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Endocrine & Metabolic Agents Flashcards

Cover high-yield endocrine medications used in diabetes, thyroid disorders, and metabolic conditions. (36 cards)

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1
Q

What is the common brand name(s) for:

allopurinol

(al-oh-PURE-i-nol)

A

Zyloprim

Class: Xanthine oxidase inhibitor

Indication: Used for gout, hyperuricemia in cancer patients, prevention of gouty arthritis and urate nephropathy, nephrolithiasis prevention, and tumor lysis syndrome

MOA: Competitive inhibitor of xanthine oxidase, converted to active metabolite oxypurinol in the liver, decreases uric acid excretion, increases urinary excretion of hypoxanthine

Side effects: skin rash; nausea/vomiting; diarrhea; hepatic toxicity; agranulocytosis; alopecia; drowsiness; rare: Stevens-Johnson syndrome; DRESS syndrome; hair discoloration

Contraindications: Known HLA-B*5801-positive

Considerations:

  • Caution in renal and hepatic impairment
  • May cause acute gout attack in early stages of use
  • Dosing changes for renal impairment, hepatic impairment

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2
Q

What is the common brand name(s) for:

canagliflozin

(ka-na-GLIF-loe-zin)

A

Invokana

Class: SGLT2 inhibitors

Indication: Used for Diabetes Mellitus Type 2, as monotherapy or with other antidiabetic medications

MOA: Inhibits SGLT2 in the renal PCT, decreasing renal glucose reabsorption and increasing urinary glucose excretion

Side effects: weight loss; hypotension; dyslipidemia; nausea; increased thirst and dehydration; increased incidence of UTI and genital yeast infections; increased risk of osteoporosis and fractures; diabetic ketoacidosis

Contraindications: Hypersensitivity to drug or its components

Considerations:

  • Efficacy dependent on glomerular filtration
  • Contraindicated in patients with GFR <50 mL/min
  • Avoid in severe hepatic impairment or renal impairment
  • Avoid in pregnancy and breastfeeding
  • Consider stopping if patient becomes volume depleted

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3
Q

What is the common brand name(s) for:

cinacalcet

(sin-a-KAL-set)

A

Sensipar

Class: Calcimimetic agent

Indication: Used for primary and secondary hyperparathyroidism, hypercalcemia

MOA: Increases sensitivity of calcium-sensing receptors on parathyroid cells, reducing PTH secretion and lowering serum calcium levels

Side effects: nausea; vomiting; paresthesias; muscle cramps; cardiac arrhythmias

Contraindications: Hypocalcemia

Considerations:

  • Start at a low dose and titrate gradually
  • Counsel patients about symptoms of hypocalcemia
  • Use with caution in hepatic impairment
  • Use with caution in women of childbearing potential

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4
Q

What is the common brand name(s) for:

colchicine

(KOL-chi-seen)

A

Gloperba

Class: Anti-gout agent

Indication: Used for acute gout, prophylaxis during allopurinol loading, familial Mediterranean fever, and atherosclerotic cardiovascular disease risk reduction

MOA: Disrupts microtubules and inhibits inflammatory leukocyte motility, blocking urate crystal-induced joint inflammation

Side effects: nausea; vomiting; diarrhea; abdominal cramps; agranulocytosis; alopecia; increased risk of GI bleeds

Contraindications: Severe renal or hepatic impairment; strong CYP3A4 inhibitor; blood dyscrasias

Considerations:

  • Dose-dependent due to diarrhea and GI side effects
  • Caution: increased risk of side effects in elderly patients

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5
Q

What is the common brand name(s) for:

dapagliflozin

(dap-a-GLIF-loe-zin)

A

Farxiga

Class: SGLT2 inhibitors

Indication: Used for Diabetes Mellitus Type 2, chronic kidney disease, heart failure

MOA: Inhibits SGLT2 in the renal PCT, decreasing renal glucose reabsorption and increasing urinary glucose excretion

Side effects: weight loss; hypotension; dyslipidemia; nausea; increased thirst and dehydration; increased incidence of UTI and genital yeast infections; increased risk of osteoporosis and fractures; diabetic ketoacidosis

