anti diabetic agents Flashcards
what class of antidiabetic is metformin
biguanides
describe the mechanism of action of met form
- Peripheral insulin sensitivity - Glucose uptake into and use and use by skeletal muscle
reduces hepatic gluconeogenesis
reduces intestinal glucose absorption
uses/ indication of metformin
type ii diabetes first choice in overweight to and PCOS
SE of metformin
GIT disturbance - diarrhoea
nausea
vomiting
lactic acidosis
contraindications of metformin
renal failure
cardiac failure
resp failure
hepatic failure
the above increase risk of lactic acidosis developing
drug interactions for metformin
contrast agents ACEi alcohol NSAID's steroids
what are sulphonyureas given an example
glipizide
blocks potassium channels on pancreatic beta cells - stimulating insulin release
SE of sulphonylureas
GIT disturbance
hypoglycaemia
weight gain
contraindications of sulphonylureas
renal failure hepatic failure porphyria pregnancy breast feeding
drug interactions for sulphonyureas
ACEi
NSAID’s
steroids
alcohol
what are the different types of insulin
rapid acting = insulin lispro short acting = soluble insulin intermediate = isophane long acting = insulin glargine biphasic = biphasic isophane insulin
how does insulin therapy act, which pathways are affected
insulin binds to tyrosine kinase receptors where it initiates 2 pathways by phosphorylations
- MAP kinase signalling pathway which is responsible for cell growth and proliferation
- PI-3K signalling pathway - responsible for the GLUT 4 receptors to the cell surface membrane
GLU-T transports glucose into the cell - pathway is responsible or protein, lipid and glycogen synthesis
uses of insulin therapy
T1DM
T2DM
what are the SE of insulin therapy
weight gain
hypoglycaemia
localised lipoatrophy
hypokalaemia
what are the CI associated with insulin
hypersensitivity to any of the therapy ingredients
hypokalaemia
