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NURS 572 Ch 56

Pharm Diabetes Mellitus 2 of 2

QuestionAnswer
What insulin can be given IV as well as SQ regular insulin is the only one
how are lispro, aspart and glargine admin these only given SQ
what insulins can be given SQ ALL insulins can be given SQ
why do we gently roll NPH and all mixes before admin roll, not shaken to preserve protamine's duration of action
what is the major side affect of all insulins hyperinsulinemia --> hypoglycemia
other SEs of insulin lipidystrophy at injection site (rotate), localized allergic reaction due to adjunct. true insulin allergy is rare
what are the drugs that can cause hypoglycemia sulfonylureas, meglitinides, insulin, amylin mimetics, incretin mimetics and gliptin DPP4inhibitors
injectible amylin mimetic that can't be combined pramlintide
name 2 injectible incretin mimetics exenatide (BID) liraglutide (QD)
MOA of pramlintide amylin mimetic: B-cells secretagogue, increase satiety. post prandial glucose regulation type1 type2
MOA of exenatide, liraglutide incretin mimetic: intestinal cells secretagogue, decrease glucagon, increase satiety. post prandial glucose regulation type 2 not controlled by oral meds.
what are SEs of amylin & incretin mimetics Compliance SEs are n/v/a. also hypoglycemia, HA
DPP4 inhibitor-gliptins admin how, with what curious SEs these are oral drugs. SEs nasopharyngitis, URI, HA and immune effects possible.
MOA of gliptins -DPP4 inhibitors they potentiate the action of incretins by deactivating their DPP4 enzyme. same net effect to increase insulin, decrease glucagon and increase satiety
name 3 gliptin DPP4 inhibitors sita, saxa & lina gliptin
can we use oral antidiabetic drugs in pregnant or lactating women no, No, NO they are contraindicated
MOA of sulfonylureas and meglitinides secretagogue to increase insulin secretion from Beta cells.
SEs of sulfonylureas and meglitinides hyperinsulinemia-->hypoglycemia, risk of weight gain
name 3 sulfonylureas glipizide, glyburide, glimepriride
which sulfonylurea is safest in elderly or those with renal impairment glipizide bwo inactive metabolites
glyburide class sulfonylurea
which sulfonylurea has potential for water retention glimepirde
name 2 meglitinides repaglinide, nateglinide
MAJOR SE of meglitinides hypoglycemia major SE
class of repaglinide meglitinide class
class of nateglinide meglitinide class
how are sulfonylureas and meglitinides administered these classes are oral admin
what 2 drug classes have 2 functions (decrease glycogenolysis, increase sensitivity peripheral receptors) biguadide/metformin and glitazones have these actions
what is primary/secondary MOA of biguadide/metformin primary = decrease glycogenolysis secondary = increase sensitivity peripheral receptors
what is primary/secondary MOA of glitazones primary = increase receptor sensitivity secondary = decreased glycogenolysis
which drug has ADR of lactic acidosis metformin has this ADR, along with a/n/v/d
which drug is contraindiated for patients with renal, liver, hypoxic or perfusion diseases, or any condition that may invoke glycolysis anerobic metabolism metformin is contraindiated for these patients
which drug class has ADR of hepatotoxicity glitazones have this ADR
Name 2 glitazones pio-glitazone, rosi-glitazone
which glitazone has long acting metabolite pio-glitazone
which glitazone may possibly increase CV deaths rosi-glitazone
sitagliptin QD class DPP4 inhibitor - gliptin
saxagliptid QD class DPP4 inhibitor - gliptin
lingagliptin QD class DPP4 inhibitor - gliptin
MOA alpha-glucosidase inhibitors take at meal so enzyme that metabolizes carbs is inactivated
what are ADRs of alpha-glucosidase inhibitors wicked flatulence, cramps, distention
name 2 oral alpha-glucosidase inhibitors acarbose, miglitol
acarbose class alpha glucosidase inhibitor
miglitol class alpha glucosidase inhibitor
Created by: lorrelaws