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Diabetes Meds

Diabetes

QuestionAnswer
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
Created by: kat10