Naplex 5

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bblapham
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229213
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Naplex 5
Updated:
2013-08-06 17:10:10
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  1. Glucophage, Fortamet, and Glumetza
    • Metformin - Biguanide - decreases hepatic glucose production, decreases intestinal absorption of glucose, improves insulin sensitivity
    • Decreases A1c 1 to 2%
    • CI with SCr less than 1.5 in males and 1.4 in females or CrCl less than 60
    • Weight neutral, hypoglycemia, lactic acidosis, GI, vitamin B12 deficiency
    • Stop in cases of hypoxia such as Dec HF, respiratory failure, and sepsis
  2. Glucovance
    Glyburide and Metformin
  3. Diabeta and Micronase
    • Glyburide - SU - stimulate increase secretion from pancreas
    • Do not use if CrCl less than 50
    • 1.25 to 5 daily, DNE 20 daily
    • Decreases A1c 1 to 2 %
    • Weight gain, hypoglycemia
  4. Amaryl
    • Glimepiride - SU
    • 1 to 4 daily, DNE 8 daily
  5. Glucotrol
    • Glipizide - SU
    • Max 20 daily
  6. Prandin
    • Repalinide - Meglitinides - stimulate insulin release from pancreas
    • Hypoglycemia, weight gain, upper resp infection
    • Decrease A1c by 0.5 to 1.5 %, used for postprandial BG
    • Do not use with SU
    • Take 15 to 30 min before meal
  7. Starliz
    • Nateglinide
    • Slightly less effective than repaglinide
  8. Actos
    • Pioglitazone - TZDs - PPAR gamma agonists causing peripheral insulin sensitivity
    • 15 to 30 gm daily max 45 daily
    • Decrease A1c 0.5 to 1.4 %
    • Peripheral edema, weight gain, increase LFTs, CHF, increase in fracture risk, increase in LFTs, pioglitazone has increased risk of bladder cancer after 1 year
  9. Avandia
    • Rosiglitazone
    • 4 to 8 mg daily
  10. Precose
    • Acarbose - alpha glucosidase inhibitor in intestines resulting in delayed absorption of glucose
    • decrease A1c 0.5 to 0.8 %, used to decrease pstpranidal BG
    • Decrease TGs and TC, weight neutral, GI side effects
    • Start at 25 mg with first bite of each main meal, max 300 mg daily
  11. Januvia
    • Sitagliptin - DPP4 inhibitors, incretin enhancer
    • 100 daily, or can start 50
    • decrease A1c 0.5 to 0.8% used for postprandial BG
    • Weight neutral, nasopharyngitis, URI, periphral edema, rash, hypoglycemia, rarely can cause acute pancreatitis
  12. Janumet
    Sitagliptin and metformin
  13. Onglyza
    • Saxagliptin and metformin
    • 5 mg daily
  14. Byetta
    • Exenatide - GLP-1 Agonists, incretin mimetics
    • Decrease A1c 0.5 to 1%, for postprandial BG
    • IR start 5 mcg SC BID for 1 month, then 10 mcg
    • Risk for pancreatitis especially in people with hx of pancreatitis, gallstones, alcoholism, and high TG
    • avoid in crcl less than 30
    • Nausea, hypoglycemia, weight loss, can cause pancreatitis
  15. Bydureon
    • Exenatide ER
    • 2 mg SC every 7 days
  16. Victoza
    • Liraglutide
    • Start t 0.6, then 1.2 then 1.8
  17. Symlin
    • Pramlintide - synthetic analog of amylin
    • start at 15 mcg prior to meals, then increase up to 60 for type 1
    • for type 2, start at 60 and increase to 120
    • Hypoglycemia, nausea, weight loss, decrease insulin by 50% when starting
    • CI gastroparesis, hypoglycemia unaware
  18. Welchol
    • Colesevelam - bile acid resin
    • Decrease LDL by 20%, decrease A1c by 0.5%, decrease postprandial BG
    • CI: bowel obstruction, TG greater than 500, history of TG induced pancreatitis
  19. Cycloset
    • Bromocriptine
    • Dopamin agonist works in CNS to decrease insulin resistane
  20. Apidra
    Glulisine
  21. Novolog
    Aspart
  22. Humalog
    Lisprot
  23. Humulin R, Novolin R
    • Regular insulin
    • Injected 30 minutes before a meal, last 4 to 6 hours
  24. Humilin N, Novolin N
    • Intermediate Insulin NOH
    • Cloudy
    • Onset 1 to 2 hours, peak 4 to 14 hours, duration up to 24 hours
    • Can be mixed with regular and fast acting insulin
    • Clear before cloudy
    • In mixed preps, the larger number is always the NPH
  25. Detemir
    • Levemir
    • Onset of 4 hours, lasts 24 hours, no peak
  26. Lantus
    • Glargine
    • Onset of 1 hour, lasts 24 hours, no peak
  27. Propyl-Thyracil
    • Propylthioracil 50 mg TId initially until reduction of symptoms
    • Also blocks converstion of T4 to T3
    • BBW - can cause liver damage and failure
    • GI upset, hepatitis, agranulocytosis
  28. Tapazole
    • Methimazole
    • 5 to 15 mg daily
  29. Glyset
    • Miglitol
    • Alphaglucosidase inhibitors
    • Taken with each meal, start at 25 mg with first bite of each main meal
  30. Drug induced lupus most commonly associated with:
    procainamide, hydralazine, isoniazid, quinidine, chlorpromazine, methyldopa, and minocycline

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