Diabetes
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| Biguanide | Metformin - Target is the liver to reduce overproduction of glucose. Max effective dose 2000mg/day
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| Sulfonyureas | Glimeperide/amaryl, Glipizide/glucotrol (has xr), Glyburide/diabeta;micronase Target beta cells in pancreas to increase secretion
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| Sulfonylureas | Increase insulin secretion, take 30 min before meal
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| 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)
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| Metformin Advantages | Cost, no weight gain, reduces LDL & Triglycerides, low r/f hypos
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| Glimeperide | Sulfonylurea, increase insulin secretion
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| Glipizide | Sulfonylurea, increase insulin secretion, comes in XR too
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| Glyburide | Sulfonylurea, increase insulin secretion
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| Sulfonylurea side effects | R/F hypoglycemia, do not skip meals, Weight gain (1-2kg)
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| 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
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| Actos (pioglitazone) | TZD, insulin sensitizer, taken daily, low r/f hypo
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| Avandia (rosiglitazone) | TZD, insulin sensitizer, taken daily or BID, low r/f hypo
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| 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
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| DPP IV Inhibitors | Sitagliptin/januvia, Saxagliptin/onglyza, Linagliptin/tradjenta, Alogliptin/nesina. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying
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| Sitagliptin/januvia | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying
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| Saxagliptin/onglyza | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying
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| Linagliptin/tradjenta | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying
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| Alogliptin/nesina | DPP IV Inhibitor. Targets gut & pancreas. Inhibits glucagon release, stimulates insulin release, delays gastric emptying
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| DPP IV Inhibitor side effects | Consider renal adjustments based upon Creatinine clearance
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| DPP IV Inhibitor advantages | No weight gain, low r/f hypoglycemia, usually no n/v, oral
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| 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
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| Exenatide/byetta&bydureon(er) | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety.
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| Liraglutide/victoza | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety.
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| Albiglutide/tanzeum | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety.
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| Dulaglutide/trulicity | INJECTABLE. Targets pancreas & gut to stimulate insulin secretion, suppress glucagon secretion, slow gastric emptying/increased satiety.
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| GLP-1 Advantages | Daily and weekly injection options, weight friendly
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| GLP-1 side effects | N/V/D, hypoglycemia, slows absorption of other drugs
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| SGLT2 Inhibitors | Canagliflozin/invokana, Dapagliflozin/farxiga, Empagliflozin/jardiance. Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria.
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| Canagliflozin/invokana | Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. 100-300mg daily
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| Dapagliflozin/farxiga | Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. 5-10mg daily
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| Empagliflozin/jardiance | Targets proximal tubule inhibiting glucose reabsorption & increasing glycosuria. 10-25mg daily
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| SGLT2 Inhibitor side effects | Genital mycotic infections, primarily in females & uncircumcised males. Osmotic diuresis
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| 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
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| 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.
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| AGI's (alpha-glucosidase inhibitors) | Acarbose/precose, Miglitol/glyset. Target gut enzymes, delays carbohydrate absorption due to inhibition of enzymes.
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| Acarbose/precose | AGI. Target gut enzymes, delays carbohydrate absorption due to inhibition of enzymes.
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| Miglitol/glyset | AGI. Target gut enzymes, delays carbohydrate absorption due to inhibition of enzymes.
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| AGI side effects | Gas; bloating r/t fermentation of carbs
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| 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
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| 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.
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| 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.
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| Non-sulfonylurea side effects | Hypoglycemia, moderate weight gain, caution in those with liver failure or on dialysis, adherence issues
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