Contraindications: Ketoacidosis; caution if dehydrated, hypotension, on antihypertensives, diuretics, or ACE inhibitors; elevated hematocrit

Considerations:

  • Efficacy dependent on glomerular filtration
  • Contraindicated in patients with GFR <50 mL/min
  • Avoid in severe hepatic impairment or renal impairment
  • Avoid in pregnancy and breastfeeding
  • Consider stopping if patient becomes volume depleted

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6
Q

What is the common brand name(s) for:

darbepoetin

(dar-be-POE-e-tin)

A

Aranesp

Class: Erythropoiesis-Stimulating Agent (ESA)

Indication: Used for anemia due to chronic kidney disease and chemotherapy

MOA: Binds to erythropoietin receptors on bone marrow, increasing red blood cell production and maturation

Side effects: hypertension; edema; fatigue; nausea; vomiting; headache; arthralgia; injection site reactions; serious: increased risk of cardiovascular events; thromboembolic events; pure red cell aplasia; tumor progression; seizures

Contraindications: Uncontrolled hypertension; pure red cell aplasia; cancer patients not undergoing chemotherapy; severe renal failure not on dialysis

Considerations:

  • Target hemoglobin levels should not exceed 11 g/dL
  • Monitor blood pressure closely

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7
Q

What is the common brand name(s) for:

desiccated thyroid

(DES-i-kay-ted THY-roid)

A

Armour Thyroid

Class: Animal thyroid hormones

Indication: Used for hypothyroidism

MOA: Dried thyroid gland tissue mimics endogenous T3 and T4 action

Side effects: weight loss; increased appetite; insomnia; headache; nervousness; tremors; heat intolerance; excessive sweating; hyperthyroidism; decreased bone density

Contraindications: Untreated thyrotoxicosis; uncorrected adrenal insufficiency

Considerations:

  • Monitor thyroid levels regularly
  • Avoid over-treatment, especially in elderly and patients with heart disease
  • Adjust dosing based on pregnancy and other conditions

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8
Q

What is the common brand name(s) for:

dulaglutide

(doo-la-GLOO-tide)

A

Trulicity

Class: GLP-1 agonists

Indication: Used for Diabetes Mellitus Type 2, usually with other oral antidiabetic drugs

MOA: Enhances GLP-1 effect by binding to GLP1Rs, stimulating glucose-dependent insulin secretion, increasing glucose uptake, decreasing glucagon secretion, delaying gastric emptying, increasing satiety

Side effects: decreased appetite; asthenia; dry mouth; dizziness; nausea; vomiting; headache; gallbladder disorders; acute pancreatitis

Contraindications: Personal or family history of medullary thyroid carcinoma with multiple endocrine neoplasia syndrome type 2

Considerations:

  • Avoid in pregnancy and breastfeeding
  • Acceptable in mild-moderate hepatic impairment but avoid in severe hepatic or renal impairment

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9
Q

What is the common brand name(s) for:

empagliflozin

(em-pa-GLIF-loe-zin)

A

Jardiance

Class: SGLT2 inhibitors

Indication: Used for Diabetes Mellitus Type 2, chronic kidney disease, heart failure

MOA: Inhibits SGLT2 in the renal PCT, decreasing renal glucose reabsorption and increasing urinary glucose excretion

Side effects: weight loss; hypotension; increased thirst and dehydration; increased incidence of UTI and genital yeast infections; increased risk of osteoporosis and fractures; diabetic ketoacidosis

Contraindications: Hypersensitivity to drug or its components

Considerations:

  • Avoid in severe hepatic impairment or renal impairment
  • Reduce dose to 10mg if GFR <60mL/min consistently
  • Avoid in pregnancy and breastfeeding

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10
Q

What is the common brand name(s) for:

epoetin alfa

(E-poe-e-tin AL-fa)

A

Epogen, Procrit

Class: Erythropoiesis-Stimulating Agent (ESA)

Indication: Used for anemia due to chemotherapy, chronic kidney disease, and zidovudine use; reduces need for allogeneic RBC transfusion

MOA: Stimulates erythropoiesis by binding to erythropoietin receptors and increasing hemoglobin levels

Side effects: hypertension; headache; nausea; fever; edema; injection site reactions; increased risk of thrombotic events; seizures; pure red cell aplasia

