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Anti-diabetic Agents

Terms in this set (27)

Normal blood glucose
70-100
Traits of metabolic syndrome
Increased waist circumference, triglycerides >150, HDL <40/50, BP >130/85, glucose >100
If A1C is greater than 7%...
Diabetes has been poorly controlled
5% A1C =
97kg/dl
Adverse effects of insulin
Hypoglycemia, tachy, HA, tired, shaky, weak, sweaty, blurred vision, dry mouth, hunger, nausea, flushed, rash
What increases the effects of insulin resulting in decreased glucose?
Alcohol, anabolic steroids, MAOIs, ASA
What decreases the effects of insulin resulting in increased glucose?
Corticosteroids, niacin, thiazide, loop diuretics, thyroid hormones
When do you give rapid acting insulin?
15 minutes before eating
Which type of insulin can be given IV?
Regular (Humulin R)
Can Glargine (Lantus), a long acting insulin, be mixed with other insulins?
No
S/S of hypoglycemia (<60)
Shaky, tired, nervous, sweaty, hungry, irritable, impatient, cold, confused, mouth tingling, hypothermia, seizures
Treatment of hypoglycemia
Hard candy, regular soft drink, 4oz OJ, spoons of sugar, glucose tabs/gel
Treatment of diabetes type 2
1. Exercise + diet
2. Basal insulin, sulfonylurea, or thiazolidinedione
Metformin (Glucophage) action
Biguianide that decreases glucose production and increases uptake in cells/intestines (only works on glucose); first generation
Metformin (Glucophage) use
Monotherapy, or with sulfonylurea or insulin
Not to be used with liver or renal dysfunction
Adverse effects of Metformin (Glucophage)
Bloating, nausea, fullness, diarrhea
Glipizide action
Sulfonylurea that binds to receptors on beta cells to increase insulin secretion and increases sensitivity in cells; decreases secretion of glucagon
Glipizide uses
Can be used with Metformin, but stop if using insulin. Give with first meal
Glipizide adverse effects
Severe hypoglycemia, weight gain
Repalinide (Prandin) action
Glinide that increases insulin secretion, take 1-30min before meals
Alpha-glucosidase inhibitor action & uses
Blocks intestinal enzyme so decrease glucose absorption.
For mild-moderate DM, can be used with insulin, given with food
Pioglitazone (Actos) uses
Thiazolidinediones that is an insulin sensitizing drug
Pioglitazone (Actos) adverse effects
Heart failure, edema, weight gain
Sitagliptin (Januvia) action
Dipeptidyl peptidase inhibitor that delays the breakdown of incretin hormones, reduces glucose concentrations
Sitagliptin (Januvia) adverse reactions
Upper respiratory tract infection, HA, diarrhea, hypoglycemia with sulfonylurea
Pramlintide (Symlin) action
Injectable drug that mimics amylin & slows gastric emptying, suppresses glucagon, & modulates appetite
Exenative (Byetta) action
Injectable drug that mimics incretin to slow gastric emptying, increase satiety, & stimulate insulin secretion
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