diabetes pharm

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Author:
cwhusker
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172776
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diabetes pharm
Updated:
2012-09-23 14:11:14
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diabetes pharm
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diabetes pharm
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  1. sulfonylureas
    • secretagogues
    • MOA: blocks ATP K+ channels in the pancreatic Beta-cells, results in Ca influx and release of preformed insulin, inhibits glucagon release
    • USES: Type 2 DM
    • AE: hypoglycemia, weight gain
  2. tolbutamide
    • insulin segretagogue
    • safe in the elderly
    • AE: hypoglycemia, weight gain
  3. chlorpropamide
    • insulin secretagogue
    • MOA: potentiates the effect of ADH - dilutional hyponatremia - SAIDH - retains water
    • USES: neurogenic diabetes insipidus
    • AE: hypoglycemia, disulfiram- like reaction with alcohol
    • long DOA (60hrs)
    • CI: pts with renal and hepatic insufficiency
  4. glyburide
    • 2nd generation insulin secretagogue
    • MOA: block ATP-K+ channels, increase Ca influx and insulin secretion
    • USES: type 2 DM
    • AE: highest incidence of hypoglycemia
    • minimal transfer across placenta
  5. glipizide
    • 2nd generation insulin secretagogue
    • MOA: block ATP-K+ channels, increase Ca influx and insulin secretion
    • USES: preferred in elderly
    • AE: less chances of hypoglycemia, weight gain
  6. glimepiride
    • 2nd generation insulin secretagogue
    • MOA: block ATP-K+ channels, increase Ca influx and insulin secretion
    • USES: type 2 DM
    • AE: less chances of hypoglycemia
  7. repaglinide
    • meglinide
    • MOA: stimulates insulin secretion by blocking ATP-sensitive K channels in the pancreatic beta cells
    • USES: fast acting, limit to postprandial hyperglycemia
    • AE: hypoglycemia
    • rapid onset
  8. metformin
    • biguanide
    • MOA: activation of AMP-stimulated protein kinase, decrease hepatic gluconeogenesis, decrease plasma glucagon, decrease glucose absorption from GIT, doesn't cause hypoglycemia or weight gain 
    • USES: type 2 DM, obese pts with insulin resistance
    • AE: GI problems, lactic acidosis
  9. rosiglitazone
    • thiazolidinediones
    • MOA: selective agonist of nucelar PPARgamma, increase insulin sensitivity by elevating AMP kinase, works on adipose tissue to reduce the flux of fatty acids into muscles
    • USES: used in combo with other oral ant-diabetic drugs in type 2 DM
    • AE: fluid retention, edema, angina, MI
    • black box warning - CHF, liver disease
  10. pioglitazone
    • thiazolidinediones
    • MOA: selective agonist of nucelar PPARgamma, increase insulin sensitivity by elevating AMP kinase, works on adipose tissue to reduce the flux of fatty acids into muscles
    • USES: used in combo with other oral ant-diabetic drugs in type 2 DM
    • AE: fluid retention, edema, angina, MI
    • black box warning - CHF, liver disease
  11. acarbose
    • alpha-glucosidase inhibitor
    • MOA: inhibits glucosidase (BB of intestinal cells and involved in the breakdown of starch and disaccharides into simple sugars), inhibits the postprandial digestion of starch and disaccharides in the GIT
    • USES: type 2 DM
    • AE: flatulence, diarrhea, ab pain
  12. miglitol
    • alpha-glucosidase inhibitor
    • MOA: inhibits glucosidase (BB of intestinal cells and involved in the breakdown of starch and disaccharides into simple sugars), inhibits the postprandial digestion of starch and disaccharides in the GIT
    • USES: type 2 DM
    • AE: flatulence, diarrhea, ab pain
  13. sitagliptin
    • alpha glucosidase inhibitor
    • MOA: inhibitor of dipeptidyl peptidase, increase circulating levels of GLP-1 and GIP
    • USES: decrease postprandial glucose excursions by increasing glucose mediated insulin secretion and decrease glucagon levels
    • AE: nasopharyngitis
  14. exenatide
    • incretin, not oral
    • MOA: GLP-1 receptor agonist, increase insulin secretion when glucose levels are elevated, slows gastric emptying, decreases appetite
    • USES: type 2 DM
    • AE: N/V

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