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kyleannkelsey
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What is the brand name for Metformin?
Glucophage
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What is the Generic name for Glucophage?
Metformin
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What are the benefits of Metformin (Glucophage)?
- No hypoglycemia
- Weight loss
- Slight TG decrease
- Controls hyperglycemia by >90%
- Obese: better CV outcomes
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What are the AE of Metformin (Glucophage)?
- Anorexia upon initiation
- B12 deficiency overtime (supplement)
- Lactic acidosis
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What are the CIs/Precautions of Metformin (Glucophage)?
- Renal impairment: male >1.5, female >1.4
- Hypoxia (severe cardiac or pulmonary disease), alcohol abuse, > 80 years
- CHF
- Hypothyroidism
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What are the DDIs of Metformin?
- Alcohol
- Iodinated contrast materials
- Cimtidine
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Which Sulfonylurea is preferred in renal impairment?
Glipizide
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What are the adverse reactions of Sunfonylureas?
- Hypoglycemia
- Rash/Photosensitivity/pruritis/hypersensitivity
- GI disturbance
- Increased mortality as first line
- Increased risk for bone fractures
- Weight gain
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What are the sulfonylureas?
- Glipizide (Glucotrol)
- Glimepiride (Amaryl)
- Glyburide (Micronase, Glynase or Diabeta) – Don’t use
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What is the brand name for Glipizide?
Glucotrol
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What is the brand name for Glimepiride?
Amaryl
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What is the generic name for Glucotrol?
Glipizide
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What is the generic name for Amaryl?
Glimepiride
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What are the Glinides?
- Repaglinide (Prandin)
- Nateglinide (Starlix)
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What is the brand name for Repaglinide?
Prandin
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What is the brand name for Nateglinide?
Starlix
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What is the generic name for Prandin?
Repaglinide
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What is the generic name for Starlix?
Nateglinide
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What are the kinetics of Glinides?
- OOA: 15 minutes
- Peak: 60–90 minutes
- DOA: less than 4 hours
- Metabolized by: CYP 3A4
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What are the advantages of Glinides?
- Rapid onset and short duration of action compared with sulfonylurea.
- Elimination is primarily through feces= good in renal insufficiency
- May be useful in patients who skip meals.
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What are the Alpha-glucosidase inhibitors?
- Acarbose (Precose)
- Miglitol (Glyset)
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What are the AE of Alpha-glucosidase inhibitors?
- Abdominal pain, flatulence, diarrhea
- Acarbose: increased liver function tests at doses of 100 mg and more than TID
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Which T2DM drugs are Weight neutral?
- Alpha-glucosidase inhibitors
- Gliptins
- SGLT2 inhibitor
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What are the CI/precautions to using Alpha-glucosidase inhibitors?
GI disorders including inflammatory bowel disease, chronic ulceration, and partial obstruction
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How do you treat hypoglycemia in a patient taking an Alpha-glucosidase inhibitor?
Use glucose tablets, not sucrose like in a candy bar or any other complex carbohydrate
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What is the MOA of Thiazolidinediones?
- Peroxisome proliferator activated receptor agonist to promote glucose uptake into target cells (skeletal muscle/adipose)
- 1. Decreases insulin resistance
- 2. Increases insulin sensitivity
- 3. No effect on insulin secretion
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What are the Thiazolidinediones?
- Pioglitazone (Actos)
- Rosiglitazone (Avandia)
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What is the brand name for Pioglitazone?
Actos
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What is the brand name for Rosiglitazone?
Avandia
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What is the generic name for Actos?
Pioglitazone
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What is the generic name for Avandia?
Rosiglitazone
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What are the adverse effects of Thiazolidinediones?
- Hepatotoxicity
- Edema
- Fracture risk is increased
- Weight gain
- Resumption of ovulation
- Bladder cancer risk
- macular edema
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What are the DDIs of Thiazolidinediones?
Decrease conc. of oral estrogens
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What are the CIs/Precautions of Thiazolidinediones?
- Edema may cause worsensing of CHF
- CI: LFTs >2.5 or >3x UL of normal
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What is the MOA of incretin mimetics?
- Stimulates glucagon-like peptide 1 receptor.
- Stimulates the production of insulin in response to high glucose concentrations
- Inhibition of the release of glucagon after meals
- Slows the rate of gastric emptying
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What are the incretin mimetics?
- Exenatide (Byetta)
- Liraglutide (Victoza)
- Exenatide-Extended Release (Bydureon)
- Albiglutide (Tanzeum)
- Dulaglutide (Trulicity)
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What is the brand name for Exenatide?
Byetta
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What is the brand name for Liraglutide?
Victoza
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What is the brand name for Exenatide-Extended Release?
Bydureon
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What is the brand name for Albiglutide?
Tanzeum
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What is the brand name for Dulaglutide?
Trulicity
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What is the generic name for Byetta?
Exenatide
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What is the generic name for Victoza?
Liraglutide
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What is the generic name for Bydureon?
Exenatide-Extended Release
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What is the generic name for Tanzeum?
Albiglutide
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What is the generic name for Trulicity?
Dulaglutide
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What are the AE of Exenatide (Byetta)?
- Hypoglycemia (greater in combination with sulfonylurea than with metformin)
- Nausea
- Diarrhea, feeling jittery, dizziness, headache, dyspepsia
- Anti-exenatide antibodies
- Possible increased risk of pancreatitis; class effect?
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What are the DDIs of Exenatide Byetta?
May affect the drug absorption that requires peak concentrations (oral contraceptives and antibiotics)
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What are the precautions of Exenatide (Byetta)?
- Cannot be used as a substitute for insulin in type 1 diabetes.
- Hypoglycemia in combination with a sulfonylurea.
- Do not use in severe renal impairment (ClCr < 30 mL/minute or
- end-stage renal disease); caution in ClCr 30-50 mL/min.
- Do not use in patients with severe GI disease.
- Pregnancy Category C
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