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Diabetes

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sgthuan's version from 2017-07-10 21:09

Diabetes Naplex

genericbrandclassdrug pearls
metforminGlucophage, Glucophage XR, Fortametbiguanide - increased insulin sensitivity, decreased hepatic glucose production, decreased glucose absorptionlactic acidosis, NO alcohol, GI upset, weight neurtral, CI - eGFR < 30, *** B12 malabsorption
repaglinidePrandinmeglitinide - increased insulin secretionpostprandial agents - TIDAC --> 15-30m BEFORE meals, hypoglycemia, weight gain, NEVER with SU
nateglinideStarlixmeglitinide - increased insulin secretionpostprandial agents - TIDAC, hypoglycemia, weight gain, NEVER with SU
repaglinide + metforminPrandiMetbiguanide/meglitinide
glipizideGlucotrol, Glucotrol XLsulfonylureas - increased insulin secretion5mg qd max 40, CYP2C9 substrates, hypoglycemia, weight gain, glipizide IR take 30m before a meal, ***all others take with breakfast or 1st meal
glimepirideAmarylsulfonylureas - increased insulin secretion1-2mg qd, max 8, hypoglycemia, weight gain, CYP2C9 substrates, ***take with breakfast or 1st meal
glyburideDiabeta, Glynase (micronized)sulfonylureas - increased insulin secretion2.5-5mg qd max 20, hypoglycemia, weight gain, CYP2C9 substrates, ***take with breakfast or 1st meal
glyburide + metforminGlucovancebiguanide/SU
pioglitazoneActosTZD - increased insulin sensitivity15-30mg qd, CI in CHF class 3/4, exacerbate CHF, *** do NOT use with active "bladder cancer", peripheral edema, weight gain, *** hepatic failure
rosiglitazoneAvandiaTZD - increased insulin sensitivity4-8mg qd, exacerbate CHF, increased risk of MI
pioglitazone + metforminActoplus Met, Actoplus Met XRbiguanide/TZD
pioglitazone + glimepirideDuetactTZD/SU
pioglitazone + alogliptinOseniTZD/DPP4
rosiglitazone + metforminAvadametbiguanide/TZD
canagliflozinInvokanaSGLT-2 inhibitor - increased urinary glucose secretion100mg qd, CI - severe renal impairment GFR<30, ESRD, weight loss, 100mg qd prior to the 1st meal**
dapagliflozinFarxigaSGLT-2 inhibitor - increased urinary glucose secretionCI - severe renal impairment GFR<30, ESRD, weight loss, 5mg qAM **
empagliflozinJardianceSGLT-2 inhibitor - increased urinary glucose secretionCI - severe renal impairment GFR<30, ESRD, weight loss, 10mg qAM **
canagliflozin + metforminInvokamet, Invokamet XRbiguanide/SGLT2
dapagliflozin + metforminXigduo XRbiguanide/SGLT2
empagliflozin + metforminSynjardy, Synjardy XRbiguanide/SGLT2
empagliflozin+ linagliptinGlyxambiSGLT2 / DDP4
sitagliptinJanuviaDPP-4 inhibitor - increased insulin secretion, decreased glucagon secretion100mg qd, acute pancreatitis, weight neutral, renal dose, ***take once daily in the morning
saxagliptinOnglyzaDPP-4 inhibitor - increased insulin secretion, decreased glucagon secretionacute pancreatitis, weight neutral, renal dose, risk of CHF, ***take once daily in the morning
linagliptinTradjentaDPP-4 inhibitor - increased insulin secretion, decreased glucagon secretionacute pancreatitis, weight neutral, ***NO renal dose, **take once daily in the morning
alogliptinNesinaDPP-4 inhibitor - increased insulin secretion, decreased glucagon secretionacute pancreatitis, weight neutral, renal dose, risk of CHF, ***take once daily in the morning
sitagliptin + metforminJanumet, Janumet XRbiguanide/DDP4
saxagliptin + metforminKombiglyze XRbiguanide/DDP4
