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64 Cards in this Set

  • Front
  • Back
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)
This is a micronized formulation of Diabeta (Glyburide)

What dose does it come in?
Glynase

1.5, 3, 6mg
What is the max dose of Diabeta (Glyburide) per day?
20mg/d
Diabeta and Metformin can be used together to produce a synergistic effect T/F
TRUE

Glyburide/Metformin
What must you warn/advise a patient about sulfonylureas?
may produce severe hypoglycemia

eat scheduled meals and snacks
How should you take Glucotrol (Glipizide)?
30 min before food
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
What is the Max dose of Glucotrol (Glipizide)?

and XL formulation?
40mg for regular

20mg for XL
This sulfonylurea agent is indicated for use with insulin
Amaryl (Glimepiride)
This sulfonylurea is long acting (24 hrs) dosed once a day
Amaryl (Glimepiride)
Amaryl

Generic
Class
Doses
MOA
Glimepiride

1,2,4mg

Sulfonylurea

increases production of insulin in pancrease and increases sensitivity of insulin in peripheral tissue
This is a first generation sulfonylurea?
Diabinese (Chorpropramide)
What is the difference between first and second generation Sulfonylureas?
2nd generaltion has less side effects and is more potent than 1st generation
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
This sulfonylurea may cause a disulfram-like reaction if taken with alcohol
Diabinese (Chlorpropramide)
This sulfonylurea may cause SIADH
Diabinese (Chlorpropramide)
This is the longest acting sulfonylurea. It has a variable and unpredicatable duration which makes it difficult to control Blood sugar
Diabinese (Chlorpropramide)
Glucophage

Generic
Class
Doses
MOA
Metformin

Biguanide

regular 500, 850, 1000mg
XR: 500, 750mg

Decreases glucose production in the Liver
This formulation of Metformin is available in Liquid
Riomet 500mg/5ml
Fortamet XR and Glumetza ER are other brands names for which diabetic medication?
Metformin
What is the maximum daily dose for Diabenese (Chloripropramide)
750mg

recommended dose <500mg/day
What is the maximum daily dose of Glucophage (Metformin)
2550mg/day
This diabetic agent has a BBW for Renal Function (monitor for lactic acidosis)
Glucophage (Metformin)
Diarrhea is an adverse effect for this Diabetic agent
Glocophage (Metformin)
This anti-diabetic agent can be given to patients with PCOS
Glucophage (Metformin)
This is a combination od Metformin and glyburide
Glucovance
This is a combination of Glipizide with Metformin
Metaglip
This class of drugs has a BBW for potential for CV risk
Thiazolidinediones (TZDs)
(Glitazones)
Avandia

Generic
Dose
Class
MOA
Rosiglitazone

Glitazone

2,4,8mg QD or BID

make muscle cells more sensitive to insulin
Drugs like Avandia and Actos increase insulin secretion (T/F)
FALSE!

only increase sensitivity to insulin in muscle cells
Glyburide can be used with Actos to create a synergistic effect
TRUE

Glitazones can produce synergistc effect with sulfonylureas

Sulfonylureas and Metformin also produce a synergistic effect
What must you monitor in a patient on a glitazone?
LFTs (Q 2 mo x 1 yr, then periodically)

Edema

Fluid Retention

weight gain
Besides increasing muscle cell sensitivity to insulin, what other benefit does Actos provide?
increases HDL-C and Decreases TG
What could you give to a patient with Type 2 diabetes who did not reach goal on Metformin alone?
Avandamet

(Rosiglitazone and Metformin)
what is in Avandaryl
Rosiglitazone and glimerpiride
what is in Duetact?
Pioglitazone and glimerpiride
These are also known as "Starch-blockers"
Alpha-Glucosidase Inhibitors
Precose

Generic
Class
Dose
MOA
Acarbose

Alpha-Glucoseidase Inhibitor
25,50,100mg

slows digestion of carbohydrates resulting in smaller glucose spike after meals
What SE could you expect from someone taking Acarbose?
gas, diarrhea due to undigested carbohydrates in lower GI tract
How should you take Precose
with the first bite of main meals
This drug can be used as an alternate to Precose (Acarbose)
Glyset (Miglitol)
Prandin

Generic
Class
Dose
MOA
Repaglinide

Meglitinide

0.5,1,2mg

Stimulates insulin secretion in pancreas by closing K channels
Starlix

Generic
Class
Dose
MOA
Nateglinide

Meglitinide

60,120mg

Stimulates insulin secretion in pancreas by closing K channels
Which diabetic drugs may have a decreased effect if given concurrently with a CYP450 3A4 inducer (barbituates, rifampin..)
Prandin(Repaglinide)/Starlix (nateglinide)
T/F CYP450 inhibitors such as ketoconazole or erythromycin may produce hyperglycemia if given together with Prandin
FALSE

inhibits prandin metabolism, increasing effect, causing HYPOGLYCEMIA
Prandin is also available combined with a sulfonylurea in "prandimet" T/F
FALSE

Combined with Metformin (a Biguanide)
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
Before intiating symlin therapy, decrease insulin dose by ____%
50%
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
Symlin (Pramlintide)
what are the contraindications for Symlin?
Gastroparesis, hypoglycemia unawareness
What is Symlins Boxed warning?
risk of insulin induced severe hypoglycemi, particularly in Type I diabetes
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
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
Byetta (Exenatide)
how is Byetta (Exenatide) administered?
SQ BID 60 min before AM and PM meals
what are common symptoms patients may feel from Byetta (Exenatide)
severe abdominal pain
vomiting
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
This Incretin Enhancer is a Mix with Sitagliptin with Metformin
Janumet
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)
Welchol (Colesevelam)
what is the Welchol (Colesevelam) dose?
6 tabs PO once daily or 3 tabs BID
which are the Rapid acting Insulins?
Humalog (Lispro)
NovoLog (Aspart)
Apidra (glulisine)
Which are the short acting insulins?
Humulin
Novolin
(Regular)
Which are the intermediate acting insulins?
NPH, Isophane
which are the long acting insulins?
Levemir (Detemir)
Lantus (Glargine)
what is the onset of rapid acting insulin
15-30 min