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52 Cards in this Set

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Diabetes goals for treatment?
FPG= 90-130
2 hour post gpandial PG<180
Glcosylated Hg<7.0%
Aspart insulin?
Rapid acting, used for premeal, monomeric, onset 5-15 min
Lispro Insulin?
Rapid acting, used for premeal, monomeric, onset 5-15 min
Glulisine Insulin?
Rapid acting, used for premeal, monomeric, onset 5-15 min
Regular insulin?
Hexamer with zink, used for meals, onset 30-60 min
NPH insulin?
Intermediate acting, conjugated with protamine peptide, used for basal insulin
Lente insulin?
Intermediate acting, conjugated with protamine peptide, used for basal insulin
Glargine insulin?
Long acting, AA substitute, ppt at body pH, no peak
Detmir insulin?
Long acting, fatty acid side chain binds to albumin, no peak
Adverse reactions of Insulin replacement therapy?
Injection site lipodystrophy
Conventional Insulin therapy?
Two injections with regular and NPH, there is a risk of htpoglycemia, and dawn phenomenon(hyperglycemia)
Intensive/standard therapy?
Premeal and long acting, decreases diabetes complications, more difficult to comply, more expensive
Chlorpropamide?
first generation Sulfonylurea for type 2 diabetes
Tolbutamide?
first generation Sulfonylurea for type 2 diabetes
Glimepiride?
second generation Sulfonylurea for type 2 diabetes
glipizide?
first generation Sulfonylurea for type 2 diabetes, short acting, drug of choice for elderly with renal failure
Glypuride?
first generation Sulfonylurea for type 2 diabetes
Sulfonylurea MOA?
inhibits beta-cell K+ channels and increases insuline secretion
Sulfonylurea on Plasma glucose?
Lowers fasting plasma glucose, not post-prandial
Sulfonylurea Side Effects?
Hypoglycemia, weight gain
Sulfonylurea CI?
Pregnancy, renal, liver failure, sulfa allergies, type 1, elderly except Glipizide
Sulfonylurea is indicated for?
Diabetes for less than 10 years, not overweight, can still secrete insulin
Repaglinide?
Meglitinide for diabetes type 2
Nateglinide?
Meglitinide for diabetes type 2
Meglitinides MOA?
Acts on K+ channels on beta-cells, different spot as Sulfonylurea
Meglitinides effects on plasma glucose?
decreases postprandial glucose
Meglitinides Indicated for?
people with sulfa allergies and cannot take sulfonylureas
Meglitinides CI?
Pregnant and liver disease
Metformin(biguanides) MOA?
Activates AMPK which decreases gluconeogenesis and glycolysis, increase glucose utilization and decreas insulin resistance
Metformin effects on plasma glucose?
Decreases FPG
Metformin Indications?
No weight gain or hypoglycemia, improved lipid profile
Metformin ADRs?
GI(take with food), decrease B-12 absorption, lactic acidosis
Metformin contraindications?
PRegnars, elderly, renal and liver disease, CHF, shock, iodinized contrast agents
Pioglitazone and Rosiglitazone?
Thiazolidediones
Thiazolidediones MOA?
PPAR-gama(transcription factors) agonist, causes increase GLUT4, increase adiponectin which increases insulin sensitivity
Thiazolidediones Effects on Plasm Glucose?
Decreases FPG, decreases triglycerides
Thiazolidediones adverse effects?
Weight gain, fluid retention, CHF
Thiazolidediones Contraindications?
Liver disease, CHF, Pregnancy
Acarbose and Miglitol
alpha-glucosidase inhibitors
alpha-glucosidase inhibitors MOA
inhibits brush boarder enzyme and decreases absorption of glucose
alpha-glucosidase inhibitors effects on plasma glucose?
decreases post prandial glucose
alpha-glucosidase inhibitors CI?
IBD, ulcers, obstruction
Pramlinitide MOA?
Amylin mimetic, decreases postprandial glucagon....
Pramlinitide Indication?
Weight loss, decrease postprandial glucose
Pramlinitide ARDs?
Nausea, hypoglycemia, injected side effects
Exenatide MOA?
GLP-1 analog, potentiates glucose mediated insulin secretion...
Exanatide Indications?
Decrease post prandial glucose and weiht loss
Sitagliptin MOA?
DPP-IV inhibitor, DPP-IV inactivates GLP-1
Sitagliptin effects of plasma glucose?
decreases post-prandial and FPG
First DOC for Diabetes type 2?
Metformin, then add Sulfonylureas or thiazolinedione, then try adding insulin
Diabetes type 2 teatments that lowers FPG?
Metformin, Sulfonylureas, Thiazolidinediones
Diabetes type 2 teatments that lowers post-prandial glucose?
Meglitinides, Alpha-glucosidase inhibitors, Pramlintide