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29 Cards in this Set
- Front
- Back
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Rapidly acting
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Lispro
Aspart Glulisine |
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Short acting
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regular insulin
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Intermediate acting
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lente
semilente isophane |
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long acting
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ultralente
protamine zinc glargine detemir |
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insulin secretagues (2)
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sulfonylureas
meglitinides |
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1st line sulfonylureas
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tolbutamine* elderly use
chlorporpamide *CI in elderly |
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2nd line sulfonylureas
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Glyburide
Glipzide Glimepride |
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meglitinides
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repaglindide
nateglinide |
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insulin sensitizers
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metformin
thiazolidinediones |
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thiazolidinediones
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pioglitazone
rosiglitazone |
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alpha - glucosidase inhibitors
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acarbose
miglitol |
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exenatide
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incretin analog
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sitagliptin
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inhibitor of DPP-IV
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pramlinitide
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amylin analogs
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colesevelam
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bile acid sequestration
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AE of Tolbutamide
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hypoglycemia (rare)
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AE of Chloropromide
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hypoglycemia in elderly
(CI in elderly) hyperemic flush with EtOH SIADH (stimulates vasopressin) |
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AE of glyburide
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hypoglycemia in 20-30% pt
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AE of glipizide
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shortest t1/2
less hypoglycemia |
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AE of glimepiride
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hypoglycemia in only 2-3% of pt
once /day longer t1/2 very LOW AE |
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generalized AE of sulfonylureas
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hypoglycemia- especially in elderly pt with remal or hepatic impairment
weight gain |
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MOA of meglitinides and sulfonylureas
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binds SUR1 and inhibits ATP sensitive K+ channels --> depolarization --> open Ca+ C --> insulin secretion
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contrast meglitinides and sulfonylureas
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rapid onset
short duration of action psotparandial glucose regulators NOT as effective in decreasing FBG |
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MOA of metformin
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sensitizes tissue to insulin
inhibits gluconeogenesis increases insulin action AMP dependant protein kinase decrease TAG, body weight DOC DM2 |
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AE of metformin
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lactic acidosis
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MOA of pioglitazone and rosiglitazone
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thiozolidinediones (insulin sensitizer)
decreases insulin resistance agonist of PPRP in DM2: promotes glucose uptake and utilization in adipose tissue |
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which has a better lipid profile?
pioglitazone or rosiglitazone? |
pioglitazone: increase HDL, decrease LDL and TAG
rosiglitazone: increase HDL and LDL |
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AE of TZD
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fluid retentsion
edema hepatotoxicity CHF exacerbation CI in heart dx |
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MOA of miglitol and acarbose
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reduce postprandial digestion of starch and dissacharides by inhibiting the breakdown of starch into monosaccarides for digestion
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