DM Oral Agents Overview

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Questions and Answers

What is the primary effect of Meglitinides on insulin production?

Inhibit insulin secretion after meals

Decrease insulin resistance in tissues

Increase insulin release from the liver

Increase insulin release from the pancreas (correct)

Which of the following medications is associated with a high risk of heart failure?

Starlix

Nateglinide

Glucotrol

Pioglitazone (correct)

What is a significant side effect associated with the use of sulfonylureas?

Nausea

Weight gain (correct)

Increased heart rate

Weight loss

Which of the following statements about Repaglinide is TRUE?

It requires administration only during meals. (B) Signup and view all the answers

What does the use of Thiazolidinediones like Pioglitazone primarily target?

Insulin sensitivity in muscle and fat tissues (B) Signup and view all the answers

Which adverse effect is NOT typically associated with α-Glucosidase Inhibitors?

Bladder cancer (A) Signup and view all the answers

What is a common characteristic of DPP-4 Inhibitors like Sitagliptin?

Increased risk of urinary tract infections (A) Signup and view all the answers

Which drug is known as a thiazolidinedione (TZD)?

Rosiglitazone (B) Signup and view all the answers

What is a significant concern when monitoring patients on α-Glucosidase Inhibitors?

Liver function (B) Signup and view all the answers

What indicates a primary adverse effect of Metformin?

Diarrhea (D) Signup and view all the answers

Incretin hormones are primarily elevated by which class of medications?

DPP-4 Inhibitors (A) Signup and view all the answers

Which of the following drugs is most likely to have gastrointestinal side effects?

Metformin (A) Signup and view all the answers

What condition is NOT commonly treated with the use of insulins mentioned in the provided data?

Bladder cancer (D) Signup and view all the answers

What is the primary mechanism of action (MOA) of Metformin?

Prevents an increase in glucose levels (C) Signup and view all the answers

Which of the following is a potential side effect of Glimepiride?

Hypoglycemia (D) Signup and view all the answers

Which of the following is true regarding Metformin?

It should be avoided in patients with renal issues. (C), It is contraindicated in pregnant patients. (D) Signup and view all the answers

Which statement is true about the 2nd generation oral agents like Glimepiride?

They should not be taken with alcohol. (D) Signup and view all the answers

What is one of the primary adverse effects associated with Metformin?

Diarrhea (D) Signup and view all the answers

In which population should Metformin be used cautiously?

Patients with a history of heart failure (B) Signup and view all the answers

Which of the following statements regarding weight change is correct for Metformin?

It is associated with weight loss. (C) Signup and view all the answers

What is a contraindication for Glipizide use?

Breastfeeding women (B) Signup and view all the answers

What is the primary effect of Sodium-Glucose Cotransporter 2 Inhibitors like Canagliflozin?

Decrease blood glucose levels (C) Signup and view all the answers

Which medication is associated with a risk of dehydration, especially in combination with diuretics?

Canagliflozin (A) Signup and view all the answers

What is a notable side effect of Glucagon-like peptide-1 receptor agonists?

Nausea, vomiting, and diarrhea (NVD) (B) Signup and view all the answers

What is the typical onset time for Rapid-acting insulin such as Humalog?

< 15 minutes (B) Signup and view all the answers

Which of the following insulin types is administered not with meals?

Intermediate insulin (NPH) (D) Signup and view all the answers

What is the duration of action for Long-acting insulin like Lantus?

24 hours (A) Signup and view all the answers

What is a contraindication for the use of Exenatide?

Renal impairment (A) Signup and view all the answers

Which of the following medications does NOT typically cause weight loss?

Humulin N (C) Signup and view all the answers

What is the peak effect time for Short-acting insulin such as Humulin R?

2-3 hours (A) Signup and view all the answers

Which insulin type is great for controlling blood sugar in patients who have extreme difficulty managing it?

Ultra-long insulin (D) Signup and view all the answers

What is a potential risk associated with Gliptins?

Pancreatitis (D) Signup and view all the answers

Which insulin type has the longest duration among the following?

Tresiba (A) Signup and view all the answers

What is the recommended administration timing for Rapid-acting insulin?

Before meals (B) Signup and view all the answers

Which medication is an incretin mimetic and should be used cautiously in patients with renal issues?

Exenatide (A) Signup and view all the answers

Study Notes

DM Oral Agents

Biguanides (Metformin):
- Prevents increase in glucose levels
- Low risk of weight gain
- Potential side effects include: decreased appetite, diarrhea, and upset stomach
- Contraindications: renal issues, heart failure, and pregnancy
- Titrate dosage to avoid gastrointestinal issues
- Suitable for patients with irregular schedules
Sulfonylureas (Glimepiride, Glipizide):
- Increases insulin release from the pancreas
- High risk of weight gain
- Potential side effects include hypoglycemia
- Contraindications: heart failure and pregnancy
- Alcohol consumption should be avoided
- Suitable for patients with scheduled treatments
Meglitinides (Glinides):
- Rapid insulin release
- High risk of weight gain
- Potential side effects include edema
- Contraindications: heart failure, and pregnancy
- Should be taken with meals
Thiazolidinediones (TZDs, Glitazones):
- Reduces insulin resistance
- Uncertain impact on weight gain
- Potential side effects include an increased risk of bladder cancer
- Contraindications include heart failure
- Should be taken in combination with other medications
a-Glucosidase Inhibitors:
- Delays carbohydrate absorption
- Low risk of weight gain
- Potential side effects include gas, cramps, bloating, and diarrhea
- Contraindications: Liver dysfunction
DPP-4 Inhibitors (Gliptins):
- Increases incretin hormone function
- Low risk of weight gain
- Potential side effects include pancreatitis
Sodium-Glucose Co-Transporters (SGLT2 Inhibitors):
- Reduces glucose absorption by the kidneys
- Low risk of weight gain
- Potential side effects: dehydration, yeast infections, urinary tract infections (UTIs), postural hypotension (especially when combined with diuretics)
Glucagon-like Peptide-1 Receptor Agonists (GLP-1):
- Increases incretin hormone function
- Low risk of weight gain
- Potential side effects include nausea, vomiting, diarrhea, and pancreatitis
- Contraindications: heart failure, pregnancy

Insulin Types

Rapid-Acting:
- Onset: less than 15 minutes
- Peak: 30-90 minutes
- Duration: 3-5 hours
- Examples: Humalog, Novolog, Apidra.
- Should be taken with meals.
Short-Acting (Regular):
- Onset: 30-45 minutes
- Peak: 2-3 hours
- Duration: 6.5 hours
- Examples: Humulin R, Novolin R.
- Should be taken with meals.
Intermediate-Acting (NPH):
- Onset: 1-3 hours
- Peak: 5-8 hours
- Duration: 14-18 hours
- Examples: Humulin N, Novolin N
- Not recommended for use without meals
Long-Acting (Basal):
- Onset: 1-2 hours
- Peak: None
- Duration: 24 hours generally
- Examples: Lantus, Levemir, Toujeo, Tresiba
- Used to manage blood sugar between meals, and at night
Ultra-Long-Acting:
- Onset: 1-2 hours
- Peak: None
- Duration: Up to 40 hours
- Examples: Tresiba
- Suitable for managing fluctuating blood glucose levels over a prolonged period throughout the 24-hour cycle

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Description

This quiz covers the various oral agents used in diabetes management, focusing on their mechanisms, benefits, and contraindications. Learn about Biguanides, Sulfonylureas, Meglitinides, and Thiazolidinediones, along with their potential side effects. Test your knowledge on these essential treatments for diabetes.