Drugs for Diabetes Mellitus
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| What are the causes of Diabetes Mellitus type 1? | Caused by absolute lack of insulin secretion. Due to autoimmune destruction of pancreatic islet cells (islets of Langerhans)
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| What are the causes of Diabetes Mellitus type 2? | Insulin resistance. Target cells become unresponsive to insulin (defective insulin receptor function); blood glucose levels rise
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| What is the treatment for Diabetes Mellitus type 2? | Oral hypoglycemic drugs
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| What are the treatment goals for DM type 2? | Preprandial blood sugar below 110 mg/dL. HbA1C of 6.5% of less
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| insulin aspart (NovoLog) action/onset/peak/duration/administration & timing/compatibility? | Rapid/ 15min/1-3hr/3-5hr/Subcutaneous; 5–10 min before a meal/Can give with NPH; draw aspart up first and give immediately
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| insulin lispro (Humalog)action/onset/peak/duration/administration & timing/compatibility? | Rapid/5–15 min/0.5–1 h/3–4 h/Subcutaneous; 5–10 min before a meal/Can give with NPH; draw lispro up first and give immediately
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| insulin glulisine (Apidra)action/onset/peak/duration/administration & timing/compatibility? | Rapid/15–30 min/1 h/3–4 h/Subcutaneous; 15 min before a meal or within 20 min after starting meal/Can give with NPH; draw glulisine up first and give immediately
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| insulin regular (Humulin R, Novolin R) action/onset/peak/duration/administration & timing/compatibility? | Short/30–60 min/2–4 h/5–7 h/Subcutaneous; 30–60 min before a meal; IV/ Can mix with NPH, sterile water, or normal saline; do not mix with glargine
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| insulin isophane (NPH, Humulin N, Novolin N, ReliOn N)action/onset/peak/duration/administration & timing/compatibility? | Intermediate/1–2 h/ 4–12 h/18–24 h/ Subcutaneous; 30 min
before first meal of the day, and 30 min before supper, if necessary/Can mix with aspart, lispro, or regular; do not mix with glargine
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| insulin detemir (Levemir)action/onset/peak/duration/administration & timing/compatibility? | Long/Gradual: over 24 h/ 6–8 h/To 24 h/Subcutaneous; with evening meal or at bedtime/ Do not mix with any other insulin
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| insulin glargine (Lantus)action/onset/peak/duration/administration & timing/compatibility? | Long/Gradual: begins at 1.1 h/No peak/To 24 h/ Subcutaneous; once daily, given at the same time each day/ Do not mix with any other insulin
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| Prototype drug: human regular insulin (Humulin R, Novolin R) mechanism of action: | To promote entry of glucose into cells
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| Adverse effects of Prototype drug: human regular insulin (Humulin R, Novolin R): | hypoglycemia
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| Only regular insulin can be given? | Intravenously
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| Stimulate release of insulin from pancreatic islet cells |
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| What drug is in the Biguanides class? | Metformin (Glucophage)
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| Block enzymes in small intestine responsible for breaking down complex carbohydrates into monosaccharides | Alpha-Glucosidase Inhibitors
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| Reduce blood glucose by decreasing insulin resistance and inhibiting hepatic gluconeogenesis | Thiazolidinediones (Glitazones)
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| Act by stimulating release of insulin from pancreatic islet cells | Meglitinides
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| Mimic effects of incretins—hormones released into blood by intestine in response to food to signal insulin secretion and stop glucagon production | Incretin Enhancers
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