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20 Cards in this Set

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What is the first-line therapy for type 2 DM?

Metformin

What are the adverse effects of metformin?

GI upset


Lactic acidosis


CI in pts with renal insufficiency

Why is metformin CI in patients with renal insufficiency?

It is metabolized by the kidneys

What is the MoA of sulfonylureas?

Close K+ channels in beta-cell membrane to trigger insulin release




(Requires islet function)



What is the difference between first and second generation sulfonylureas?

First gen: disulfuram-like effects


Second gen: Hypoglycemia

Name 2 first generation sulfonylureas

Chlorpropamide


Tolbutamide

Name 3 second generation sulfonylureas

Glimepiride


Glipizide


Glyburide

What is the MoA for thiazolidinediones?

Increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription regulator

What are the adverse effects of thiazolidinediones?

Weight gain


Edema


Hepatotoxicity


Increased risk of fractures


CI in pts with HF

What is the MoA for meglitinides?

Stimulates postprandial insulin release by binding to K+ channels (different site from sulfonylureas)

Name 2 GLP-1 analogs

Exenatide


Liraglutide

What is the MoA of GLP-1 analogs?

Increases glucose-dependent insulin release


Decreases glucagon release


Decreases gastric emptying


Increases satiety

What are the adverse effects of GLP-1 analogs?

N+V


Pancreatitis


Modest weight loss

What is the MoA of DPP-4 inhibitors?

Inhibits DPP-4 enzyme that deactivates GLP-1

What are the adverse effects of DPP-4 inhibitors

Mild urinary or respiratory infections

What is the suffix associated with sodium-glucose cotransporter 2 (SGLT-2) inhibitors?

-agliflozin

What is the MoA of SGLT-2 inhibitors

Blocks reabsorption of glucose in PCT

What are the adverse effects of SGLT-2 inhibitors?

Glucosuria --> UTIs, vaginal yeast infections


Hyperkalemia


Dehydration (orthostatic hypoTN)

Name 2 alpha-glucosidase inhibitors

Acarbose


Miglitol

What is the MoA of alpha-glucosidase inhibitors?

Inhibit intestinal brush-border alpha-glucosidases