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IOS 9 Exam 3

Treatment of DM Pharmacotherapy

QuestionAnswer
Drug induced hyperglycemi-causesa Corticosteroids, antipsychotics, protase inhibitors, thiazide diuretics, beta-bloackers, cyclosporine, niacin
Drug induced hypoglycemia -causes Beta-blockers, salicylates, pentamidine, ethanol, fibric acid
Sulfonylurea reduction in A1C is 1-2% (watch sulfa allergy)
Repraglinide and Nateglitinide A1C reduction Must eat 30g CHO and A1C reduced 0.7-1.7% (0.5)
Dosing of secretagogues Repraglitinide 0.5mg then increase (16mg max) Nateglitineide- 60mg upto 120mg
Metformin dosing 5000mg QD increase to BID -max 2000mg
Glucovance starting dose 1.25/250 max- 20/2000mg
Metagrip dosing 2.5/250 QD or BID max 20/2000
Avandamet dosing 2.5/500BID max 8/2000mg
Contrindications to metformin Scr>1.5men or women 1.4, risk of lactic acidosis, CHF +diuretic, metabolic acidosis (shock)
Withhold metformin Risk of lactic acidosis, major surgery (restricted food/fluids), acute MI, septicemia, iodinated contrast media
Rosiglitazone dosing 4mg/BID max 8mg if taken with insulin decrease insulin 15-25%
TZD cautions Precaution in liver dysfunction, anovulatory patients, pregnancy, CHF class III and IV
Pioglitazone dosing 15-45mg (combo30) decrease dose of insulin 15-25% in together
Alphaglucodiase inhibitors Side effects abdominal discomfort
meds that effect post-prandial secretagologes, alpha glucosidase inhibitors, DDD4 inhibitor(Sitagliptin), Byetta, Pramlintide,
Drugs that effect basal Biguanides, TZD, sulfonylureas
Created by: liza001
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