Antidiabetic Drugs Flashcards
Biguanides- Metformin MOA
Activates AMP kinase
Metformin Primary Action
- Decreases Hepatic Glucose production
- Enhances Insulin sensitivity in muscle and fat/peripheral tissue
- Decreases glucose intestinal absorption
Advantages of Metformin
- Rare hypoglycemia
- Dec CVD events
- Cheap
- Weight loss or weight neutral
Disadvantages of Metformin
GI side effects
Dosing with metformin
- with eGFR >60 mL/min, no dose adjustment needed
- eGFR 45-60 mL/min: needs frequent renal function monitoring every 3-6 mo
- Moderate Chronic Kidney disease (eGFR 30 -45 mL/min): do not initiate metformin
When to discontinue Metformin
D/C metformin at the time of or before an iodinated contrast imaging (eGFR 30-60 mL/min); reevaluate eGFR 48 hrs after the imaging procedure
Sulfonylureas 2nd generation drugs
Glyburide
Glipizide
Glimepiride
Sulfonylureas MOA
Initially binds to high affinity 140-kDA SU receptor and block K channel in beta cells to increase insulin release
Sulfonylureas Primary Action
Increase Insulin Secretion
Sulfonylureas disadvantages
Hypoglycemia, increase weight
Metglitinides primary action
increase insulin secretion
Metglitinides advantages
decrease postprandial glucose excursions, dose flexibility (short acting)
Metglitinides disadvantages
hypoglycemia, increase weight
Metglitinides drugs
Repaglinide
Nateglinide
Metglitinides contraindication
sulfonylureas (bc of same MOA)
