Term
|
Definition
Pulmicort Flexhaler®
Respules (nebulized
solution)
90, 180 mcg
0.25/1mL
0.5/2mL
180-1200 mcg/day
(1-2 inh BID) |
|
|
Term
|
Definition
Flovent® HFA
Flovent Diskus® DPI
44, 110, 220 mcg
50, 100, 250 mcg
88-440 mcg/day
(1-2 inh BID) |
|
|
Term
|
Definition
Asmanex® 110, 220 mcg 220-440 mcg/day
*may be given HS or
divided BID |
|
|
Term
|
Definition
| Lispro (Humalog), aspart (Novolog), and glulisine (Apidra) |
|
|
Term
|
Definition
| Regular (Humulin R, Novolin R) |
|
|
Term
| Type of Insulin - Intermediate |
|
Definition
| NPH (Humulin N, Novolin N) |
|
|
Term
|
Definition
| Glargine (Lantus), detemir (Levemir) |
|
|
Term
Type of Insulin - Pre-Mixed
Combinations |
|
Definition
•NPH + regular: Humulin 70/30, 50/50, and Novolin 70/30
•Neutral protamine lispro+ lispro: Humalog Mix 75/35 and
50/50
•Neutral protamine aspart + aspart: Novolg Mix 70/30 |
|
|
Term
|
Definition
A1C reduction of 1.5%-2%
– FPG reduction of 60-80mg/dl
Typically the drug of choice in DM2
Precautions:
– Geriatrics, CHF, liver impairment, alcoholism
– Should not initiate in ≥80 years old
Renal impairment:
• Males: SCr ≥1.5mg/dl, females ≥1.4mg/dL |
|
|
Term
|
Definition
MOA:
– Enhance insulin secretion from functioning pancreatic beta cells
A1C reduction of 1.5%-2%
– FPG reduction of 60-70mg/dl |
|
|
Term
|
Definition
|
|
Term
|
Definition
5-40mg Daily/BID
Maximum recommended once daily dose is
15mg QD
Safe in renal impairment
Geriatric or liver disease: start with 2.5mg
QD |
|
|
Term
|
Definition
2.5-20mg Daily/BID
Use 1.25mg in risk of hypoglycemia
Micronized formulation has better
absorption |
|
|
Term
|
Definition
Enhance insulin secretion from functioning pancreatic beta cells
Glucose dependent insulin secretion
• Rapid acting
– Absorbed in 0.5-1 hour
– Half life 1-1.15 hours
• Efficacy:
– A1C reduction of <1%
Skip a meal, skip a dose
• Add a meal, add a dose
Generic (Brand) Dose range
Nateglinide 60-120mg TID 1-30 min prior to meals
Repaglinide (Prandin) 0.5-16mg TID 15-30 min prior to meals |
|
|
Term
|
Definition
60-120mg TID 1-30 min prior to meals
less side effects |
|
|
Term
|
Definition
| 0.5-16mg TID 15-30 min prior to meals |
|
|
Term
|
Definition
Bind to the Peroxisome Proliferator Activator Receptor-
Y(PPAR-Y)
• Modulates gene transcription involved in insulin and lipid metabolism
– Enhances insulin sensitivity at muscle, liver, and fat tissues
• Requires the presence of insulin
A1C reduction of 1-1.5%
– FPG reduction of 60mg/dl
Contraindications
– NYHA Class III or IV HF
– Use with caution in Class I and II
– Moderate or severe hepatic impairment |
|
|
Term
|
Definition
15-45mg
daily
May improve cardiovascular mortality, MI,
and stroke |
|
|
Term
|
Definition
2-8mg
daily
•Prescribers and patients must enroll in
access program
•Available in specially certified pharmacies |
|
|
Term
|
Definition
Glucagon-Like Peptide
1(GLP-1) and glucosedependent
insulinotopic
peptide (GIP) are secreted
by cells in the intestinal
mucosa to:
• These effects combine to
limit PPG
• Rapidly inactivated by
dipeptidyl-peptidase 4
(DPP4)
– GLP-1 half life <10
– Suppresses glucagon
secretion (GLP-1)
– Increase insulin secretion
(GLP-1 and GIP)
– Slows gastric emptying
and reduces food intake by
increasing satiety (GLP-1) |
|
|
Term
|
Definition
Binds and activates GLP-1 receptors
– Suppress postpradial glucose dependent glucagon secretion
– Increase glucose dependent insulin secretion
– Slows gastric emptying and increases satiety
– Effects are glucose-dependent
A1C reduction of 1%-1.5% |
|
|
Term
|
Definition
5 mcg SC BID before meals (0-60 min)
Can increase to 10mcg BID after 1
month of therapy
•Injected before meals
•Available in pen
•CrCl<30ml/min: Not
recommended |
|
|
Term
|
Definition
2mg SC once weekly
•The most A1C reduction
•Must be reconstituted |
|
|
Term
|
Definition
Start with 0.6mg SC daily for 1 week,
Then increase to 1.2mg SC daily
*After 1 week, may titrate to 1.8mg SC
daily if needed
•Administered any time of
day, same time every day
•Available in pen
•No hepatic or renal dosing
adjustments |
|
|
Term
|
Definition
Inhibits degradation of endogenous GLP1 and GIP
– Suppress postpradial glucose dependent glucagon
secretion
– Increase glucose dependent insulin secretion
A1C reduction of 0.5-1% |
|
|
Term
|
Definition
100mg daily
CrCl 30-50ml/min: 50mg daily
CrCl ≤30ml/min: 25mg daily |
|
|
Term
|
Definition
5 mg daily
CrCl ≤50ml/min: 2.5mg daily |
|
|
Term
|
Definition
5mg daily
CrCl <30ml/min: use with caution |
|
|