linagliptin + metforminJentadueto, Jentadueto XRbiguanide/DDP4
alogliptin + metforminKazanobiguanide/DDP4
exenatideByetta (multidose pen), Bydureon (ER - vial or pen)GLP-1 agonist - increased insulin secretion, decrease glucagon secretion, slows gastric emptying, improve satietypancreatitis, NOT recommend if CrCl < 30, weight loss, IR - 5mcg SQ BID 60m BEFORE meals, ER - 2mg SQ qWEEK
liraglutideVictoza (multidose pen), Saxenda (weight loss)GLP-1 agonist - increased insulin secretion, decrease glucagon secretion, slows gastric emptying, improve satietypancreatitis, ***0.6mg SQ qd x 1w then 1.2mg SQ qd x 1w & can increase to 1.8mg qd if needed, weight loss, **risk of thyroid C-cell Carcinoma in rats
dulaglutideTrulicityGLP-1 agonist - increased insulin secretion, decrease glucagon secretion, slows gastric emptying, improve satietypancreatitis, 0.75mg SQ qWEEK, weight loss, ***risk of thyroid C-cell carcinoma in rats
albiglutideTanzeum (need reconstitution)GLP-1 agonist - increased insulin secretion, decrease glucagon secretion, slows gastric emptying, improve satietypancreatitis, 30mg SQ qWEEK, weight loss, ***risk of thyroid C-cell carcinoma in rats
lixisenatideAdlyxin (multidose pen)GLP-1 agonist - increased insulin secretion, decrease glucagon secretion, slows gastric emptying, improve satietypancreatitis, 10mcg SQ qd x 14 days given within 60m of the 1st meal and then 20mcg SQ qd
acarbosePrecoseAlpha-glucosidase inhibitor - delays glucose absorption25mg TIDAC at ***FIRST bite, weight neutral, GI s/e, use glucose pill for hypoglycemia NOT sucrose, increased LFT - cirrhosis
miglitolGlysetAlpha-glucosidase inhibitor - delays glucose absorption25mg TIDAC at ***FIRST bite, weight neutral, GI s/e, use glucose pill for hypoglycemia NOT sucrose
pramlintideSymlin (multidose pen)amylinomimetic - slowing gastric emptying, decreased glucagon secretionBBW - severe hypoglycemia within 3 hours with insulin, used in BOTH T1 & T2DM, SQ prior to each major meal > 250kcal or > 30g CHO, weight loss, *** reduce MEALTIME insulin" by 50%
colesevelamWelcholbile acid binding resins*** increased TG, CI - TG>500, ** constipation, weight neutral
bromocriptineCycloset, Parlodel (for Parkinson's)dopamine agonist - reset hypothalamic circadian activitiesweight neutral, take dose within 2 hours of waking, NOT recommended in psychosis
insulin lisproHumalograpid acting insulinhypoglycemia, ***hypokalemia, weight gain
insulin aspartNovolograpid acting insulinhypoglycemia, ***hypokalemia, weight gain
insulin glulisineApidrarapid acting insulinhypoglycemia, ***hypokalemia, weight gain
insulin glargineLantus, Basaglar, Toujeo (300u/ml)long acting insulingive qHS or BID, do NOT mix with other insulin
insulin regularHumulin R, Novolin Rshort acting insulinavailable WITHOUT Rx, ***OK to used in IV solution, alone or in combination with intermediate acting insulin
insulin NPHHumulin N, Novolin Nintermediate acting insulinavailable WITHOUT Rx, alone or mixed with rapid and short acting insulin (clear before cloudy)
insulin detemirLevemirlong acting insulingive qHS or BID, do NOT mix with other insulin
insulin degludecTresibar (200u/ml)long acting insulingive qHS or BID, do NOT mix with other insulin, ***stable in room temp for 8 weeks
insulin 70% NPH + 30% regularHumulin 70/30, Novolin 70/30intermediate acting insulinavailable WITHOUT Rx, 10ml vial
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