Diabetes - 2 Flashcards
Glinides
- insulin secretagogues
- stimulates insulin release
- rapid onset + short action duration
- combine with metformin (not sulphonylureas)
- dont use with gemfibrozil (hypoglycaemia)
Sulphonylureas
- insulin secretagogue
- promote insulin release and sensitivity, reduces hepatic glucose production
Biguanides
- Insulin sensitizers
- improved glucose uptake, reduces hepatic glucose production (main)
- slows intestinal glucose absorption
- reduces hyperlipidaemia, reduces appetite
- long term vit B12 deficiency
Thiazolidinediones
- insulin sensitizers
- regulates adipocyte production, secretion of fatty acids and glucose metabolism
- do not use in nursing mothers
- can interact with contraceptives, can cause osteopenia
Alpha-glucosidase inhibitors
- reversibly inhibits alpha glucosidase small intestine
- lowers glucose uptake
- no patients with colonic ulceration or intestinal obstruction
Dipeptidyl Peptidase IV inhibitors
- inhibit DPP-IV enzyme responsible for incretin hormone inactivation
- incretin hormones cause increased insulin release
- nasopharyngitis and pancreatitis can occur
Metformin
Biguanide
Glyburide
Sulphonylurea
- has active metabolites - caution with renal impairment
- relative safety in pregnancy
Rosiglitazone
Thiazolidinedione
-do not use in nursing mothers
Repaglinide
Glinide
-not for use with gemfibrozil
Sitagliptin
Depeptidyl Peptidase-IV inhibitor
Acarbose
alpha-glucosidase inhibitor
-poorly absorbed - primarily by intestinal bacteria
Glipizide
Sulphonylurea
Nateglinide
Glinide
-not with gemfibrozil
Miglitol
alpha glucosidase inhibitor
-very well absorbed, no systemic effects
Glimepride
Sulphonylurea
Saxagliptin
Dipeptidyl peptidase-IV inhibitors
-metabolized by CYP3A4/5
Pioglitazone
Thiazolidinediones
-has active metabolites
Gliclazide
Sulphonylurea
