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19 Cards in this Set
- Front
- Back
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Sulfonylureas | 2nd Generation |
Glyburide ( Diabeta, Micronase, Glynis’s PresTab) Glipizide (Glucotrol, Glucotrol XL) Glimepiride (Amaryl) |
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Sulfonylureas |
Glyburide, Glipizide, Glimepiride MOA- increase secretion of preformed insulin from beta cells of the pancreas by closing K channels 2ndary- increases insulin receptor sensitivity and decreased hepatic glucose output |
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Sulfonylureas Adverse Effects |
Glipizide, Glimepiride, Glyburide
Hypoglycemia -> most common Dermatologic réactions: rash, photosensitivity, hypersensitivity GI - NV , abnormal liver function tests WEIGHT GAIN |
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Sulfonylureas |
Glyburide, Glimepiride, Glipizide Metabolism and Excretion Hepatically Metabolized -use with caution and at reduced doses in patients with hepatic impairment Rénal Excretion - May accumulate in patients with CrCl <30mL/min |
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Biguanides |
Metformin | Glucophage |
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Biguanides Contraindications |
eGFR <30 mL/min Rénal impairment Liver - May decrease the ability to eliminate lactic acid Hypoxic state- acute or chronic alcohol abuse, elderly, CHF |
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Biguanides |
No hypoglycemia Weight loss Decrease triglycerides NVD |
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Biguanides |
No hypoglycemia Weight loss Decrease triglycerides NVD -> metallic taste |
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TZD |
Rosiglitazone & Pioglitazone Hepatoxicity and Edema Fracture risk - caution w/ women with pre existing osteoporosis Bladder CA - caution against active bladder CA and caution in patients with history |
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TZD |
Rosiglitazone & Pioglitazone Hepatoxicity and Edema Fracture risk - caution w/ women with pre existing osteoporosis Bladder CA - caution against active bladder CA and caution in patients with history |
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TZD |
Rosi, Pio Exacerbate CHF Exacerbate CHF |
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GLP-1 Agonists |
ELAD (Exenatide, Liraglutide, Albiglutide, Dulaglutide) Once or twice daily Not recommended with CrCl <30 mL/min Should not be used in patients with a personal or family history of medullary thyroid cancer NV, HA, Pancreatitis |
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DPP-4 Inhibitors |
SSAL (Sitagliptin, Saxagliptin, Alogliptin, Lingagliptin) Inhibits DPP-4 enzyme that is responsible for the breakdown on incertum hormones GLP-1 Once daily FDA: sévère joint pain AE: well tolerated, pancreatitis (rare) , heart dz ? |
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Sodium Glucose Cotransporter (SGLT)2 inhibitors |
CDE (Canagliflozin, Dapagliflozin, Empaglifozin) Reduces réabsorption of filtered glucose, increased urinary excretion of glucose, thereby reducing plasma glucose concentrations |
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SGLT -2 Advantages |
Weight loss Low risk of hypoglycemia BP lowering Rénal protection |
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SGLT-2 inhibitors CONCERNS |
Limp amputation Électrolyte disturbances Decreased BP Bacterial urinary tract infections Fungal genital infections Malignancy |
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Thioureas |
Propylthiouracil (PTU) Methimazole (Tapazole) MOA: inhibits the iodination of tyrosine and the coupling of iodotyrosines PTU also inhibits the peripheral conversion of T4 to T3 Does not effect the release of preformed T4 and T3 |
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Thioureas |
PTU (protein bound) Methimazole - bound to protein Both agents have very short half lives, however, they accumulate in the thyroid gland to exert longer effects Patient becomes euthyroid over a 1-2 month period |
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Thioureas Adverse Effects |
PTU (Propylthiouracil), Methimazole (Tapazole) Rash, Fluid Retention , decreased WBC , reverses on dc if caught early |
