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10 Cards in this Set
- Front
- Back
Sulfonylureas
-MOA -uses -drugs |
MOA: Increase insulin secretion by activating sulfonylurea receptor on islet cell
-used for relative insulinopenia and in lean patients (causes weight gain) -1st gen: chlorpropamide, golbutamide. tolazamide, acetohexamide -2nd gen: glyburide, glipizide, glimeperide |
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Biguanides
-MOA -uses -drugs |
MOA: decrease hepatic gluconeogenesis which may reduce peripheral insulin resistance
-used for obesity plus insulin resistance, hypoglycemia due to SUs and PCOS -Metformin |
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Thiazolidinediones
-MOA -uses -drugs |
MOA: decrease peripheral insulin resistance by increasing GLUT 4 proteins - reduces fatty acids as well
-used for insulin resistance and PCOS -pioglitazone, rosiglitazone |
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Meglitinides
-MOA -uses -drugs |
MOA: increase insulin secretion when glucose exceeds threshold level - glucose dependent so it does not induce insulin release in fasting state
-used in relative insulinopenia -repaglinide, nateglinide |
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alpha-Glucosidase inhibitors
-MOA -uses -drugs |
MOA: slow the breakdown of complex CHO in GI tract - slow absorption of CHO
-used in postprandial hyperglycemia - rarely ever used -acarbose, miglitol |
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Which T2DM medications (2) are contraindicated in renal insufficiency?
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1. Metformin (biguanide)
2. Glyburide (sulfonylurea) |
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Which T2DM medications (2) are contraindicated in CHF?
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1. Metformin (biguanide)
2. Thiazolidinediones |
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Which T2DM medications (2) should be used if the patient has a history of hypoglycemia?
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Use medications that don't increase insulin release:
1. Metformin (inhibits gluconeogenesis) 2. TZDs (increase GLUT 4 - decrease insulin resistance) Sulfonylureas and meglitinides increase insulin secretion |
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T1DM
-what is the best approach for treatment? |
Best insulin therapy regiments mimic physiologic insulin release - spike after every meal
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Insulin
-rapid acting -intermediate acting -long acting |
Rapid: aspart, lispro, glulisine
Intermediate: NPH Long: glargine, detemir |