Diabetes

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Author:
adguvetis
ID:
161827
Filename:
Diabetes
Updated:
2012-07-09 21:19:59
Tags:
Pharmacy
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Description:
Diabetes
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  1. Criteria for the diagnosis of diabetes
    • Signs and symptoms of diabetes and a random plasma glucose of > 200 mg/dL
    • FPG > 126 mg/dL
    • 2-hr plasma glucose of > 200 mg/dL during a 75 g oral glucose tolerance test
    • HbA1C > 6.5% 
  2. ADA Goal HbA1C
    < 7%
  3. ADA Blood Glucose goals
    • Preprandial: 70-130 mg/dL
    • Postprandial: < 180 mg/dL 
  4. Treatment goals for labs
    • LDL: < 100 mg/dL without overt CVD ( < 70 mg/dL)
    • Trig: < 150 mg/dL
    • HDL: > 40 mg/dL M; > 50 mg/dL W
    • BP: < 130/80 mmHg
  5. Initial therapy for Type II diabetes
    Metformin 500mg QD-BID (titrate to 2g daily)
  6. Metformin MOA
    • Decrease glucose output
    • Decrease intestinal absorption of glucose
    • Improves insulin sensitivity 
  7. Metformin BBW
    Lactic acidosis
  8. Sulfonylureas MOA
    Stimulate insulin secretion
  9. Meglinitide MOA
    Stimulate insulin secretion
  10. Meglitinides
    • Repaglinide (Prandin)
    • Nateglinide (Starlix) 
  11. Thiazolidinediones (TZDs) MOA
    PPAR gamma agonists cause increased peripheral insulin sensitivity
  12. Alpha-glucosidase inhibitors
    • Acarbose (Precose)
    • Miglitol (Glyset) 
  13. Alpha-glucosidase inhibitors MOA
    • Delayed glucose absorption
    • Inhibit metabolism of sucrose to glucose and fructose 
  14. Used to decrease postprandial glucose
    • Meglitinides
    • Alpha-Glucosidase inhibitors 
  15. DPP4-Inhibitors
    • Sitagliptan (Januvia)
    • Saxagliptan (Onglyza)
    • Linagliptan (Tradjenta)
  16. DPP4-Inhibitors MOA
    • Increase insulin secretion
    • Decrease glucagon secretion from pancreatic alpha cells
  17. Side effect: Nasopharyngitis, URIs
    DPP4-Inhibitors
  18. GLP-1 Agonists
    • Exenatide (Byetta)
    • Liraglutide (Victoza) 
  19. Primary SE: Nausea
    • Exenatide
    • Liraglutide 
  20. Cause weight gain
    • Sulfonylureas
    • TZDs
    • Insulin 
  21. Weight neutral
    • Metformin
    • Meglitinides
    • Alpha-glucosidase inhibitors
    • DPP4-Inhibitors 
  22. Cause weight loss
    • GLP-1 Agonists
    • Pramlintide 
  23. Rapid-acting insulins
    • Lispro (Humalog)
    • Aspart (Novolog)
    • Glulisine (Apidra)

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