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unique part about SGLT2 inhibitors
- no dependent on beta cell function or insulin resistance
- less glucose in blood also decreases amt that the pancreas has to work
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SGLT-2 inhibitor MOA
- inhibitor of SGLT2
- blocks reabsorption of filtered glucose and reduce renal threshold for glucose
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SGLT-2 inhibitor drug
canagliflozin
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SGLT-2 inhibitors CI
- hypersensitivity
- severe renal impairment (GFR < 30 ml/min; ESRD; on dialysis)
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SGLT-2 inhibitors precautions
- hypotension (watch out for hypovolemia in pts with renal impairment, elderly, low systolic bp, or on diuretics, ACEi or ARB)
- impaired renal fx
- hyperkalemia
- hypoglycemia with other meds that cause hypoglycemia
- genital mycotic infections
- inc LDL
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SGLT-2 inhibitors DDIs
- digoxin - inc AUC and Cmax
- inducers of UGT 1A9 and UGT2BB (rifampin, ritonavir, phenobarbital, phenytoin)
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