pioglitazone (Actos) Dosing
|
Max: 45 mg daily Avoid if LFTs > 3x ULN |
|
|
Repaglinide (Prandin) Dosing
|
Initial: 0.5 mg before meals Max: 16 mg daily Caution severe renal/hepatic impairment |
|
|
Nateglinide (Starlix) Dosing
|
No titration Caution in severe renal/hepatic impairment |
|
|
Glipizide (Glucotrol) Dosing
|
Max: 40 mg daily (20 mg daily) CrCl < 50%: decrease dose by 50% |
|
|
Glyburide (Diabeta) Dosing
|
Max: 20 mg daily Avoid if CrCl < 50% |
|
|
Glimeperide (Amaryl) Dosing
|
Max: 8 mg daily Avoid if CrCl < 30 ml/min |
|
|
Sitagliptin (Januvia) Dosing |
Max: 100 mg daily CrCl < 50: 50 mg daily CrCl < 30: 25 mg daily Can use with HD |
|
|
Saxagliptin (Onglyza) Dosing
|
Max: 5 mg once daily CrCl < 50: 2.5 mg once daily |
|
|
Linagliptin (Tradjenta) Dosing
|
Initial: 5 mg once daily Max: 5 mg once daily No renal dose adjustment |
|
|
Aloglitpin (Nesina) Dosing |
Max: 25 once daily CrCl < 60: 12.5 mg daily CrCl < 30: 6.25 mg daily |
|
|
Exenatide (Byetta) Dosing
|
Initial: 5 mcg SQ BID Max: 10 mcg SQ BID Avoid if CrCl < 30 |
|
|
Exenatide (Bydureon) Dosing
|
Avoid if CrCl < 30 |
|
|
Liraglutide (Victoza) Dosing |
Max: 1.8 mg daily No renal dose adjustment recommended (caution: limited experience) |
|
|
Alogliptin (Tanzeum) Dosing |
Max: 50 mcg once weekly No renal dose adjustment recommended |
|
|
Canagliflozin (Invokana) Dosing
|
Initial: 100 mg once daily Max: 300 mg once daily Avoid if eGFR < 45 (max: 100 from 45-60) |
|
|
Dapagliflozin (Farxiga) Dosing |
Max: 10 mg once daily Avoid if eGFR < 60 |
|
|
Empagliflozin (Jardiance) Dosing
|
Initial: 10 mg once daily Max: 25 mg once daily Avoid if eGFR < 30 |
|
|
Pramlintide (Symlin) Dosing
|
Max: 120 mcg SQ with meals No renal dose recommended |
|
|
Alpha glucosidase inhibitor A1C reduction
|
0.6 % |
|
|
Metformin A1C reduction |
1.5-2 % |
|
|
SU A1C reduction
|
1.5-2% in drug naiive (loss of efficacy after 6 months) |
|
|
Glitinide A1C reduction
|
0.8% |
|
|
TZD A1C reduction
|
1-1.5% |
|
|
DPP4 inhibitor A1C reduction
|
0.7-1% |
|
|
GLP1 agonist A1C reduction
|
Efficacy sustained for ~3 years Depends on BL value 2nd agent needed if high FBP |
|
|
SGLT2 inhibitor A1C reduction
|
1% |
|
|
Amylin A1C reduction |
0.6% |
|
|
GLP1 Agonist glycemic effects
|
Prandial Need 2nd agent for high FBG Low hypoglycemia risk (glucose-dependent action) as monotherapy |
|
|
SU glycemic effects
|
Prandial/FBG Hypoglycemia common (1/2 lives of agents relate to risk) Greater in elderly, liver, renal |
|
|
Glitinide glycemic effects
|
Skip meal, skip dose Glucose-sensitive: hypoglycemia risk (less than SU) DO NOT USE with SU |
|
|
Metformin glycemic effects
|
No hypoglycemia May also decrease TG, LDL, and increase HDL |
|
|
TZD glycemic effects
|
May take 3-4 months to see these effects Possible decrease in TG 10-20% |
|
|
a-glucosidase inhibitor glycemic effects
|
Only modest effects on glycemic control May be good for patients near A1C target and good fastings but high PP levels |
|
|
DPP4 glycemic effects
|
FBG (block 100% of DPP4 enzymes for ~ 12hours) No effect on gastric emptying or satiety like GLP1 No increased hypoglycemia as monotherapy Weight neutral |
|
|
SGLT2 inhibitor glycemic effects
|
Can lead to reductions in weight, BG, and BP |
|
|
GLP agonist PK
|
Bydureon takes 6-7 weeks to achieve SS Renal failure: progressive increase in 1/2 life and increased S/E |
|
|
GLP-1 Agonists: Warnings
|
Avoid if patient has gastroparesis (delayed gastric empyting) |
|
|
Sulfonylurea PK
|
Glyburide 1/2 life: 10 hrs Glimeperide 1/2 life: 5 hours Glipizide 1/2 life: 2 hours |
|
|
Glitinide PK
|
Provides increased insulin secretion during meals for patients close to glycemic goal |
|
|
Metformin PK
|
Weight reduction of 2-3 kg |
|
|
TZDs PK
|
No renal dose adjustment Antiglycemic effect over 24 hours |
|
|
a-glucosidase inhibitor PK
|
May be most useful for patients with near-target A1C and FBG but high PP levels |
|
|
DPP4 Inhibitors PK
|
Dose reductions for safety issues: only 100% of enzyme can ever be inhibited |
|
|
SGLT2 inhibitor PK
|
1/2 life of 13 hours |
