Diabetes Medications

Front 1

Biguanide class medication

Back 1

Metformin/Glucophage

Front 2

What is the MOA of Metformin?

Back 2

Decreases hepatic glucose production and enhances insulin sensitivity in skeletal muscle

Front 3

What is the only diabetes medication that can cause a reduction in weight?

Back 3

Metformin

Front 4

What are the most common complaints with the use of Metformin?

Back 4

Abdominal cramping and nausea

Front 5

What deficiency is related to the use of Metformin?

Back 5

B12 deficiency

Front 6

What is the most serious side effect of metformin use?

Back 6

Lactic acidosis

Front 7

Contraindications for metformin use include:

Back 7

impaired renal function, decompensated cardiac failure or liver failure, major surgery, iodinated contrast material, alcohol use.

Front 8

What is the MOA for sulfonylureas?

Back 8

Stimulates intact beta cells to release more insulin via ATP sensitive K channels

Front 9

What are the adverse effects of sulfonylurea drug use?

Back 9

Hypoglycemia, weight gain

Front 10

First generation sulfonylureas

Back 10

Chlorpropamie/Diabinese
Tolbutamide/Orinase

Front 11

Second generation sulfonylureas

Back 11

Glipizide/Glucotrol
Glyburide/Micronase
Glimepriride/Amaryl (3rd)

Front 12

non-sulfonylurea secretagogues

Back 12

Meglitinides

Front 13

Meglitinides

Back 13

Neteglinide/Starlix
Repaglinide/Prandin

Front 14

What is the MOA of Thiazolindinedoines/Glitazones?

Back 14

Improve insulin sensitivity in skeletal muscle, fat, and liver. Decrease hepatic glucose production.

Front 15

What drugs belong to the Glitazone class?

Back 15

Rosiglitazone/Avandia
Pioglitazone/ACTOS

Front 16

What labs need to be monitored when using a glitazone?

Back 16

LFTs at initiation, 1 month and 3 months looking for a rise in ALT

Front 17

What are the adverse effects of glitazones?

Back 17

increased risk for CHF, reduced bone density, weight gain

Front 18

How do Alpha-glucosidase inhibitors work?

Back 18

inhibition of the alpha-glucosidase enzymes in the brush border and interference with hydrolysis of carbohydrates.

Front 19

What two drugs belong to the Alpha-glucosidase inhibitor class?

Back 19

Acarbose/Precose
Miglitol/Glyset

Front 20

Acarbose in high dose is associated with

Back 20

moderate transaminase elevations and can cause fatal hepatic faliure

Front 21

Unabsorbed carbs can cause:

Back 21

abdominal pain
diarrhea
flatulence

Front 22

Alpha-glucosidase inhibitors are contraindicated in:

Back 22

chronic intestinal disease, IBD, colonic ulceration, any degree of intestinal obstruction

Front 23

How does the use of alpha-glucosidase inhibitors complicate treatment for hypoglycemia.

Back 23

Due to it's inhibition of carbohydrate hydrolysis, pure glucose is needed to raise blood sugar levels

Front 24

What is the MOA of Sitagliptin/Januvia?

Back 24

Competitive inhibition of dipeptidyl peptidase 4 which breas down incretins (GLP-1 and GIP)
GLP-1 and GIP potentiate the secretion of insulin and suppress the release of glucagon by the pancreas driving blood glucose levels toward normal.

Front 25

What are Dr. Miller's recommendations for treatment of type 2 diabetes?

Back 25

Use Metformin, give B12, monitor kidney function
If blood glucose levels are still high, consider adding a sulfonylurea

Front 26

Synthetic amylin injected separately from insulin with meals

Back 26

Pramlintide/Symlin

Front 27

Synthetic exendin-4 (Gila monster) that acts as an incretin mimetic

Back 27

Exanatide

Front 28

Rapid acting insulin

Back 28

Lispro/Asparat
Humulog/Novalog

Front 29

Short Acting Insulin

Back 29

Regular
Humulin R

Front 30

Intermediate acting insulin

Back 30

NPH, Humulin N

Front 31

long acting insulin

Back 31

Glargine
Lantus

Front 32

Potent hyperglycemic agent used to treat severe hypoglycemia

Back 32

Glucagon

Front 33

Increases native glucagon secretion

Back 33

decreased glucose levels
increased catecholamines
increased amino acids
acetylcholine
Cholecystokinin

Front 34

Inhibits glucagon production and secretion

Back 34

increased glucose
increased somatostatin
increased insulin
increased free fatty acids and ketones
Increased urea production