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DIT DM drugs
oral agents to control type 2 diabetes
| Question | Answer |
|---|---|
| lactic acidosis is a rare but worrisome side effect | Metformin |
| most common side effect is hypoglycemia | sulfonylureas |
| often used in combo with any other oral agent | Metformin |
| also helps lower triglycerides and LDL cholesterol | Metformin |
| not safe in settings of hepatic dysfunction or CHF | metformin/glitazones |
| should not be used in pts with elevated serum creatinine | Metformin |
| should not be used in pts with liver cirrhosis, elevated serum creatinine or IBD | alpha glucosidase inhibitors |
| Hepatic serum transaminase levels should be carefully monitored when using these agents | metformin/glitazones |
| not associated with weigt gain, often used in overweight diabetics | Metformin |
| metabolized by liver; excellent choice in pts with renal disease | glitazones |
| primarily effects postprandial hyperglycemia | alpha glucosidase inhibitors |
| MOA: closes K channel on beta cells --> depolarization --> Ca influx --> insulin release | sulfonylureas |
| MOA: inhibits alpha-glucosidase at intestinal brush border | alpha glucosidase inhibitors |
| MOA: agonist at PPARgamma receptors --> improved target cell response to insulin | TZDs |
| 28 yo with well managed IDDM comes in with DKA. Recently had a cold and took OTC meds. Why does he have DKA? | infections can cause DKA |
| How is hemoglobin glycosylated in DM to form HbA1c | non enzymatic glycosylation |