Contraindications: Uncontrolled hypertension; pure red cell aplasia; neonates; infants; pregnant; and breastfeeding for multidose vials

Considerations:

  • Start at the lowest effective dose to reduce RBC transfusions
  • Adjust dose based on hemoglobin response
  • Avoid increasing Hb >11 g/dL due to cardiovascular risk
  • Do not increase dose more frequently than once every 4 weeks
  • Measure hemoglobin levels weekly until stable, then every 2–4 weeks

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11
Q

What is the common brand name(s) for:

exenatide

(ex-EN-a-tide)

A

Byetta, Bydureon

Class: Incretin mimetics

Indication: Used for Diabetes Mellitus Type 2 as an adjunct medication with diet and exercise

MOA: Binds GLP-1 receptors, stimulating the adenylyl cyclase pathway to produce insulin in pancreatic beta-cells, resulting in increased insulin, decreased glucagon, and delayed gastric emptying

Side effects: decreased appetite; weight loss; nausea; vomiting; constipation; diarrhea; asthenia; headache; dizziness; injection site reactions; severe pancreatitis (rare)

Contraindications: History or family history of medullary thyroid carcinoma; Multiple endocrine neoplasia syndrome type 2; History of drug-induced immune-mediated thrombocytopenia

Considerations:

  • Avoid in severe renal impairment
  • Avoid in elderly patients or those with low BMI (weight loss)
  • Avoid in pregnancy and breastfeeding

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12
Q

What is the common brand name(s) for:

febuxostat

(fe-BUK-soe-stat)

A

Uloric

Class: Xanthine Oxidase Inhibitor

Indication: Used for treating gout

MOA: Inhibits xanthine oxidase, the enzyme responsible for changing hypoxanthine to xanthine to uric acid, helping to decrease uric acid in the body

Side effects: Decreased appetite, weight loss, nausea, vomiting, constipation, diarrhea, asthenia, headache, dizziness, and injection site reactions; severe pancreatitis (rare)

Contraindications: Use with azathioprine or mercaptopurine

Considerations:

  • Avoid in severe renal impairment
  • Avoid in elderly patients or those with low BMI (weight loss)
  • Avoid in pregnancy and breastfeeding
  • Not for treatment of asymptomatic hyperuricemia

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13
Q

What is the common brand name(s) for:

glimepiride

(glim-EP-i-ride)

A

Amaryl

Class: Sulfonylureas

Indication: Used for treating Diabetes Type 2

MOA: Inhibits ATP-sensitive K+ channels, preventing K+ efflux and causing Ca2+ influx and activation of pulsatile insulin secretion. No effect on basal insulin secretion. Limits hepatic gluconeogenesis and lipolysis. Increases insulin sensitivity in DM2.

Side effects: weight gain; hypoglycemia; skin rashes; nausea; vomiting; abdominal pain; cholestasis; hematologic reactions

Contraindications: Hypersensitivity to the drug or any of its components

Considerations:

  • 1st generation of these drugs are no longer used (e.g., acetohexamide)
  • Advise patient to limit alcohol intake
  • Therapy starts with low doses
  • Administered orally

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14
Q

What is the common brand name(s) for:

glipizide

(GLIP-i-zide)

A

Glucotrol

Class: Sulfonylureas

Indication: Used for treating Diabetes Type 2

MOA: Inhibits ATP-sensitive K+ channels, preventing K+ efflux and causing Ca2+ influx and activation of pulsatile insulin secretion. No effect on basal insulin secretion. Limits hepatic gluconeogenesis and lipolysis. Increases insulin sensitivity in DM2.

Side effects: weight gain; hypoglycemia; skin rashes; nausea; vomiting; abdominal pain; cholestasis; hematologic reactions

Contraindications: Type 1 diabetes mellitus; diabetic ketoacidosis (with or without coma)

Considerations:

  • 1st generation of these drugs are no longer used (e.g., acetohexamide)
  • Advise patient to limit alcohol intake
  • Therapy starts with low doses
  • Administered orally

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15
Q

What is the common brand name(s) for:

glyburide

(GLYE-byoor-ide)

A

Micronase, Diabeta

Class: Sulfonylureas

Indication: Used for Diabetes Type 2 as monotherapy or in combination with metformin

MOA: Inhibits ATP-sensitive K+ channels, preventing K+ efflux and causing Ca2+ influx and activation of pulsatile insulin secretion. No effect on basal insulin secretion. Limits hepatic gluconeogenesis and lipolysis. Increases insulin sensitivity in DM2.

