Question and answers
Sodium Glucose Contransorter Inhibitors (SGLT2 Inhibitors) DRUGS - ANSWER-Canagliflozin (Invokana),
Dapagliflozin (Farxiga),
Empagliflozin (Jardinance)
Sodium Glucose Contransorter Inhibitors (SGLT2 Inhibitors) MECHANISM OF ACTION AND DRUG
EFFECTS - ANSWER-Glucose is normally filtered from the kidneys, and most of it is reabsorbed into
circulation. This drug prevents the reabsorption of glucose, so it is excreted in the urine.
Sodium Glucose Contransorter Inhibitors (SGLT2 Inhibitors) INDICATIONS - ANSWER-type 2 diabetes
mellitus
Sodium Glucose Contransorter Inhibitors (SGLT2 Inhibitors) CONTRAINDICATIONS - ANSWER-
contraindicated in DKA, moderate to severe kidney impairment, breastfeeding
Sodium Glucose Contransorter Inhibitors (SGLT2 Inhibitors) ADVERSE EFFECTS - ANSWER-yeast
infections, increased urination, hypotension, hypovolemia, UTIs, hyperkalemia, increase in LDL
cholesterol, risk for ketoacidosis
Sodium Glucose Contransorter Inhibitors (SGLT2 Inhibitors) INTERACTIONS - ANSWER-rifampin
(decreases effects of SGLT2 inhibitors), loop diuretics, ace inhibitors, some herbs, hypoglycemia can
occur when used with other drugs
What does SGLT2 normally do? What happens when it is inhibited? - ANSWER-SGLT2 normally
transports sodium and glucose into cells for re-absorption. By inhibiting this transporter, the glucose is
excreted by the kidneys.
when should you take a SGLT2 inhibitor? - ANSWER-in the morning
,What suffix is used with the SGLT2 inhibitors? - ANSWER--agliflozin
Incretin Mimetics (injectable antidiabetic drugs) MECHANISM OF ACTION AND DRUG EFFECTS -
ANSWER-stimulate insulin secretion, reduce postprandial (after-meal) glucagon production, slow gastric
emptying, and increase satiety (feeling of being full). The increase in insulin and decrease in postprandial
glucagon causes a decrease in blood sugar.
Incretin Mimetics (injectable antidiabetic drugs) INDICATIONS - ANSWER-type 2 diabetes for people who
couldn't get control with other drugs
Incretin Mimetics (injectable antidiabetic drugs) CONTRAINDICATIONS - ANSWER-cant' be given with
insulin,
if pen freezes you have to throw it away, hypersensitivity to drug,
family history of medullary thyroid carcinoma, and patients with multiple endocrine neoplasia
syndrome type 2.
Incretin Mimetics (injectable antidiabetic drugs) ADVERSE EFFECTS - ANSWER-Black box warning of
developing thyroid c-cell tumors, NV&D, weight loss of 5 to 10 lbs, rare cases of hemorrhagic or
necrotizing (necrosis) pancreatitis
Incretin Mimetics (injectable antidiabetic drugs) INTERACTIONS - ANSWER-delays absorption of oral
drugs like tylonal or contraceptives by slowing gastic emptying. If taking sulfonylureas the dose may
need to be reduced if hypoglycemia occurs.
Incretin Mimetics (injectable antidiabetic drugs) DRUGS - ANSWER-Exenatide (byetta),
Liraglutid (victoza)
When should you give a Incretin Mimetic? Exenatide (byetta), Liraglutid (victoza) - ANSWER-give 60
minutes before a meal, usually AC aka before breakfast
How are Incretin Mimetics dosed? Exenatide (byetta),Liraglutid (victoza) - ANSWER-they are titrated up
what route is Incretin Mimetics given? Exenatide (byetta), Liraglutid (victoza) - ANSWER-subcutaneous
, what do incretin hormones naturally do in the body? Exenatide (byetta), Liraglutid (victoza) - ANSWER-
1) stimulate insulin secretion 2) reduce postprandial glucagon production 3) slow gastric emptying 4)
increase satiety
all the above helps decrease blood sugar!
Exenatide (byetta) - ANSWER-Incretin mimetic
Liraglutid (victoza) - ANSWER-incretin mimetic
What drug is the only Amylin Agonist (injectable antidiabetic drugs)? - ANSWER-Pramilintide (symlin)
Amylin Agonists (injectable antidiabetic drugs) drug: Pramilintide (symlin) MECHANISM OF ACTION AND
DRUG EFFECTS - ANSWER-mimics the natural hormone amylin. Amylin is secreted by the beta cells of
the pancreas along with insulin in response to food. Amylin decreases postprandial plasma glucose in 3
ways. 1) slows gastric emptying 2) suppresses glucagon secretion and hepatic glucose production 3)
increases satiety (sense of having eaten enough). When insulin increases, amylin increase, so this drug is
given with insulin.
Amylin Agonists (injectable antidiabetic drugs) drug: Pramilintide (symlin) INDICATIONS - ANSWER-type
1 or type 2 diabetes, given if target blood glucose level could not be reached with insulin alone.
Amylin Agonists (injectable antidiabetic drugs) drug: Pramilintide (symlin) CONTRAINDICATIONS -
ANSWER-Gastroparesis (a condition that affects the stomach muscles and prevents proper stomach
emptying) and drugs that alter GI motility
Amylin Agonists (injectable antidiabetic drugs) drug: Pramilintide (symlin) ADVERSE EFFECTS - ANSWER-
nausea, vomiting, anorexia, headache
Amylin Agonists (injectable antidiabetic drugs) drug: Pramilintide (symlin) INTERACTIONS - ANSWER-
Pramilintide (symlin) doesn't cause hypoglycemia alone, but if it is being taken with insulin, the insulin
dose needs to be reduced by 50 percent.
Don't mix insulin and Pramilintide (symlin) in the same syringe.