Summary
Summary Drugs used in Diabetes
- Course
- Institution
Summary of the drugs used in diabetes, including their efficacy, safety, adherence and any relevant clinical information
[Show more]
Seller
Follow
mariawasfy
Content preview
Drug Class Drug Name Dosage When to AE/ADR Clinical Considerations Monitor CV/HF/R/H Contraindication&A1C take
Biguanide Metformin / 500-2000mg With meals GI-related Weight neutral / anorexia A1C Renal: -Metabolic acidosis
ER BID / TID (if ER, take (NVD) B12 (LT) decrease -Previous lactic acidosis
1-1.5% Start 250mg with largest Low hypo risk Hb <45 GFR -Excessive alcohol use
and titrate q3- meal) Metallic taste SCr CI <15 GFR (risk of lactic acidosis
7d. Max Lactic acidosis LT safety data CV: which can be 50% fatal)
2550mg. CI in CV -Severe stress
Flat at SADMANS Collapse / -Severe infection
2000mg Cardioresp -Severe dehydration
insufficienc
y
Hepatic:
CI if severe
dysfunction
SGLT2 Canagliflozin 100-300mg AM, before Polydipsia -Weight loss (2-3 kg, 60- Pre: GFR Renal: Amputation (Invokana),
OD first meal Polyuria 100g of glucose) Don’t start if Fracture
0.5-1% Dapagliflozin 5-10mg OD AM Genital -Lower BP (5/2 mmHg) Ongoing: GFR GFR <20, DKA (doubles risk)
preferred infection -Low hypo risk K+ at baseline, vol status
Empagliflozin 10-25mg OD AM Lightheadednes -NO LT safety data then 2-4wk, then ********MOA: SGLT2i
preferred s -SADMANS q3-6m Liver: lower renal glucose
Hypovolemia -Less effective in elderly Don’t start if threshold by 4-5 mmol/L
Postural due to GFR Vol status dysfunction (normal is 10-11; in
hypotension *Expect 4-6 ml/min T2DM is 14)
Increased DKA decrease A1C CV
risk ** if decrease <15-20%, CV benefit
Constipation lower dose or stop Changes in risk
Nausea
GLP1RA Dulaglutide 0.75-1.5mg SC GI: NVD (up to Weight loss SCr CVD History of medullary
QW 50% Low risk of hypo reduction thyroid cancer
1-1.5% Exenatide 5-10mcg BID SC, 0-60 Injection site NO LT safety data with
min BID rxn Dulaglutide MEN-2
before food *** FYI/MOA Liraglutide
Exenatide ER 2mg QW SC Acute Complement insulin Semaglutide Gastroparesis
Liraglutide 0.6-1.8mg OD SC (same pancreatitis release
(3mg for time) Can also promote
weight loss) Risk of Thyroid insulin release before
Semaglutide 0.25-1mg QW SC C-cell tumors sugar levels rise
Semaglutide 7-14mg PO 30 min before
W only
PO OD
, <120ml
DPP4i Alogliptin 6.25-25mg Before 1st Headache Weight neutral SCr Renal:
OD meal Nasopharyngitis Low risk of hypo adjust dose
0.7% Linagliptin 5mg OD Rash (rare) NO LT safety data LFT (Alogliptin except
Saxagliptin 2.5-5mg OD Acute Improved post prandial only) Linagliptin
Sitagliptin 25-100mg OD pancreatitis? control
HF? HF:
caution
Saxagliptin
TZD’s Pioglitazone 15-45 mg OD -Fluid retention 6-12 weeks for full effect SCr CV: CI: HF, CV risk
Rosiglitazone 4-8mg OD or -Edema LFTs CV risk ?
0.82% Met BID -Weight gain PROactive for PIO
-Non-fatal MI HF:
(Rosi) Nissan for ROSI CI in HF
-Bladder cancer
(Pio) Slow onset, longer duration Risk of
- lots of targets= of glycemic control fractures in
lots of ADRs elderly
(women)
Meglitinides Repaglinide 0.5-4mg with 15 min AC Headache -Flexible dosing (skip dose SCr Renal:
meals Weight gain if skip meal) LFTs Cautious if
1% mono Max 16mg Hypoglycemia -Rapid onset and short failure
0.7% Met (lower risk than duration of action
SU’s) -Useful to lower Liver:
UTRI postprandial glucose Safe
SU’s Glyburide 1.25-20mg 30 min AC Hypoglycemia Low cost SCr Renal:
OD / BID (not HS) Weight gain LT safety data LFTs lower dose
1-2% mono Gliclazide 80-320 mg NV SADMANS
0.8% Met OD / BID Hypersensitivity Stimulate insulin release. Lower dose
Gliclazide 30-120 mg Breakfast in elderly
MR OD
Glimepiride 1-8mg OD 30 min AC
(not HS)
a- Acarbose 25-100mg With first GI (flatulence, Low hypo risk (if hypo, SCr
Glucosidase divided TID bite diarrhea) titrate use glucose) LFTs
Inhibitor drug up slowly. Weight neutral
Useful for postprandial
0.6% LFT increase at control
high doses Avoid if GI disorder
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller mariawasfy. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.89. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
56326 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now