Side effects: weight gain; hypoglycemia; skin rashes; nausea; vomiting; abdominal pain; cholestasis; hematologic reactions

Contraindications: Type 1 diabetes mellitus; diabetic ketoacidosis (with or without coma); use with bosentan

Considerations:

  • 1st generation of these drugs are no longer used (e.g., acetohexamide)
  • Advise patient to limit alcohol intake
  • Therapy starts with low doses
  • Administered orally

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16
Q

What is the common brand name(s) for:

hydroxychloroquine

(hye-DROX-ee-klor-oh-kwin)

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A

Plaquenil

Class: Antimalarial, DMARD

Indication: Used for prophylaxis and treatment of malaria, rheumatoid arthritis, and lupus

MOA: Precise mechanism is unconfirmed; hypothesized to raise lysosomal pH within malaria parasites, preventing hemoglobin proteolysis and thus preventing parasite replication; also raises pH within APCs, reducing antigen presentation and dampening the immune inflammatory response

Side effects: abdominal pain; diarrhea; decreased appetite; nausea and vomiting; headache; QT prolongation; rare side effects include visual impairment; tinnitus; retinopathy; vertigo; corneal edema; arrhythmias; seizures

Contraindications: Hypersensitivity to the drug or any of its components

Considerations:

  • Screen for retinopathy before commencing treatment (long-term administration)
  • Toxicity is very dangerous and hard to treat, so seek specialist advice
  • Ideally avoid in pregnancy but it is acceptable
  • Avoid in breastfeeding due to risk of neonatal toxicity

17
Q

What is the common brand name(s) for:

insulin aspart

(IN-soo-lin AS-part)

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A

NovoLog

Class: Rapid-acting insulin

Indication: Used to manage Diabetes Mellitus Type 1 and Type 2.

MOA: Rapid-acting insulin analog that binds to the insulin receptor, mimicking the endogenous effects of insulin.

Side effects: hypoglycemia; edema; weight gain; hypokalemia; lipodystrophy at injection site (uncommon)

Contraindications: Hypersensitivity to the drug or any of its components.

Considerations:

  • Onset: 10-20 mins
  • Peak: 1 hour
  • Duration: 2-5 hours
  • Caution in renal impairment, in elderly

18
Q

What is the common brand name(s) for:

insulin degludec

(IN-soo-lin DE-glue-dek)

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A

Tresiba

Class: Ultra long-acting insulin

Indication: Used for Diabetes Type 1 and Type 2 management.

MOA: Acts via membrane-bound receptors on target tissue (liver, muscle, adipose tissue) to regulate metabolism of carbohydrate, proteins, and fats.

Side effects: hypoglycemia; edema; weight gain; hypokalemia; lipodystrophy at injection site (uncommon)

Contraindications: Hypersensitivity to the drug or any of its components.

Considerations:

  • Assess and consider altering doses in pregnancy and/or breastfeeding
  • Decrease dose in hepatic or renal impairment
  • Onset: 1 hour
  • Peak: 9 hours
  • Duration: 42 hours

19
Q

What is the common brand name(s) for:

insulin detemir

(IN-soo-lin DET-eh-meer)

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A

Levemir

Class: Long-acting insulin

Indication: Used for Diabetes Mellitus Type 1 and Type 2.

MOA: Binds to insulin receptors, lowering blood glucose by stimulating cellular uptake of glucose and by inhibiting the output of glucose from the liver.

Side effects: Hypoglycemia, edema, weight gain, hypokalemia, lipodystrophy at injection site (uncommon).

Contraindications: Hypoglycemia episode, asthma, COPD (inhalation powder).

Considerations:

  • Slow release of insulin – basal level
  • Duration: 16-24H
  • Diabetic patient started on lower dose
  • Caution in renal impairment, in elderly

20
Q

What is the common brand name(s) for:

insulin glargine

(IN-soo-lin GLAR-jeen)

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A
  • Lantus
  • Basaglar
  • Toujeo

Class: Long-acting insulin

Indication: Used for Diabetes Mellitus Type 1 and Type 2.

