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Combination drugs for type 2 diabetes

Bridgeman, Mary Barna PharmD, BCPS, BCGP; Dalal, Kavitha S. PharmD

doi: 10.1097/01.NURSE.0000531888.22149.39

Mary Barna Bridgeman is a clinical associate professor at Rutgers University Ernest Mario School of Pharmacy in Piscataway, N.J. Kavitha S. Dalal is a critical care pharmacist at Virtua in Marlton, N.J.

Unless otherwise specified, the information in the preceding summaries applies to adults, not children. Consult the package insert for information about each drug's safety during pregnancy and breastfeeding. Also consult a pharmacist, the package insert, or a comprehensive drug reference for more details on precautions, drug interactions, and adverse reactions.

The following combination medications are indicated as adjuncts to diet and exercise in adults with type 2 diabetes mellitus. Can you identify their components? To find out, match each brand name in Section I with its generic name in Section II.

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Section I

_____ 1. Qtern (AstraZeneca)

_____ 2. Soliqua (Sanofi-Aventis)

_____ 3. Xultophy (Novo Nordisk)

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Section II

a. insulin glargine and lixisenatide. This product combines insulin glargine, a long-acting human insulin analogue, and lixisenatide, a glucagon-like peptide-1 (GLP-1) receptor agonist. Teach patients to administer it once daily as a subcutaneous injection in the thigh, upper arm, or abdomen within an hour before the first meal of the day. Don't administer I.V. or I.M.

b. insulin degludec and liraglutide. A combination of a long-acting human insulin analogue and a GLP-1 receptor agonist, this drug is injected subcutaneously once daily at same time each day with or without food in the thigh, upper arm, or abdomen. It has a boxed warning for thyroid C-cell tumors. Teach patients signs and symptoms of thyroid tumors, including a neck mass and dysphagia.

c. dapagliflozin and saxagliptin. Taken orally, this drug combines dapagliflozin, a SGLT-2 inhibitor, with saxagliptin, a dipeptidyl peptidase-4 inhibitor. Monitor patients for signs and symptoms of acute pancreatitis, including acute onset of severe upper abdominal pain.

Resources available upon request.

ANSWERS: 1c, 2a, 3b

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