Antidiabetic Drugs Flashcards
Diabetes mellitus is
Condition characterised by hyperglycemia due to absolute or relative lack of insulin
Type of DM
Type 1 IDDM or juvenile
Type 2 NIDDM
GDM
Anti diabetic drugs
Oral anti diabetic drugs
Injectable diabetic drugs
Oral anti diabetic drugs are
Oral hypoglycaemic drugs
Oral euglycemic drugs
Injectables
Insulin
Other agents
Oral hypoglycaemic agents sulfonylurea group 1st gen
Tolbutamide
Chlorpropamide
Tolazamide
2nd generation sulfonylurea group
Gliclazide
Glipizide
Glimepride
Glibenclamide
Disadvantage of 2nd gen
Minimum 30% B cell needed for their action
Disadvantage of 2nd gen
Minimum 30% B cell needed for their action
A/E of sulphonylureas
Weight gain
Hypoglycemia
Chance of hyponatraemia
Renal impairment
Euglycemic agents are
Insulin sensitizers
Glucosidase inhibitors
Incretin mimetic
Insulin sensitizers
Biguanides : metformin , phenformin
Thia-zoli-dine-Diones = Pioglitazone , Rosiglitazone
Incretin mimetics dipeptidyl peptidase -4 enzyme inhibitor
Sitagliptin
Vildagliptin
Lindagliptin
Saxagliptin
Injectable Anti Dm drugs are
Insulin
Insulin analogues
Insulin is
Secreted from B cell of islets of langerhans of pancreas
MW 5808
A chain has 21 @a
B chain has 30 @a
Insulin conventional
Short acting : regular ( 6-8hrs )
Immediate acting = NPH lenter (12-18hrs )
Long acting = ultralente (24-36 hrs )
Insulin analogues
Rapid acting = insulin Lispro , aspart , glulisine
Long acting = insulin glargine, detemir
Ultra long acting = degludec
Indications of insulin
IDDM
NIDDM when OAD failure
GDM
DM with complications # diabetic keto acidosis # Hyperosmolar non ketotic state / COMA
# diabetic retinopathy # diabetic nephropathy
DM with severe infections
Pre operative and post operative management of DM patients
Management of hyperkelemia ( glucose potassium co transport )
A/E of insulin
Hypoglycaemia
Insulin resistance
Insulin allergy
Lipodystrophy
Weight gain
Hypokalemia
A/E of insulin
Hypoglycaemia
Insulin resistance
Insulin allergy
Lipodystrophy
Weight gain
Hypokalemia
M/A of insulin
LIVER
(+) of hepatic glucose uptake
(-) of glycogenolysis
(-) of gluconeogenolysis
MUSCLE
(+) of glucose uptake and utilisation
(-) proteolysis
Gluconeogenesis
ADIPOSE TISSUE
increase glucose uptake
(-) lipolysis
(-) gluconeogenesis
M/ A of glimepride
(+) b cell of pancreas —-release of insulin ——- decrease blood glucose by increase glucose uptake by cell
M/A of sitagliptin
(-) dpp-4
No activation of glucagon like peptide 1 and gastric inhibitory peptide
Increase insulin level and glucagon level
Decrease blood glucose level
Anti DM action
Management of hypoglycaemia
If patient can swallow = sugar sugar containing foods and glucose
If patient is unconscious = I/ v glucose or dextrose running 25% glucose in 100mil water
Indications of metformin
NIDDM
Non diabetic patients = POLYCYSTIC OVARIAN DISEASE
OBESITY
A/E of metformin
Anorexia
Epigastric discomfort
Diarrhoea
Lactic acidosis
Metformin M/A
Increase glucose uptake in muscle and adipose tissue
Increase conversion of lactate from glucose
Decrease Glucose absorption from GIT
(+) glycolysis
Decrease plasma glucagon level
Reduced hypergylcemia
Anti diabetic action
Metformin M/A
Increase glucose uptake in muscle and adipose tissue
Increase conversion of lactate from glucose
Decrease Glucose absorption from GIT
(+) glycolysis
Decrease plasma glucagon level
Reduced hypergylcemia
Anti diabetic action