MOA: Provides basal levels of insulin and facilitates control of glycemia throughout the day.

Side effects: Hypoglycemia, edema, weight gain, hypokalemia, lipodystrophy at injection site (uncommon).

Contraindications: Hypoglycemia episode.

Considerations:

  • Slow release of insulin – basal level
  • Duration: 20-24H
  • Diabetic patient started on lower dose
  • Caution in renal impairment, in elderly

21
Q

What is the common brand name(s) for:

insulin glulisine

(IN-soo-lin GLOO-li-seen)

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A

Apidra

Class: Rapid-acting insulin

Indication: Used for Diabetes Mellitus Type 1 and Type 2.

MOA: Rapid-acting insulin analog that binds to the insulin receptor, mimicking the endogenous effects of insulin.

Side effects: hypoglycemia; edema; weight gain; hypokalemia; lipodystrophy at injection site (uncommon)

Contraindications: Hypersensitivity to the drug or any of its components.

Considerations:

  • Onset: 10-20 mins
  • Peak: 1 hour
  • Duration: 2-5 hours
  • Caution in renal impairment, in elderly

22
Q

What is the common brand name(s) for:

insulin isophane
Neutral Protamine Hagedorn (NPH)

(IN-soo-lin EYE-soe-fane – NOO-tral PRO-ta-meen HAG-er-dorn)

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A

Humulin N, Novolin N

Class: Insulin analog, intermediate-acting

Indication: Used for Diabetes Mellitus Type 1 and Type 2.

MOA: Consists of particles of insulin combined with zinc, protamine, and phenol.

Side effects: hypoglycemia; edema; weight gain; lipodystrophy (rare)

Contraindications: Hypoglycemia episode

Considerations:

  • May need to adjust dose in pregnancy and breastfeeding
  • Also adjust dose lower in hepatic and renal impairment
  • Onset is 1-4 hours, peak is within 6-10 hours

23
Q

What is the common brand name(s) for:

insulin lispro

(IN-soo-lin LIS-pro)

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A

Humalog

Class: Rapid-acting insulin

Indication: Used for Diabetes Mellitus Type 1 and Type 2.

MOA: Rapid-acting insulin analog that binds to the insulin receptor, mimicking the endogenous effects of insulin.

Side effects: hypoglycemia; edema; weight gain; hypokalemia; lipodystrophy at injection site (uncommon)

Contraindications: Hypoglycemia episode

Considerations:

  • Onset: 10-20 mins
  • Peak: 1 hour
  • Duration: 2-5 hours
  • Caution in renal impairment, in elderly

24
Q

What is the common brand name(s) for:

insulin regular

(IN-soo-lin REG-yoo-lar)

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A

Humulin R, Novolin R

Class: Insulin

Indication: Used for Diabetes Mellitus Type 1 and Type 2.

MOA: Acts via membrane-bound receptors on target tissue (liver, muscle, adipose tissue) to regulate metabolism of carbohydrate, proteins, and fats.

Side effects: hypoglycemia; edema; weight gain; lipodystrophy (rare)

Contraindications: Hypersensitivity to the drug or any of its components.

Considerations:

  • May need to adjust dose in pregnancy and breastfeeding
  • Also adjust dose lower in hepatic and renal impairment

