| Question | Answer |
| ADA goal for AIC | <7% |
| goal estimated average glucose | <154 mg/dl |
| preprandial blood glucose | 70-130 mg/dl |
| how frequent urine test for albumin | annual |
| aspirin therapy for prevention for what age group | men >50yo, female >60 age |
| Glucovance | metformin + glyburide |
| actoplus Met | pioglitazone + metformin |
| Janumet | sitagliptin + metformin |
| Glumetza | Metformin |
| Fortamet | metformin |
| glucophage | metformin |
| contraindication of metformin | scr>1.5 (male), >1.4 (female) or CrCl <60ml/min |
| caution and bbw for metformin | caution with HF, bbw- lactic acidosis |
| metformin ER rec to be taken daily of when in the day? | daily at evening |
| Glumetza and Fortamet - counseling point of seeing medicine in the stool | glumetza-shell of medicine in stoll
fortamet- looks like a lumpy tablet in the stool
not a problem... medicine has been absorbed |
| Sulfonylureas SHOULD NOT be used with what other antidiabetic drug class d/t to similar MOA? | MEGITINIDES (secreatogues) |
| Diabinese | Chlorpropamide
- older agent. not used anymore d/t long duration and risk for hypoglycemia |
| Glucotrol, Glucotrol XL | Glipizide |
| Amaryl | Glimpiride |
| Diabeta | Glyburide |
| Micronase. Which has better absorption? | micronized has better absorption.
Glyburide |
| What two drug classes are not recommended for use by ADA d/t long-lasting hypoglycemia? | Diabinese (Chlorpropamide) and (Diabeta, Micronase) Glyburide *partially active metabolite that can accumulate in renal dysfxn (CrCl<50) |
| Prandin | Meglitinides |
| actos | pioglitazone |
| Duetact | Pioglitazone + Glimepirmide (Amaryl) = Duetact |
| Avandia | Rosiglitazone |
| MOA of TZDs?
Which TZDs are better for lipids? | pioglitazone;
increase insulin sensitivity |
| Common S/E to TZDs? | Hepatic & Cardiovascular risk |
| Which drug class may take several weeks to see results of blood sugar lowering? | TZDs |
| Precose. MOA? | Acarbose. MOA: inhibit alpha-glucosidase in the intestine and amylase in the pancreas- delayed absorption of glucose. inhibit metabolism of sucrose to glucose and frutose |
| T/F: Titrate Acarbose (Precose) & Miglitol (Glyset) should be titrated slowly d/t GI effects | True |
| What is the advantage of using alpha-glucosidase inhibitors? | increase HDL, decrease TG and total cholesterol
& don't cause weight gain! |
| Which med class can't lower blood sugar themselves? | Alpha-glucosidase inhibitor |
| If you get low blood sugar with alpha-glucosidase inhibitors, you can't treat hypoglycemia with sucrose form of sugar | True. |
| januvia | sitagliptin |
| Juvisync | sitagliptin + simvastatin |
| side effects to januvia | - nasopharyngitis, upper respiratory tract infections, peripheral edema, rash, hypoglycemia
- weight neutral |
| what are incretin enhancers vs. incretin mimetics? | DPP4 inhibitors and GLP-1 agonists (extenidtide-byetta; victoza -liraglutide) |
| Byetta (class?) | Exenatide |
| (class?) Liraglutide | victoza |
| Primary side effect to Byetta?
Top S/e involves? Should be avoided in... | Exenatide- NAUSEA
* note: other known side effects: PANCREATITIS, RENAL (AVOID IN SEVERE IMPAIRMENT CrCl <30ml/min) |
| Which med requires a MedGuide? Should not be used in a special patient population? | dont use in pts with hx of pancreatitis, gallstones, alcoholism, or high TGs
(REQUIRES MedGuide!!!)
avoid in severe renal impairment |
| Symlin (generic, class) | Pramlintide |
| Unique use of Symlin? Comes in two different dosage form | Pramlintide (amylinomimetic)- mimics the hormone that mangages post-prandial glucose
SymlinPen 120 (Type 2)
SymlinPen 60 (Type 1)
* can be use in BOTH TYPE 1 AND 2 DM |
| common s/e to Symlin? | - hypoglycemia
- nausea
- anorexia (d/t preventing glucagon increase) |
| There's a diet restriction when using Pramlintide. what is it? | Only use if you consumed > or equal 250 kcal or >or equal 30grams of carbohydrates/day |
| What Bile-acid binding resin may possibly help with glycemic control? | - Colesevelam (Welchol) |
