12. Antidiabetics PHARM Flashcards
Metformin: location of action?
Liver: decreases excessive glucose glucose output by liver
Metformin: what patients should this not be given to?
- patients with impaired liver, kidney fxn
- alcoholics
- patients with cardiac insufficiency (due to possibly accum of lactic acid)
Metformin: AEs?
nausea, vom, diarrh. Rarely, lactic acidosis
Sulfonyureas/Glyburide: site of action?
incr insulin secr from pancreas. uses sulfonylurea receptor on beta pancreatic cells to block K channel –> insulin release.
Sulfonylurea/Glyburide: AEs?
wt gain, hypoglycemia, tolerance, some pts don’t respond
Sulfonylurea/Glyburide? work on T1DM? why?
NO because of lack of pancreatic beta cells
Thiazolidinediones/Pioglitazone: site of action?
incr target tissue sensitivity to insulin (muscle)
Thiazolidinediones/Pioglitazone: AEs?
wt gain, liver toxicity, fluid retention, fractures.
Thiazolidinediones/Pioglitazone: mechanism?
bind to PPAR receptors, affects gene expression
Thiazolidinediones/Pioglitazone: patients who should not receive?
pts with cardiac problems
which of these agents should be taken w meals to minimize side effects?
metformin
which of these agents has a low risk of hypoglycemia? why?
metformin, because it decreases glucose rather than increasing insulin
which of these agents can only be taken SubQ?
exenatide
which of these agents has a block-box warning? for what?
metformin, for lactic acidosis
what is generally considered the drug of choice?
metformin, because it does not cause weight gain. unless pt is at risk for lactic acidosis
