Greetings my name is sheryl with ax and i’m the national diabetes initiative chair for the student national pharmaceutical association also known as snappa and i would like to welcome you to part 5 and the final part of the life of sweet savory patient-centered mini lecture series this mini lecture will cover new diabetes medication options a few words about
Snapper snapper is an educational service organization of pharmacy students whose purpose is to plan organize coordinate and execute programs geared toward the improvement of the health educational and social environment of the community we are dedicated to the pharmacy profession and serving the underserved now a few words about our guest speaker dr. laurie laurie
Dr. laurie armistead is currently a postgraduate year one ambulatory care resident at the university of north carolina medical center and clinics she received her pharmd from the university of north carolina esselman school of pharmacy in 2015 and a master’s degree in chemistry from unc in 1998 her career interests include providing ambulatory care pharmacy services
To underserved populations specifically internal medicine and primary care without further ado dr. laurie armistead well welcome back i’d say the previously my name is laurie armistead and i’m currently a pharmacy resident and laboratory care at the university of north carolina medical center in clinics in part 2 of this particular series we will be exploring
Some of the many flavors of new diabetes medications medications that have been developed over the last 20 years now here’s a smattering some of the newer medications out there perhaps you recognize some of their names parking some of them perhaps said ago lipton or victoza rings a bell or januvia or pioglitazone invokana to jo and far zika are some of the newest
Medications having been fda approved in the last few years we’re not going to explore all of these medications and more over the neck what a while a class of medications that made their arrival on the scene a few years after metformin but within the past 20 years are the thiazolidinediones or dvds pioglitazone and rosiglitazone pioglitazone goes by the brand name
Actos and rows of what is owned by avandia they are dosed as indicated they were first approved for use in the u.s. in the late 1990s they increase the storage and use of glucose and decrease insulin resistance because they work in slightly different ways in metformin and so funny areas they can be taken in conjunction with either type of medication in order to
Improve overall blood glucose control now dvds don’t cause hypoglycemia or low blood sugar like insulin and so funny areas do and they produce an effect that is durable unlike the sulfonylureas we previously discussed some studies even show that tv ds may improve cholesterol levels an added benefit unfortunately tv ds have quite a few negatives like insulin and so
Far nearly as they can cause weight gain they can also cause edema or water retention and swelling and therefore can worsen heart failure dvds can also weaken bones increasing the risk of developing osteoporosis it may cause gas and diarrhea with use pcbs are also more expensive than metformin to fajnie areas because of these negatives pcbs aren’t currently used
As much as they used to be especially since there are newer better medications out there dpp-4 inhibitors are another class of medication that showed up about 10 years ago in the early 2000s siddig lipton saxagliptin linagliptin and allah gluten are often owned by the brand names of januvia onglyza to agenda and nesina they are oral medications enter typically
Ghosts as listed here now set up lipton was a first dpp-4 inhibitor to be improved by the fda being approved in 2006 alig lipton the most recently approved dpp-4 inhibitor was approved by the fda in 2013 now all dpp-4 inhibitors decrease glucose absorption and increased insulin production they’re often take taken with metformin to maximize benefit because they
Work a little bit differently dpp-4 inhibitors are pretty effective but not as effective as some of the other medications we’ve discussed on the positive side they don’t contribute to weight gain and have few side effects so they are pretty well tolerated they’re also pretty inexpensive they do however carry a risk of causing hypoglycemia particularly if taken
With silvana areas or insulin and they make all of pancreatitis inflammation of the pancreas or in rare instances edema glp-1 agonists are another new class of medications but they are injectables not oral medications exenatide comes in two forms the twice-daily by ada and the once-weekly liberian liraglutide goes by the brand name victoza alba blue tide goes by
Tan geum and dulaglutide goes by trulicity victoza is injected once daily while pansy amande trulicity are injected once weekly just like bydureon the once weekly formulations are more convenient but they do have larger needles which causes an issue for some people by ada was the first glp-1 agonists to be improved to be approved in the us and was done so in 2006
The two most recent glp-1 agonists have been approved in the last two years and all gop agonist decrease glue absorption and increased insulin production just like dpp-4 inhibitors glp-1 agonists are quite effective more so than dpp-4 inhibitors they also don’t cause hypoglycemia a very attractive benefit of glp-1 agonist additionally they also can promote weight
