1Metformin is a
Biguanides
2Metformin works by
decreasing hepatic glucose production
increase insulin sensitivity
influence gut function
3What are the contraindications for metformin?
severe renal or hepatic impairment
heart failure
excessive alcohol intake
prior to iodinated contrast
4What are the sulfonylureas?
GLimepiride
Glipizide
5What is the MOA of sulfonylurea?
stimulates pancreatic beta cell insulin release
6What are the indications for sulfonylureas?
in addition to metformin
CI to metformin
7What are the AE of. sulfonylureas?
hypoglycemia
coma
weight gan
n/v
anemia
8What is the most common adverse effect of glimepiride or glipizide?
hypoglycemia
9What medications might you use if the patient has chronic renal disease?
glimepiride
glipizide
repaglinide
thiazolidinediones
10What drugs interact with sulfonylureas?
ETOH
antifungals
anticoagulants
TCAs
beta blockers
calcium channel blockers
11What are the CI for sulfonylureas?
type I DM
pregnancy
lactation
hepatic or renal insufficiency (in some)
12What is the MOA of meglitinides?
stimulates pancreatic beta cell insulin release
13What are the meglitinides?
repaglinide
nateglinide
14Indications for reaglinide or nateglinide?
CI to metformin
combination with metformin
15Naeglinide is CI in patients with
chronic renal or liver disease
16What is the MOA of Thiazolidinediones?
increases insulin sensitivity at the peripheral receptor sites
17What effect does thiazolidinediones have?
increased glucose utilization
decrease glucose production
decreased FFA release
18What are the two thiazolidinediones?
rosiglitazone
pioglitazone
19Which thiazolidinediones has an effect on triglycerides?
pioglitazone
20What are the SE of thiazolidinediones?
weight gain
edema
risk of HF w/ prolonged therapy
skeletal fractures
21What arae the CI with thiazolidinediones?
heart failure
bladder CA
active liver disease
high risk for fractures
pregnancy
type I DM
22What do the GLP-1 receptor agonists end with?
tide
23What is the MOA for GLP-1 receptor agonists?
mimics the action of endogenous GLP-1 causing increased glucose dependent insulin secretion, decreased glucagon secretion and delayed gastric emptying
24What are the CI for GLP-1 receptor agonists?
renal failure
hx of gastroparesis
hx of pancreatitis
type I DM
DKA