Diabetes
Help!
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| ADA goal for AIC | <7%
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| goal estimated average glucose | <154 mg/dl
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| preprandial blood glucose | 70-130 mg/dl
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| how frequent urine test for albumin | annual
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| aspirin therapy for prevention for what age group | men >50yo, female >60 age
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| Glucovance | metformin + glyburide
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| actoplus Met | pioglitazone + metformin
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| Janumet | sitagliptin + metformin
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| Glumetza | Metformin
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| Fortamet | metformin
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| glucophage | metformin
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| contraindication of metformin | scr>1.5 (male), >1.4 (female) or CrCl <60ml/min
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| caution and bbw for metformin | caution with HF, bbw- lactic acidosis
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| metformin ER rec to be taken daily of when in the day? | daily at evening
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| 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
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| Sulfonylureas SHOULD NOT be used with what other antidiabetic drug class d/t to similar MOA? | MEGITINIDES (secreatogues)
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| Diabinese | Chlorpropamide
- older agent. not used anymore d/t long duration and risk for hypoglycemia
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| Glucotrol, Glucotrol XL | Glipizide
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| Amaryl | Glimpiride
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| Diabeta | Glyburide
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| Micronase. Which has better absorption? | micronized has better absorption.
Glyburide
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| 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)
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| Prandin | Meglitinides
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| actos | pioglitazone
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| Duetact | Pioglitazone + Glimepirmide (Amaryl) = Duetact
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| Avandia | Rosiglitazone
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| MOA of TZDs? Which TZDs are better for lipids? | pioglitazone;
increase insulin sensitivity
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| Common S/E to TZDs? | Hepatic & Cardiovascular risk
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| Which drug class may take several weeks to see results of blood sugar lowering? | TZDs
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| 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
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| T/F: Titrate Acarbose (Precose) & Miglitol (Glyset) should be titrated slowly d/t GI effects | True
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| What is the advantage of using alpha-glucosidase inhibitors? | increase HDL, decrease TG and total cholesterol
& don't cause weight gain!
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| Which med class can't lower blood sugar themselves? | Alpha-glucosidase inhibitor
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| If you get low blood sugar with alpha-glucosidase inhibitors, you can't treat hypoglycemia with sucrose form of sugar | True.
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| januvia | sitagliptin
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| Juvisync | sitagliptin + simvastatin
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| side effects to januvia | - nasopharyngitis, upper respiratory tract infections, peripheral edema, rash, hypoglycemia
- weight neutral
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| what are incretin enhancers vs. incretin mimetics? | DPP4 inhibitors and GLP-1 agonists (extenidtide-byetta; victoza -liraglutide)
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| Byetta (class?) | Exenatide
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| (class?) Liraglutide | victoza
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| 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)
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| 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
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| Symlin (generic, class) | Pramlintide
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| 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
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| common s/e to Symlin? | - hypoglycemia
- nausea
- anorexia (d/t preventing glucagon increase)
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| 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
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| What Bile-acid binding resin may possibly help with glycemic control? | - Colesevelam (Welchol)
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