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