Loss and they also may provide some cardiovascular or heart benefit and the weight loss is one of the most attractive benefits of the agonist that causes a lot of people to want to try them even though they are injectables amongst the downsides gop ones in addition to be an injectable is that they may cause nausea and vomiting there is also a smaller risk that
They may cause pancreatitis or thyroid cancer but the risk for those very small glp-1 agonists also tend to be quite expensive but many insurance companies will cover them another use of the glp-1 agonists liraglutide is as a weight-loss agent under the brand name sex enda it is important to note that liraglutide must be given at higher doses in order to be used
Primarily as a weight-loss agent victoza for blood glucose control is given at one point two to one point eight milligrams sex zinda used for weight loss is given at three milligrams both victoza and sex senda contain liraglutide and those are injectables typically administered in abdomen die for upper arm sglt2 inhibitors are the newest oral diabetes agents to be
Developed eniko frozen de pago frozen and info go frozen are currently in use but there are other sglt2 inhibitors currently being developed invokana as you might know chemical closin is those 2 100 to 300 milligrams once daily far seiga is dosed at 10 5 to 10 milligrams once daily anjar dians is dosed at 10 or 25 milligrams daily the first agent invokana was approved
In 2013 with the others close behind sglt2 inhibitors are quite unique and that they work on the kidneys helping the body get rid of extra glucose through the urine because of the risk of low blood pressure and dehydration with these agents however it is important to drink plenty of fluids while taking them sglt2 s are pretty effective agents with minimal risk of
Causing low blood glucose they also may promote some weight loss and may even lower blood pressure which could be beneficial if you currently have hypertension however caution must be used because these agents may also call low blood pressure or dehydration as i previously mentioned the large is concerned with these agents however is their propensity to cause freak
At urination as well as more urinary tract infections they are also quite extensive there are also some new insulin products that have been developed which as to the insulin options that are currently available afrasia is a ultra rapid inhaled insulin that works immediately but lasts less than an hour there are also some new highly concentrated insulins humulin
You 500 contains regular insulin but at a concentration that is five times greater than standard humulin because it is more concentrated it last longer and beacon stink can be considered more of an intermediate acting insulin like nph to jo a concentrated form of glargine is three times more concentrated than lantus it is useful for those who require high doses
Of glargine in order to control the blood sugar’s these higher accentuated insulins are much more dangerous than standard dose insolence however and must be used with extreme caution it is also worth mentioning that there are some other new insulin products that are currently in use and even more coming out all of the in all of them are similar to the ones listed
Here i just wanted to list a few here to give you a few examples of some of the new products that are currently out now finally a few other diabetes medications worth mentioning or coalesce mlm also known as well call when used for diabetes colesevelam is a bile acid sequestrants which means it binds bile acid in your gut it is also used as a cholesterol-lowering
Medication but under a different brand name mick little and our clothes are agents at block glucose absorption in the gut accordingly they may cause da minimal discomfort diarrhea and flatulence finally pamela no tide is an injectable medication that is given with mealtime insulin to improve glucose control it may also promote weight loss in summary there are many
Many flavors of diabetes medications both old and new and there are newer new ones coming out all the time the best options for you will depend on whether you have type 1 or type 2 diabetes the amount of glucose control you need what side effects you can tolerate if you are willing to use injectable medications or not what type of prescription insurance coverage you
Have and what has worked for you in the past or sale for you in the past diabetes is a chronic condition that may require medication changes along the way for optimum control the good thing is that they’re loosing is that there are many options out there for you and your diabetes care provider to absorb thank you dr. armistead i just want to give a very special
Thanks to walmart sam’s club and snappa by whom this web lecture was sponsored thank you again dr. armistead for taking the time to discuss the pros and cons of new diabetes medications they are currently available on the market thank you to all the listeners of this web lecture we do hope that this has been informative and will be helpful in your everyday life
And in managing your diabetes this concludes the patient center web lecture miniseries
Transcribed from video
Medication Options 2 By Student National Pharmaceutical Association (SNPhA)
