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26 Cards in this Set
- Front
- Back
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Goal of therapy
1) Pre-prandil: 2) Post-prandial 3) LDL |
1) Pre-prandial 90-130
2) Post prandial <180 3) LDL<100 (or <70 for HX with VAD) |
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Insulin mixtures
(70/30, 75/25), the larger number is ... |
Longer acting insulin
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Why we don't mix Lantus with other insulins?
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Because Lantus pH=4., once injected, the insulin precipitates at physiologic pH forming a depot that releases insulin slowly over 24 hours
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You can give regular insulin in....
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1) SC
2) IV 3) IM |
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Which insulin is used in the insulin pump?
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Velosulin
(Give bolus 30 minutes before meals) |
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Type I or Type II DM need higher doses insulin?
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Type II (0.7-1.5 U/kg, compare to 0.5-0.8 U/kg)
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Symlin (pramlintide acetate)
1) for Type I or Type II 2) synthetic analog of ? Used within 28 days |
1) Both Type I and Type II
Type I (15 mcg SC before meals) Type II (60-120 mcg SC before meals) 2) human amylin |
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What are the cautions before prescribing Amylin?
1) 2) 3) 4) 5) |
1) A1C >9%
2) gastroparesis 3) on GI motility medications 4) alpa-glucosidase inhibitors 5) Hypersensitivity to the metacresol presservative |
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Storage insulins
1) Levemir --> 2) Byetta--> 3) Vials --> 4) Symlin--> 5) NPH/NovoLog MIx 6) Humalog mixes/Humulin 70/30 |
1) Levemir --> 42 days (6 weeks)
2) Byetta--> 3) Vials --> 4) Symlin--> 5) NPH/NovoLog MIx 6) Humalog mixes/Humulin 70/30 |
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Opticlick
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do not fridge
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Dawn phenomenon
--> Normal effects --> high glucose between 4 am - 8 am --> check glucose at 3 am --> 60 mg/dL< or > 60 mg/dL? |
> 60 mg/dL
(if < 60 mg/d is somogyi effects) |
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drugs stimulate insulin release can cause....
1) 2) |
1) weight gain
2) hypoglycemia EX: 1) sulfonylureas 2) Meglitinides |
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Which 2nd generation of sulfonylureas is ok to use in renal patients?
Sulfonylureas take 30 minutes before meals |
Amaryl (glimepiride)
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Glyburide (Diabeta, glynase)
1) 2) 3) 4) |
1) 2nd gene sulfonylureas
2) Preg Cat B 3) do not use in renal failure 4) max: 20 mg/day fpr glyburied, or glynase 12 mg/day |
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MOA of metformin
1) 2) |
1) Inhibits hepatic glucose production
2) Enhanced insulin mediated glucose uptake |
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Max dose of metformin
1) Glucophage 2) Glucophage XR 3) Fortamet ER 4) Glumetza ER |
1) 2550 mg/day
2) 2000 mg/day 3) 2500 mg/day 4) 2000 mg/day |
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GlucoVANCE
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Glyburide/metformin
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Who should not take metformin (higher risk in lactic acidosis)?
1) 2) 3) 4) 5) 6) |
1) renal disease (Cr>1.5 for male; >1.4 for female)
2) liver disease 3) COPD 4) CHF 5) elderly with illness 6) Pt is undergoing CAT scan |
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BBW on Avandia
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1. Possible heart failure
(Rosiglitazone) |
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Why do not combine TZD (actos, or avandia) with
1) Nitrates? 2) insulin? |
1) TZD + Nitrates--> higher risk CVD events
2) TZD + insulin --> increase risk of edema and heart failure |
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MOA of TZD (actos, avandia)?
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Increased skeletal muscle cells sensitive to insulin (Insulin sensitizers)
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Which classes, if patients skips meals, they should skip meals?
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1. alpha-glucosidase inhibitors
2. Meglitinides |
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What is the MOA of meglitinides?
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Stimulate insulin release
1) hypoglycemia 2) weight gain |
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What class of Januvia and Galvus?
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Gliptins
(sitagliptin and vildagliptin) 1. Increased the activity of incretins by inhibiting DPP-4 |
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1) Janumet
2) Side effect of Januvia? |
1) Januvia + metformin
2) upper respiratory tract infections, HA, abdomonial pain |
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1) What is MOA of Byettea?
2) dose? 3) AE? 4) warning? a. b. hypoglycemic if taking with sulfonylureas |
1) Mimic incretin activity
2) 5-10 mcgSC BID 60 minutes before meals 3) Nausea, constipatin (Slow GI motility), and rash at injection site 4) acute pancreatitis (report any unexplained abdominal pain with or without nausea and vomiting); |
