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64 Cards in this Set
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Diabeta
Generic Name Doses MOA |
Glyburide
1.25, 2.5, 5 mg Increases beta cell production of insulin in pancreas and increases target cell insulin sensitivity (muscle) |
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This is a micronized formulation of Diabeta (Glyburide)
What dose does it come in? |
Glynase
1.5, 3, 6mg |
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What is the max dose of Diabeta (Glyburide) per day?
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20mg/d
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Diabeta and Metformin can be used together to produce a synergistic effect T/F
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TRUE
Glyburide/Metformin |
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What must you warn/advise a patient about sulfonylureas?
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may produce severe hypoglycemia
eat scheduled meals and snacks |
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How should you take Glucotrol (Glipizide)?
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30 min before food
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Glucotrol
Generic Doses MOA |
Glipizide
Regular:5, 10mg XL: 2.5, 5, 10mg Increases insulin production in pancreas and increases sensitivity to inculin in peripheral tissue |
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What is the Max dose of Glucotrol (Glipizide)?
and XL formulation? |
40mg for regular
20mg for XL |
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This sulfonylurea agent is indicated for use with insulin
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Amaryl (Glimepiride)
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This sulfonylurea is long acting (24 hrs) dosed once a day
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Amaryl (Glimepiride)
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Amaryl
Generic Class Doses MOA |
Glimepiride
1,2,4mg Sulfonylurea increases production of insulin in pancrease and increases sensitivity of insulin in peripheral tissue |
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This is a first generation sulfonylurea?
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Diabinese (Chorpropramide)
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What is the difference between first and second generation Sulfonylureas?
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2nd generaltion has less side effects and is more potent than 1st generation
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Diabinese
Generic Class Doses MOA |
Chlorpropramide
100, 250mg sulfonylurea (1st Generation) increases production of insulin in pancrease and increases sensitivity of insulin in preipheral tissue |
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This sulfonylurea may cause a disulfram-like reaction if taken with alcohol
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Diabinese (Chlorpropramide)
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This sulfonylurea may cause SIADH
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Diabinese (Chlorpropramide)
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This is the longest acting sulfonylurea. It has a variable and unpredicatable duration which makes it difficult to control Blood sugar
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Diabinese (Chlorpropramide)
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Glucophage
Generic Class Doses MOA |
Metformin
Biguanide regular 500, 850, 1000mg XR: 500, 750mg Decreases glucose production in the Liver |
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This formulation of Metformin is available in Liquid
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Riomet 500mg/5ml
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Fortamet XR and Glumetza ER are other brands names for which diabetic medication?
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Metformin
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What is the maximum daily dose for Diabenese (Chloripropramide)
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750mg
recommended dose <500mg/day |
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What is the maximum daily dose of Glucophage (Metformin)
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2550mg/day
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This diabetic agent has a BBW for Renal Function (monitor for lactic acidosis)
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Glucophage (Metformin)
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Diarrhea is an adverse effect for this Diabetic agent
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Glocophage (Metformin)
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This anti-diabetic agent can be given to patients with PCOS
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Glucophage (Metformin)
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This is a combination od Metformin and glyburide
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Glucovance
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This is a combination of Glipizide with Metformin
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Metaglip
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This class of drugs has a BBW for potential for CV risk
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Thiazolidinediones (TZDs)
(Glitazones) |
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Avandia
Generic Dose Class MOA |
Rosiglitazone
Glitazone 2,4,8mg QD or BID make muscle cells more sensitive to insulin |
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Drugs like Avandia and Actos increase insulin secretion (T/F)
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FALSE!
only increase sensitivity to insulin in muscle cells |
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Glyburide can be used with Actos to create a synergistic effect
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TRUE
Glitazones can produce synergistc effect with sulfonylureas Sulfonylureas and Metformin also produce a synergistic effect |
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What must you monitor in a patient on a glitazone?
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LFTs (Q 2 mo x 1 yr, then periodically)
Edema Fluid Retention weight gain |
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Besides increasing muscle cell sensitivity to insulin, what other benefit does Actos provide?
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increases HDL-C and Decreases TG
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What could you give to a patient with Type 2 diabetes who did not reach goal on Metformin alone?
