UPNS 325 Exam #1: Oral Hypoglycemic Agents

Which oral hypoglycemic agent does not cause hypoglycemia?

Metformin

Why does Metformin not cause hypoglycemia?

Decreases glucose production by the liver (not the pancreas)

What should be given if a patient taking an alpha-glucosidase inhibitor (Acarbose) develops hypoglycemia?

-GLUCOSE

-No table sugar

Why are alpha-glucosidase inhibitors different than other oral hypoglycemic agents?

-Blocks carbohydrate breakdown

-Table sugar (sucrose) will not be effective

What are Oral Hypoglycemic agents used for?

Type 2 Diabetes (after diet has failed)

How do Sulfonylureas work?

Stimulates the pancreas to release insulin

What are the adverse effects of Sulfonylureas?

Hypoglycemia

What is a MAJOR contraindication of Sulfonylureas?

Sulfa allergy

What is the drug class of Glyburide (Micronase)?

Sulfonylureas

How do Meglitinides work?

Stimulates the pancreas to release insulin

What are the adverse effects of Meglitinides?

Hypoglycemia

Which oral hypoglycemic drugs would be good for patients with a sulfa allergy?

Meglitinides

What is the drug class of Repaglinide (Prandin)?

Meglitinides

What is the drug class of Nateglinide (Starlix)?

Meglitinides

How do Biguanides work?

Decreases glucose production by the liver

What are the adverse effects of Biguanides?

-GI issues (NVD, loss of appetite)

-Lactic acidosis (rare)

What are the MAJOR contraindications of Biguanides?

-Poor renal function

-IV contrast

For IV contrast, how long should you hold Metformin for?

48 hours

What is the drug class of Metformin (Glucophage)?

Biguanides

How do Alpha-Glucosidase Inhibitors work?

-Inhibits Alpha-glucosidase

-Delays absorption of carbohydrates

What are the adverse effects of Alpha-Glucosidase Inhibitors?

-Flatulence

-Diarrhea

What is a MAJOR contraindication of Alpha-Glucosidase Inhibitors?

Inflammatory Bowel Disease

What is the drug class of Acarbose (Precose)

Alpha-Glucosidase Inhibitor

How do Thiazolidinediones work?

Reduces insulin resistance

What are the adverse effects of Thiazolidinediones?

-Fluid retention

-Weight gain

What is a major precaution in Thiazolidinediones?

Heart Failure patients

What is the drug class of Pioglitazone (Actos)?

Thiazolidinedione

How do DPP-4 Inhibitors work?

-Works through the incretin system

-Decreases blood glucose levels

What are the adverse effects of DPP-4 Inhibitors?

-Pancreatitis

-Hypersensitivity reactions

What is the drug class for Sitagliptin (Januvia)?

DPP-4 Inhibitor (Gliptin)