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Diabetes Oral Medications

front 1

Biguanides – MOA

(Metformin)

back 1

  • Lowers the amount of glucose released from the liver
  • Helps the body absorb and use more glucose

front 2

Biguanides – Examples

back 2

Metformin

front 3

Biguanides – Weight Change

back 3

None

front 4

Biguanides – Side Effects

back 4

  • Diarrhea
  • Flatulence
  • Lactic Acidosis

front 5

Biguanides Notes

back 5

  • Reduction Vitamin B12
  • Infrequent hypoglycemia if the patient not well nourished
  • Hold Metformin for 48 hours after contrast imaging interventions

front 6

Sulfonylureas – MOA

back 6

  • Helps pancreas release more insulin

front 7

Sulfonylureas – Examples

back 7

**GL.....

Glipizide (Glucotrol, Glucotrol XL)

Glimepiride (Amaryl)

Glyburide (Micronase, DiaBeta)

Glyburide, microionized (Glynase PresTabs)

Tolbutamide(Orinase)

front 8

Sulfonylureas – Weight Change

back 8

GAIN

front 9

Sulfonylureas – Side Effects

back 9

  • HYPOGLYCEMIA
  • nausea
  • dizziness

front 10

Important Facts with Sulfonyureas: contraindications, Insulin pairing, Beers List

back 10

  • Sulfa allergies
  • Do not pair with insulin bc can cause hypoglycemia
  • Glyburide & Glimepiride on Beers List (Medications inappropriate for older patients)
  • Decreases A1c by 1-2 %

front 11

Metaglides MOA

back 11

  • stimulate release of insulin from pancreatic beta cells = lower blood glucose

front 12

Metaglides Examples

back 12

Repaglinide (Prandin)

Nateglinide (Starlix)

front 13

Metaglinides Weight Change

back 13

Gain

front 14

Metaglinides Side Effects

back 14

  • Hypoglycemia

front 15

DPP4 Inhibitors – MOA

(Dipeptidyl peptidase-4 inhibitor)

back 15

  • Helps body use incretins ––> (hormones that make the pancreas release more insulin and stop liver from making extra glucose)
  • increase incretin levels (GLP-1 and GIP), which stop glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels

front 16

DPP4 Inhibitors – Examples

(Dipeptidyl peptidase-4 inhibitor)

back 16

--Gliptans

  • Alo gliptin (Nesina)
  • Sita gliptin (Januvia)
  • Saxa gliptin (Onglyza)
  • Lina gliptin (Trajenta)

front 17

DPP4 Inhibitors – Weight Change

(Dipeptidyl peptidase-4 inhibitor)

back 17

None

front 18

DPP4 Inhibitors – Side Effects

back 18

  • Pancreatitis
  • Nose/Sinus Congestion

front 19

DPP4 Contraindications

back 19

Do not use with GLP-1

front 20

SGLT2 Inhibitors – MOA

back 20

  • Helps glucose leave the body via urine because the kidneys aren't able to absorb as much glucose back into the blood

front 21

SGLT2 Inhibitors – Examples

back 21

-- Flozin

  • Canagli flozin (Invokana)
  • Dapagli folozin (Farxiga)
  • Empagli flozin (Jardiance)

front 22

SGLT2 Inhibitors – Weight Change

back 22

LOSE

front 23

SGLT2 Inhibitors – Side Effects

back 23

  • Yeast Infections/UTIs
  • Hypoglycemia
  • Low blood pressure
  • DKA

front 24

GLP1 Agonists – MOA

back 24

  • Helps make more insulin when blood glucose rises
  • Slows emptying of food from the stomach
  • Helps you feel full with meals and decreases your appetite

front 25

GLP1 Agonists – Examples

back 25

"–tide" given via INJECTION

Dulaglu tide (Trulicity)

Liraglu tide (Victoza)

Exena tide (Byetta)

Albiglu tide (Tanzeum)

front 26

GLP1 Agonists – Weight Change

back 26

LOSE

front 27

GLP1 Agonists – Side Effects

back 27

  • Increases risk for pancreatitis

front 28

Thiazolidinediones – MOA

back 28

  • Helps muscles and fat use up insulin better (reduce peripheral insulin resistance)

front 29

Thiazolidinediones – Examples

back 29

-–glitazone

Pio glitazone (Actos)

Rosiglitazone (Avandia)

front 30

Thiazolidinediones – Weight Change

back 30

GAIN

front 31

Thiazolidinediones – Side Effects

back 31

  • Peripheral Edema – can worsen CHF
  • Increases risk of osteoporosis/breaking bone
  • Increase risk with bladder cancer (Pioglitazone)

front 32

Thiazolinediones

back 32

  • Reduces A1c up to 1-2 %

front 33

Alpha Glucosidase Inhibitor MOA

back 33

  • Inhibits the gut enzymes that normally break down starches to release glucose

front 34

Alpha Glucosidase Examples

back 34

Acarbose

front 35

Alpha Glucoseidas Side Effects

back 35

  • Diarrhea