Group B (antidiabetic/weight management/vitamins)

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23 Terms

1
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Generic: Calcitriol

Brand: Rocaltrol

Vitamin

Management of secondary hypothyroidism and resultant metabolic bone disease in those with renal failure, and for management of hypocalcemia

Usual dosage: 0.5-2 mg daily

Active form of vitamin D3

Contraindicated in patients with hypercalcemia and vitamin D toxicity

Side effects: related to vitamin D toxicity and include hypercalcemia syndrome and calcium intoxication (weakness, headache, somnolence, nausea, vomiting, dry mouth)

Pearls: do not take OTC vitamin D during therapy, do not exceed prescribed amount of calcium, do not take OTC magnesium/antiacids

2
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Generic: Canagligozin

Brand: Invokana

Antidiabetic

As an adjunct to diet and exercise in adults with type II diabetes

Start with 100mg before the first meal of the day

Sodium- Glucose Cotransporter 2 Inhibitor

Contraindicated in patients with severe renal impairment

Avoid in pregnancy

Side Effects: UTI, genital myotic infections, and increased urination, increased thirst, constipation, nausea

Pearls: take before first meal of the day, closely follow recommended diet and exercise, monitor blood glucose, promptly report urinary pain/dizziness, keep well hydrated, avoid excessive alcohol, avoid salt subs with K

3
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Generic: Dapaglifozin

Brand: Farxiga

Antidiabetic

As an adjunct to diet and exercise in adults with type II diabetes

One tablet daily in the morning

SGLT2

Use is contraindicated in patients with severe renal impairment

Correct hypotension before starting therapy

May precipitate ketoacidosis

Side Effects: UTI, genital mycotic infection, increased urination, dyslipidemia, discomfort in urination, constipation

Pearls: follow diet and exercise recommendations, quarterly HbA-1c testing, do not use urine glucose testing, promptly inform physician if you become pregnant, contact doctor with signs of ketoacidosis

4
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Generic: Dulaglutide

Brand: Trulicity

Antidiabetic

As an adjunct to diet and exercise in adults with type II diabetes

0.75-1.5 once weekly

GLP-1

Reduces gastric emptying which may change rate and extent of orally administered drugs

Contraindicated in patients with a personal or family history of medullary thyroid carcinoma and MES type II

Side Effects: nausea, diarrhea, vomiting, abdominal pain, decreased appetite, dyspepsia, fatigue

Pearls: report signs of thyroid carcinoma and pancreatitis, if dose is missed admin as soon as possible if there are at least 3 days until next scheduled dose, if less than 3 days remain skip and admin on regularly scheduled day, store unused pens in the fridge, opened pens may be stored below 30C for 14 days, do not store pens with a needle attached, use new needle for each dose

5
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Generic: Empagligozin

Brand: Jardiance

Antidiabetic

As an adjunct to diet and exercise in adults with type II diabetes, to reduce risk of cardiovascular death in adults with type II diabetes

SGLT2

Use with insulin increases risk of hypoglycemia

Contraindicated in patients with severe renal impairment

Avoid use during the second and third trimesters of pregnancy

Side Effects: UTI, genital myotic infections, increased urination, dyslipidemia, discomfort when urinating

Pearls: follow diet/exercise, quarterly HbA1c testing should be preformed, do not use urine glucose tests, inform doctor if you become pregnant, contact doctor if signs of ketoacidosis

6
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Folic Acid

Vitamin

For treatment of megaloblastic anemias due to deficiency, anemias during pregnancy/lactation, anemias in infancy/childhood

Up to 1 mg a day

Water soluble

Contraindicated in anemias where B12 is deficient

Side effects: rarely allergy

Pearls: do not discontinue without checking with physician

7
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Generic: Glimepiride

Brand: Amaryl

Antidiabetic

As an adjunct to diet and exercise in adults with type II diabetes, for use in combo with insulin to lower blood glucose in patients whose hypoglycemia cannot be lowered by diet/exercise

The usual maintenance dose is 1-4mg daily with a max of 8mg daily

Sulfonylurea: stimulates insulin release from beta cells

Contraindicated in patients with diabetic ketoacidosis, patients should be warned about hypoglycemia

Side Effects: dizziness, asthenia, headache, nausea

Pearls: take with breakfast, compliance with therapy is essential, follow prescribed diet closely, avoid excessive use of alcohol, be aware of signs of hypoglycemia

8
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Generic: Glipizide

Brand: Glucotrol, Glucotrol XL

Antidiabetic

As an adjunct to diet in the treatment of non-insulin dependent stable or maturity onset type of mild to moderately severe diabetes

Normal dosage range is 5-20 mg per day

Sulfonylurea

Contraindicated in juvenile, unstable, or complicated diabetes mellitus as the sole therapy, in patients allergic to sulfa drugs, and diabetic ketoacidosis