25
# What is the common brand name(s) for: levothyroxine | (LEE-voe-thye-ROX-een)
* Synthroid * Levoxyl * Unithroid | Class: Synthetic thyroid hormone ## Footnote **Indication:** Used for Hypothyroidism and Pituitary thyrotropin-simulating hormone suppression. **MOA:** Levo-isomer of T4, which is converted to T3 peripherally, increasing cellular metabolic rate and supporting fetal growth/development. **Side effects:** hyperthyroidism in high doses; fever; arthralgia; malaise; insomnia; tremor; nausea and vomiting; weight loss; palpitations **Contraindications:** Uncorrected adrenal insufficiency; hypersensitivity to glycerol and edetate disodium **Considerations:** * Obtain a baseline ECG if administering to patients with cardiac changes * Advise patient to take medication on an empty stomach * Hypersensitivity to levothyroxine or any component of the formulation is not considered a contraindication - may need dose reduction and slow titration
26
# What is the common brand name(s) for: linagliptin | (lin-a-GLIP-tin)
Tradjenta | Class: DPP-4 inhibitors ## Footnote **Indication:** Diabetes Mellitus Type 2 **MOA:** Inhibits the enzyme DPP4, increasing GLP-1 and GIP levels to stimulate glucose-dependent insulin secretion and increase glucose uptake. **Side effects:** joint and skeletal muscle pain; cough; nasopharyngitis; rhinitis; rare: angioedema; skin reactions; pancreatitis **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Generally well tolerated in older adults * Once daily, orally administered
27
# What is the common brand name(s) for: liothyronine | (lye-oh-THYE-ro-neen)
Cytomel | Class: Synthetic thyroid hormone ## Footnote **Indication:** Hypothyroidism; Myxedema coma **MOA:** Binds to thyroid hormone receptors to increase metabolic rate but does not increase plasma T4. **Side effects:** oligomenorrhea; heat intolerance; arrhythmias; tremor; nausea; vomiting; weight loss; insomnia; myalgia **Contraindications:** Thyrotoxicosis; uncorrected adrenal insufficiency; concurrent use with artificial rewarming **Considerations:** * Does not cross the placenta enough to have an effect, acceptable in pregnancy if low-dose * May have to increase dose in pregnancy
28
# What is the common brand name(s) for: liraglutide | (lir-a-GLOO-tide)
Victoza, Saxenda | Class: Incretin mimetics (GLP-1 agonists) ## Footnote **Indication:** Diabetes Mellitus Type 2 (monotherapy or with other medications along with diet and exercise) **MOA:** Binds GLP1R on pancreatic beta-cells to stimulate insulin production, decrease glucagon production, and delay gastric emptying. **Side effects:** decreased appetite; asthenia; dry mouth; dizziness; nausea; vomiting; headache; gallbladder disorders; rare: acute pancreatitis **Contraindications:** IBD; diabetic gastroparesis; severe cardiac failure; caution if thyroid disease **Considerations:** * Administer subcutaneously once daily * Avoid in pregnancy and breastfeeding * Acceptable in mild-moderate hepatic impairment but avoid in severe hepatic or renal impairment
29
# What is the common brand name(s) for: metformin | (met-FOR-min)
Riomet | Class: Biguanides ## Footnote **Indication:** Diabetes Mellitus Type 2 **MOA:** Decreases hepatic glucose output and glucose absorption from the gut, increases insulin sensitivity. **Side effects:** GI disturbances; diarrhea; lactic acidosis (rare); weight loss **Contraindications:** Severe renal dysfunction; abnormal creatinine clearance; acute or chronic metabolic acidosis **Considerations:** * Duration of action: 18 hours * Consider withholding before and for 48 hours after use of IV contrast * Can be used in pregnancy and breastfeeding * Avoid in severe hepatic or renal impairment * Monitor B12 levels
30
# What is the common brand name(s) for: methotrexate | (meth-oh-TREX-ate)
Trexall | Class: Antifolate (antimetabolite); DMARD ## Footnote **Indication:** Rheumatoid arthritis; Crohn's disease; psoriasis refractory to other treatment; some malignancies **MOA:** Inhibition of dihydrofolate reductase and other enzymes, resulting in decreased DNA synthesis; converted to an active metabolite that inhibits AICART. **Side effects:** anemia; cough; diarrhea; dyspnea; fever; fatigue; decreased appetite; nausea; vomiting; thrombocytopenia; hepatotoxicity; renal toxicity; intrathecal: neurotoxicity; NDL **Contraindications:** Psoriasis; rheumatoid arthritis; polyarticular juvenile idiopathic arthritis; pregnancy; alcohol use disorder; liver disease; immunodeficiency syndrome; preexisting blood dyscrasias **Considerations:** * Administering folic acid reduces hepatotoxicity * End therapy if the patient develops ulcerative stomatitis * Calcium folinate is used to treat overdose and/or toxicity * Avoid in pregnancy (teratogenic) and breastfeeding * Avoid in severe renal and/or hepatic impairment