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Avandamet
(Rosiglitazone and Metformin) |
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what is in Avandaryl
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Rosiglitazone and glimerpiride
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what is in Duetact?
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Pioglitazone and glimerpiride
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These are also known as "Starch-blockers"
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Alpha-Glucosidase Inhibitors
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Precose
Generic Class Dose MOA |
Acarbose
Alpha-Glucoseidase Inhibitor 25,50,100mg slows digestion of carbohydrates resulting in smaller glucose spike after meals |
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What SE could you expect from someone taking Acarbose?
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gas, diarrhea due to undigested carbohydrates in lower GI tract
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How should you take Precose
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with the first bite of main meals
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This drug can be used as an alternate to Precose (Acarbose)
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Glyset (Miglitol)
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Prandin
Generic Class Dose MOA |
Repaglinide
Meglitinide 0.5,1,2mg Stimulates insulin secretion in pancreas by closing K channels |
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Starlix
Generic Class Dose MOA |
Nateglinide
Meglitinide 60,120mg Stimulates insulin secretion in pancreas by closing K channels |
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Which diabetic drugs may have a decreased effect if given concurrently with a CYP450 3A4 inducer (barbituates, rifampin..)
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Prandin(Repaglinide)/Starlix (nateglinide)
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T/F CYP450 inhibitors such as ketoconazole or erythromycin may produce hyperglycemia if given together with Prandin
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FALSE
inhibits prandin metabolism, increasing effect, causing HYPOGLYCEMIA |
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Prandin is also available combined with a sulfonylurea in "prandimet" T/F
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FALSE
Combined with Metformin (a Biguanide) |
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Symlin
Generic Class MOA |
Pramlintide
Amylin Analog Modulates gastric Emptying Prevents postprandial rise in plasma glucagon Satiety leading to decreased caloric intake and potential weight loss |
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Before intiating symlin therapy, decrease insulin dose by ____%
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50%
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This is used as adjunctive treatment in Type I or 2 diabetic patients who use mealtime insulin therapy and who have failed to achieve desired glucose control despite optimal insulin therapy
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Symlin (Pramlintide)
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what are the contraindications for Symlin?
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Gastroparesis, hypoglycemia unawareness
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What is Symlins Boxed warning?
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risk of insulin induced severe hypoglycemi, particularly in Type I diabetes
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Byetta
Generic Class MOA |
Exenatide
Incretin mimetic enhances glucose dependent insulin secretion by the pancreatic B cell Suppresses inappropriately elevated glucagon secretion Slows gastric emptying |
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This is preferred for adjunctive therapy to achieve glycemic control in patients with Type 2 DM who are taking metformin and/or sulfonylurea, a TZD, or combinations but have not achieved adequate glycemic control
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Byetta (Exenatide)
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how is Byetta (Exenatide) administered?
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SQ BID 60 min before AM and PM meals
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what are common symptoms patients may feel from Byetta (Exenatide)
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severe abdominal pain
vomiting |
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Januvia
Generic Class Dose MOA |
Sitagliptin
Incretin Enhancer 25,50 100mg Prevents rapid degredation of incretin hormones, resulting in increased postprandial levels of incretin hormones (GLP-1 and GIP) By enhancinf incretin DPP-IV inhibitors lower blood glucose in a glucose-dependent manner, enhanace B-cell mass, and promote satiety |
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This Incretin Enhancer is a Mix with Sitagliptin with Metformin
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Janumet
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This is a Bile Acid Sequestrant indicated for hyperlipidemia and for Type 2 diabetes (As an adjunct wo diet and exercise to improve glycemic control)
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Welchol (Colesevelam)
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what is the Welchol (Colesevelam) dose?
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6 tabs PO once daily or 3 tabs BID
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which are the Rapid acting Insulins?
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Humalog (Lispro)
NovoLog (Aspart) Apidra (glulisine) |
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Which are the short acting insulins?
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Humulin
Novolin (Regular) |
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Which are the intermediate acting insulins?
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NPH, Isophane
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which are the long acting insulins?
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Levemir (Detemir)
Lantus (Glargine) |
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what is the onset of rapid acting insulin
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15-30 min
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