Side effects: nausea, diarrhea, heartburn, pruritus, and urticaria, mild hypoglycemic reaction

Pearls: take 30 min before meals, compliance essential, follow diet, avoid excessive alcohol

9
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Generic: Glyburide

Brand: Micronase, Diabeta

Antidiabetic

As an adjunct to diet in treatment of non-insulin dependent stable or maturity onset type of mild to moderate diabetes

Normal dosage range is 2.5-5 mg given once or twice daily

Sulfonylurea

Contraindicated in juvenile, unstable, or complicated diabetes mellitus as the sole therapy, and in diabetic ketoacidosis

Use caution in patients with serious renal, hepatic, thyroid function, or in pregnant or nursing

Side Effects: nausea, heartburn, pruritus, urticaria, mild hypoglycemia reactions

Pearls: take with breakfast, follow diet, avoid excessive diet

10
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Generic: Insulin Aspart (rDNA Origin)

Brand: Novolog

Antidiabetic

Treatment of type I and type II diabetes

Dosage must be individualized

Drugs that may decrease hypoglycemia effects: corticosteroids, diltiazem, epinephrine, OC

Increase hypoglycemia effects: alcohol, anabolic steroids, beta blockers

Do not mix novolog with lantus

Side Effects: hypoglycemia, hypersensitivity (redness, swelling, itching)

Pearls: follow diet, admin 5-10 min before eating, do not change syringe brands/dose without notifying, consult physician during illness, continually monitor blood or urine glucose, wear or carry diabetic identification, store in fridge

11
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Generic: Insulin Degludec

Brand: Tresiba

Antidiabetic

To improve diabetic control in adults with diabetes

Dosage must be individualized

Drugs that may decrease hypoglycemia effects: corticosteroids, diltiazem, epinephrine, OC

Increase hypoglycemia effects: oral antidiabetic drugs, ACE inhibitors, fluoxetine, MAOs

Contraindicated during episodes of hypoglycemia

Side Effects: injection site rxn, lipodystrophy, weight gain, edema, nasopharyngitis, headache, upper respiratory tract infection, diarrhea

Pearls: dosing technique is important, leave needle in for 6 seconds, follow diet carefully and monitor glucose, do not mix with other insulin products, product should be clear and colorless, unopened vials should be refrigerator, wear diabetic ID

12
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Generic: Insulin Glargine (rDNA Origin)

Brand: Lantus, Troujeo, Basaglar

Antidiabetic

Indicated for once daily subcutaneous admin at bedtime

Dosage must be individualized

Drugs that may decrease hypoglycemia effects: corticosteroids, diltiazem, epinephrine, OC

Increase hypoglycemia effects: alcohol, anabolic steroids, beta blockers

Side effects: pain at injection site, allergic reactions, hypoglycemia reactions

Pearls: follow diet, do not change brands/syringes, do not dilute/mix, consult physician during illness, should be colorless/clear, unopened vials should be refrigerator, wear diabetic ID

13
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Generic: Insulin Lispro (rDNA Origin)

Brand: Humalog

Antidiabetic

Treatment of type I or II diabetes

Dosage must be individualized

Drugs that may decrease hypoglycemia effects: corticosteroids, diltiazem, epinephrine, OC

Increase hypoglycemia effects: alcohol, anabolic steroids, beta blockers

Side effects: hypoglycemia, hypersensitivity

Pearls: follow diet, admin 15 min before eating, do not change syringe brands, contact doctor with any illness, continually monitor blood glucose or urine glucose, wear diabetic ID

14
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Generic: Linagliptin

Brand: Tradjenta

Antidiabetic

As an adjunct to diet/exercise in type II diabetes

5 mg taken once daily

DDP-4 inhibitor

Contraindicated in patients with known or suspected hypersensitivity

Side effects: nasopharyngitis, diarrhea, cough, with other DDP-4 inhibitors: joint pain

Pearls: closely follow diet, quarterly HbA-1c testing

15
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Generic: Liraglutide (rDNA Origin)

Brand: Victoza, Saxenda

Antidiabetic

As an adjunct to diet and exercise to improve glycemic control in adults with type II

One dose administered once daily

GLP-1

Contraindicated in patients with a personal or family history or medullary thyroid carcinoma

Increases the risk of medullary thyroid carcinoma

Side effect: nausea, diarrhea, vomiting, constipation, headache

Pearls: report symptoms of thyroid carcinoma/pancreatitis, read and understand med guide, no not store pens with needle attached

16
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Generic: Metformin Hydrochloride

Brand: Glucophage (XR)

Antidiabetic

Used as adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus, used concomitantly with sulfonylurea

Usual starting dose is one 500mg tablet given twice a day with meals or one 850mg tablet given with the morning meals