31
# What is the common brand name(s) for: pioglitazone | (pye-oh-GLI-ta-zone)
Actos | Class: Thiazolidinediones ## Footnote **Indication:** Diabetes Mellitus Type 2 **MOA:** Agonist of PPAR-γ, increases transcription of insulin-responsive genes, increases insulin sensitivity, and decreases insulin resistance. **Side effects:** edema; increased risk of heart failure; increased body weight; decreased bone mineral density; increased risk of osteoporosis and fractures in older women; may increase risk of bladder cancer **Contraindications:** Heart failure (NYHA Class 3, Class 4) **Considerations:** * Avoid in pregnancy and breastfeeding * Monitor liver function periodically * Not recommended in pediatrics
32
# What is the common brand name(s) for: potassium chloride | (poe-TASS-ee-um KLOR-ide)
Klor-Con, K-Dur | Class: Electrolyte supplement ## Footnote **Indication:** Hypokalemia **MOA:** Reduces release of acetylcholine at the myoneural junction, inducing muscle relaxation; inhibits calcium influx, reducing muscle contraction. **Side effects:** hyperkalemia; gastrointestinal upset; arrhythmias with rapid IV infusion; pain at IV infusion site **Contraindications:** Structural, pathological, and/or pharmacologic cause for GI tract delay; use with potassium-sparing diuretics **Considerations:** * Klor-Con is multiple doses per day, K-Dur once daily * Educate patients about signs and symptoms of low and high potassium levels
33
# What is the common brand name(s) for: repaglinide | (re-PAG-li-nide)
Prandin | Class: Meglitinides ## Footnote **Indication:** Diabetes Mellitus Type 2 (1st line) **MOA:** Inhibits ATP-sensitive potassium channels, causing Ca2+ influx and activation of pulsatile insulin secretion; no effect on basal insulin secretion. **Side effects:** hypoglycemia; abdominal pain; diarrhea **Contraindications:** Use with gemfibrozil **Considerations:** * Should not be used with other oral antidiabetic drugs or insulin * Can be used with metformin * Take before meals * Avoid in hepatic impairment
34
# What is the common brand name(s) for: saxagliptin | (sax-a-GLIP-tin)
Onglyza | Class: DPP-4 inhibitors ## Footnote **Indication:** Diabetes Mellitus Type 2 **MOA:** Inhibits the enzyme DPP4, increasing GLP-1 and GIP levels to stimulate glucose-dependent insulin secretion and increase glucose uptake. **Side effects:** joint and skeletal muscle pain; cough; nasopharyngitis; rhinitis; rare: angioedema; skin reactions; pancreatitis **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Generally well tolerated in older adults * Orally administered
35
# What is the common brand name(s) for: semaglutide | (sem-a-GLOO-tide)
Ozempic, Wegovy | Class: GLP-1 agonists ## Footnote **Indication:** Diabetes Mellitus Type 2 (usually in combination with other oral antidiabetic drugs), weight management **MOA:** Enhances GLP-1 effect by binding to GLP1Rs on pancreatic B-cells, stimulating glucose-dependent insulin secretion and increasing glucose uptake. **Side effects:** decreased appetite; asthenia; dry mouth; dizziness; nausea; vomiting; headache; gallbladder disorders; rare: acute pancreatitis **Contraindications:** ketoacidosis; gastroparesis; IBD; cardiac failure **Considerations:** * Avoid in pregnancy and breastfeeding * Acceptable in mild-moderate hepatic impairment but avoid in severe hepatic or renal impairment * Wegovy indicated for weight management
36
# What is the common brand name(s) for: sitagliptin | (sit-a-GLIP-tin)
Januvia | Class: DPP-4 inhibitors ## Footnote **Indication:** Diabetes Mellitus Type 2 **MOA:** Inhibits the enzyme DPP4, increasing GLP-1 and GIP levels to stimulate glucose-dependent insulin secretion and increase glucose uptake. **Side effects:** joint and skeletal muscle pain; cough; nasopharyngitis; rhinitis; rare: angioedema; skin reactions; pancreatitis **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Generally well tolerated in older adults * Once daily, orally administered
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