click below
click below
Normal Size Small Size show me how
Diabetes Meds
Diabetes
Question | Answer |
---|---|
Biguanide | Metformin - Target is the liver to reduce overproduction of glucose. Max effective dose 2000mg/day |
Sulfonyureas | Glimeperide/amaryl, Glipizide/glucotrol (has xr), Glyburide/diabeta;micronase Target beta cells in pancreas to increase secretion |
Sulfonylureas | Increase insulin secretion, take 30 min before meal |
Metformin Side Effects | GI (nausea/diarrhea), R/F lactic acidosis; monitor Creatinine as it is cleared by kidneys (avoid in women if >1.4, men if >1.5) |
Metformin Advantages | Cost, no weight gain, reduces LDL & Triglycerides, low r/f hypos |
Glimeperide | Sulfonylurea, increase insulin secretion |
Glipizide | Sulfonylurea, increase insulin secretion, comes in XR too |
Glyburide | Sulfonylurea, increase insulin secretion |
Sulfonylurea side effects | R/F hypoglycemia, do not skip meals, Weight gain (1-2kg) |
Thiazolidiones (TZD's) | Pioglitizone/actos; Rosiglitazone/avandia. Targets muscles & liver, insulin sensitizer. Takes 8-12 weeks for full effect, take w/o regard to meals |
Actos (pioglitazone) | TZD, insulin sensitizer, taken daily, low r/f hypo |
Avandia (rosiglitazone) | TZD, insulin sensitizer, taken daily or BID, low r/f hypo |
TZD side effects | Fluid retention/edema, weight gain common (water retention + increase fat mass), fractures r/t slowing of protein building in bone, low r/f bladder ca |
DPP IV Inhibitors | Sitagliptin/januvia, Saxagliptin/onglyza, Linagliptin/tradjenta, Alogliptin/nesina. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying |
Sitagliptin/januvia | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying |
Saxagliptin/onglyza | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying |
Linagliptin/tradjenta | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying |
Alogliptin/nesina | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying |
DPP IV Inhibitor side effects | Consider renal adjustments based upon Creatinine clearance |
DPP IV Inhibitor advantages | No weight gain, low r/f hypoglycemia, usually no n/v, oral |
GLP-1 | Exenatide/byetta & bydureon ER, Liraglutide/victoza, Albiglutide/tanzeum, Dulaglutide/trulicity. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety. Injectable |
Exenatide/byetta&bydureon(er) | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety. |
Liraglutide/victoza | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety. |
Albiglutide/tanzeum | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety. |
Dulaglutide/trulicity | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety. |
GLP-1 Advantages | Daily and weekly injection options, weight friendly |
GLP-1 side effects | N/V/D, hypoglycemia, slows absorption of other drugs |
SGLT2 Inhibitors | Canagliflozin/invokana, Dapagliflozin/farxiga, Empagliflozin/jardiance. Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. |
Canagliflozin/invokana | Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. 100-300mg daily |
Dapagliflozin/farxiga | Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. 5-10mg daily |
Empagliflozin/jardiance | Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. 10-25mg daily |
SGLT2 Inhibitor side effects | Genital mycotic infections, primarily in females & uncircumcised males. Osmotic diuresis |
Amylin Analog | Pramlintide/symlin. Targets pancreas, liver, gut to suppress glucagon secretion, decrease hepatic glucose output, slow gastric emptying. INJECTABLE taken prior to major meals |
Pramlintide/symlin | Amylin Analog, given in conjunction with insulin. Decrease preprandial insulin by 50% at initiation. If Type 1DM 15mcg-60mcg, 4step titration, if Type 2 DM 60mcg-120mcg, 2step titration. Increase dose every 3-7 days depending on GI tolerance. |
AGI's (alpha-glucosidase inhibitors) | Acarbose/precose, Miglitol/glyset. Target gut enzymes, delays carbohydrate absorption due to inhibition of enzymes. |
Acarbose/precose | AGI. Target gut enzymes, delays carbohydrate absorption due to inhibition of enzymes. |
Miglitol/glyset | AGI. Target gut enzymes, delays carbohydrate absorption due to inhibition of enzymes. |
AGI side effects | Gas; bloating r/t fermentation of carbs |
Non-sulfonylurea | Repaglinide/prandin, Nateglinide/starlix. Targets functioning beta cells in pancreas to stimulate short-term insulin secretion. Rapid onset (1hour peak), short duration (4hours). Reduces postprandial BG. Take 0-30min before meal, NO MEAL NO MED |
Repaglinide/prandin | Non-sulfonylurea. Targets functioning beta cells in pancreas to stimulate short-term insulin secretion. Rapid onset (1hour peak), short duration (4hours). Reduces postprandial BG. |
Nateglinide/starlix | Non-sulfonylurea. Targets functioning beta cells in pancreas to stimulate short-term insulin secretion. Rapid onset (1hour peak), short duration (4hours). Reduces postprandial BG. |
Non-sulfonylurea side effects | Hypoglycemia, moderate weight gain, caution in those with liver failure or on dialysis, adherence issues |