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18 Cards in this Set

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Glyburide, Glipizide, Glimepiride
Sulfonylureas
Glyburide
t1/2= 1-2hrs, but 24 hr action
Best for elderly due to the small half life.
Easy to use package.
Glipizide
t1/2= 2-4 hrs
Contraindications for Sulfonylurea Use
1.DKA
2.Diabetic coma
Caution when using Sulfonylureas
1.Renal/Hepatic Dz
2.HYPOGLYCEMIA
3.Metabolic Stress
BLACK BOX on Sulfonylureas
May increase CV mortality (mainly 1st generations)
When do pts take sulfonylureas?
30 mins b/f meals
Meglitinide and Nateglinide
Secretagogous (other than sulfonylureas)
When should pts take Meglitinide and Nateglinide
15 mins bf meal... TID...short acting
SE of 'other secretagogous'
Hypoglycemia
GI disturbance
Arthralgia
Weight gain
Meglitinide
t1/2= <1hr...3hr action
*Work through Cyt P450 pathway, so competes with macrolides and antifungals for metabolism*
Meglitinide and Nateglinide Contraindication
T1DM
DKA
Nateglinide
t1/2= 1.5hrs
*Work through Cyt P450 pathway*
Metformin
Can be used in 10yo and up. DOES NOT cause hypoglycemia. Works by decreasing gluconeogensis and absorption of glucose from GI. Increases glucose intake by skeletal muscle.
Metformin T Max
4-8hrs
SE of metformin
GI disturbance
Weight loss
Metallic taste in mouth
CI of metformin
Renal dysfnx
Abnormal CrCl
CHF requiring meds
Metabolic acidosis
Metformin Black Box
Lactic Acidosis: Monitor creatinine and GFR. Initial presenting symptom is Abdominal Pain.