Diabetes Drugs 1
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Which Insulins have a rapid OOA/DOA?
Which Insulins have a short OOA/DOA?
Which Insulins have an intermediate OOA/DOA?
Which Insulins have a long OOA/DOA?
What additive does NPH have to help create a suspension rather than a solution?
Which Insulin is cloudy?
A cloudy vs. a clear Insulin indicates what?
- Cloudy: Suspension
- Clear: Solution
What is a rapid OOA/DOA for insulin?
- OOA: 5-15 minutes
- DOA: 3-5 hrs
What is a Short OOA/DOA for insulin?
- OOA: 30-60 minutes
- DOA: 5-8 hrs
What is an intermediate OOA/DOA for insulin?
- OOA: 2-4 hours
- DOA: 10-16 hours
What is a long OOA/DOA for insulin?
- OOA: 2-6 hours
- DOA: 8-24 hours
What is the mechanism that gives Detimir its long OOA and DOA?
- Bound to Myristic acid, which make it highly albumin bound
- Must remove Myristic acid and be released from albumin to be active = slow process
What is the mechanism that gives Glargine its long OOA and DOA?
- 2 arginines added to end of B chain
- Enhances crystal formation at physiological pH, which is slow to dissolve
- Stored at pH 4
What is the mechanism that gives Insulin Lispro and Aspart their rapid OOA and DOA?
The amino acids are switched at 29 and 28 on the B chain
Which insulin is sometimes called peakless?
What is the goal fasting glucose for a diabetic?
What is the goal for postprandial glucose in a diabetic?
What is the goal fr Hb A1c for diabetics?
What are the Adverse effects of Insulin?
- Weight gain
- Local reactions – itching, rash, lipohypertrophy
Which hypoglycemic drugs are Insulin sensitizers?
Which hypoglycemic drugs are Insulin releasers?
Sulfonylureas and Meglitinides
Which hypoglycemic drugs are Glucose absorption inhibitors?
Alpha Glucosidase inhibitors
Which hypoglycemic drugs mimic endogenous incretins?
Which hypoglycemic drugs are Dipeptidyl peptidase – IV inhibitors that prevent the breakdown of endogenous incretins?
Which hypoglycemic drugs are Amylin analogues?
Which hypoglycemic drugs increase glucose excretion?
Na glucose co-transporter 2 inhibitors
What groups of Hypoglycemic drugs are PO?
Sulfonylureas and Meglitinides, Biguanide, Thiazolidinediones, Alpha Glucosidase Inhibitors, Gliptins, Na+-glucose co-transporter 2 inhibitors
What groups of Hypoglycemic drugs are IV?
Incretin drugs and Pramlintide
Sulfonylureas and Meglitinides differ in what way?
- Sulfonylureas: Given 1 or 2x per day = Fast OOA (1 hr) and very long DOA
- Meglitinides: Given before meals = Very Rapid OOA (20 min) and short DOA (2-3 hrs)
- Metabolites: Sulfonylureas have active ones and Meglitinides do not
What is the OOA and DOA of Glipizide?
- OOA: 1 hr
- DOA: 10-20 hours
What type of drug is Glipizide?
What type of drug is Repaglinide?
What is the OOA and DOA of Repaglinide?
- OOA: 20 minutes
- DOA: 2-3 hours
What are the 2nd Gen Sulfonylureas?
Glyburide, Glipizide and Glimepiride
What are the Meglitinides?
Repaglinide and Nateglinide
Does Glipizide have active liver metabolites?
Does Repaglinide have active liver metabolites?
What is the MOA of Sulfonylurea and Meglitinides?
- Stimulate release of Insulin from B-cells
- By: Blocking ATP sensitive K+ channels and depolarizing B-cells
- May increase sensitivity of muscle and fat cells to insulin
Which drug can be used in patients with Sulfa allergies, Sulfonylureas or Meglitinides?
Which drug can be used in patients with renal impairment, Sulfonylureas or Meglitinides?
Meglitinides – not excreted by the kidneys
What are the Adverse effects of Sulfonylureas or Meglitinides?
- Excessive hypoglycemia
- Sulfa allergy (Sulfonylureas)
- Weight gain
- Loss of effectiveness/secondary failure
- Sulfonylureas cautioned in renal failure
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