Biguanide

Alcohol may potentiate the effect

May cause lactic acidosis resulting in death, hypothermia, hypotension, and resistant bradyarrhythmias, risk factors include advanced age, radiological studies with contrast, surgery, hypoxic states, excessive alcohol use, and hepatic impairment

Side effects: decreased vitamin B12 absorption, lactic acidosis, diarrhea, vomiting, nausea, flatulence, anorexia, bloating, lactic acidosis

Pearls: should be taken with meals, avoid excessive alcohol, closely follow diet/exercise, keep well hydrated

17
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Generic: Methotrexate Sodium

Brand: Trexall

Antimetabolite

Treatment of gestational choriocarcinoma, treatment of breast cancer, symptomatic control of severe, recalcitrant, disabling psoriasis, severe active rheumatoid arthritis

10-25 mg per week until adequate response is achieved

Antineoplastic Agent, Antimetabolite (Antifolate); Antirheumatic, Disease Modifying; Immunosuppressant Agent

Because of the possibility of serious toxicity reactions (which can be fatal), methotrexate should only be used in life-threatening neoplastic diseases, or in patients with psoriasis or rheumatoid arthritis with severe, recalcitrant, disabling disease which is not adequately responsive to other forms of therapy

Side effects: ulcerative stomatitis, leukopenia, nausea, abdominal distress, malaise, fatigue, chills, fever, dizziness, sun sensitivity, decreased resistance to infection

Pearls: take on empty stomach, keep hydrated, avoid prolonged exposure to sunlight, follow appropriate contraceptives, have periodic lab work

18
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Generic: Phentermine Hydrochloride

Brand: Adipex-P, Ionamin

Weight management

Short term weight reduction

The usual adult dose is one tablet/capsule before breakfast or 1-2 hours after breakfast

Central nervous system stimulant

Use with MONAMINE OXIDASE INHIBITORS may precipitate a hypertensive crisis

Use with FENFLURAMINE OR DEXFLENFLURAMINE may cause primary pulmonary hypertension

Side effects: primary pulmonary hypertension, hypertension, tachycardia, restlessness, dizziness, insomnia, euphoria, dysphoria

Pearls: best taken early to avoid insomnia, WARNING: this medication may be habit forming, take doses as prescribed

19
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Generic: Pioglitazone Hydrochloride:

Brand: Actos

Antidiabetic

As an adjunct to diet/exercise for type II diabetes

15-30mg given once daily

PPAR

Contraindicated in patients with congestive heart failure

Side effects: upper respiratory tract infection, headache, sinusitis, myalgia, tooth disorder, aggravation of diabetes

Pearls: follow dietary/exercise, quarterly HbA-1c testing, call doctor if you experience sudden dysuria or urinary urgency

20
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Generic: Semaglutide

Antidiabetic and weight management

Ozempic: adjunct to diet and exercise to improve type II diabetes

Wegovy: adjunct to reduce calorie diet and physical activity for chronic weight management, 2.4 mg once weekly

GLP-1

Hypoglycemia may occur with insulin or sulfonylurias

Contraindicated with thyroid carcinoma/MES type II

Side effects: nausea, vomiting, diarrhea, abdominal pain, constipation, headache, fatigue, dyspepsia, dizziness, education

Pearls: doses should be injected subcut, never share opened pen, stay hydrated

21
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Generic: Sitagliptin Phosphate

Brand: Januvia

Antidiabetic

Adjunct to diet and exercise to improve glycemic control in patients with type II diabetes

Normal adult dose is 100mg once daily

DDP-4

May increase concentration of digoxin

Side effects: nosopharyngitis

Pearls: follow recommended diet/exercise, quarterly HbA-1c testing

22
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Generic: Sitagliptin Phosphate with Metformin Hydrochloride

Brand: Janumet XR

As an adjunct to diet and exercise to improve glycemic control in patients with type II diabetes

Once tablet twice a day with meals or one XR tablet

Metformin may cause lactic acidosis resulting in death, hypothermia, hypotension, and resistant bradyarrhythmias. Risk factors include advanced age, radiological studies.

Side effects: diarrhea, upper respiratory tract infection, headache, nausea, abdominal pain, vomiting

Pearls: taken with meals, keep hydrated, avoid excessive alcohol, follow diet/exercise, quarterly HbA-1c

23
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Vitamin D, Ergocalciferol: Drisdol

Vitamin D2

For treatment of refractory rickets/vitamin D resistant rickets, for treatment of hypoparathyroidism

Non-FDA: vitamin D def

50,000 IU weekly for eight weeks

Mineral oil interferes with fat absorption

Contraindicated in patients with hypercalcemia malabsorption syndrome

Side effects: range between therapeutic and toxic doses are narrow, toxicity: renal function, mental retardation, bone demineralization, calcification of soft tissue, nausea, anorexia, constipation, anemia, weight loss