Term
| MOA of incretins - GLP-1 agonists |
|
Definition
| peptide hormones (incretins) released from cells in the GI in reponse to food |
|
|
Term
| Glucagon - like Peptide -1 (GLP-1) |
|
Definition
potentiates insulin secretion
inhibits secretion of glucagon
slows gastric emptying
promotes satiety |
|
|
Term
| In patients with diabetes the use of ____ results in modest lowering of fasting glucose and marked reduction of postprandial levels |
|
Definition
| incretins - GLP-1 agonists |
|
|
Term
| Approved by the FDA as adjuctive therapy for patients with type 2 diabetes who have not achieved optimal glycemic control on metformin, a sulfonylurea, such as glyburide or both |
|
Definition
GLP - 1 agonist (incretin mimetic)
exenatide
liraglutide |
|
|
Term
| ____ GLP - 1 agonist is not indicated for use with insulin |
|
Definition
|
|
Term
| MOA of exenatide and Liraglutide |
|
Definition
promotes insulin release
suppresses postprandial plasma glucagon
slows gastric emptying
increases satiety |
|
|
Term
| Exenatide and Liraglutide administration |
|
Definition
can't give orally because they are peptides
injection, subq |
|
|
Term
| Adverse effects of exenatide and liraglutide |
|
Definition
hypoglycemia
NVD
acute pancreatitis in patients with diabetes |
|
|
Term
| Can Exenatide and Liraglutide be given to pregnant women |
|
Definition
|
|
Term
| slows gastric emptying; can decrease the rate and extent of absorption of other drugs |
|
Definition
| exenatide and liraglutide |
|
|
Term
| oral drugs, particularly antibiotics and contraceptives, should be taken at least one hour before injecting _____ |
|
Definition
|
|
Term
| inactivates incretin hormones |
|
Definition
| Dipeptidyl peptidase IV (DPP-IV) |
|
|
Term
| Dipeptidyl peptidase IV (DPP-IV) drugs |
|
Definition
Sitagliptin (prototype)
alogliptin
lingagliptin
saxagliptin |
|
|
Term
| inhibits DPP-IV and results in an increase amount of active incretins (GLP-1 and GIP), reduced release of glucagon, and increase release of insulin to restore blood glucose levels towards normal |
|
Definition
| Sitagliptin (and all other gliptins) |
|
|
Term
| stuffed nose, sore throat, HA, stomach pain, pancreatitis, diarrhea |
|
Definition
|
|
Term
| both GLP-1 receptor agonists and DPP-4 inhibitors ahve been linked to ____ |
|
Definition
|
|
Term
| approval delayed by the FDA becuase of a possible increased risk of bladder cancer |
|
Definition
|
|
Term
| Sodium glucose cotransporter 2 (SGLT2) inhibitor |
|
Definition
canagliflozin
dapagliflozin
empagliflozen |
|
|
Term
| transports filtered glucose from the proximal renal tubule into tubular epithelial cells |
|
Definition
|
|
Term
| inhibition reduces resorption of glucose in the kidney, resulting in increased urinary glucose excretion, with a consequent lowering of plasma glucose levels as well as weight loss |
|
Definition
|
|
Term
| can SGLT2's be given to pregnany women? |
|
Definition
|
|
Term
| Frequent mycotic genital infections in both women and men and a possible increased risk of bladder cancer with ___ may limit their use |
|
Definition
|
|
Term
| HbA1c about 7% - treat with |
|
Definition
| therapeutic lifestyle changes |
|
|
Term
|
Definition
| a single oral agent will probably work |
|
|
Term
type 2 diabetes
HbA1C 9-10% treat with |
|
Definition
two or more agents will probably be neededÂ
(metformin and one of the others) |
|
|
Term
| DOC for treating type 2 diabetes if tolerable |
|
Definition
|
|
Term
| With metformin, if needed what can be added |
|
Definition
a sulfonylurea, a GLP-1 receptor agonist, or possibly a DPP-4 inhibitor
Insulin- if HbA1C not controlled |
|
|
Term
| In the elderly, along with metformed also... |
|
Definition
SU or Meglitinides or alpha-glucosidase inhibitor
(risk of hypoglycemia may be > in the elderly w/ SU than the other two classes)
can add or substitute insulin |
|
|
Term
| _____ is considered the only acceptable pharmacologic therapy during pregnancy in the US and diabetes |
|
Definition
|
|
Term
| The most important time to have tight glucose control is the... |
|
Definition
| first 2 months of pregnancy during organogensis |
|
|
Term
| Oral agents are not used because they may be teratogenic or cause fetal hyperinsulinemia or hypoglecemia ----one exception |
|
Definition
| glyburide if a very good reason |
|
|
Term
| a carbohydrate intolerance that develops during 4% of pregnancies |
|
Definition
| gestational diabetes mellitus (GDM) |
|
|
Term
| Screen women at risk (some provides screen all women) @ what weeks during pregnancy? |
|
Definition
| 24-28 weeks w/ glucose tolerance test |
|
|
Term
remember to look at last 2 slides
questions |
|
Definition
|
|
