Diabetes Flashcards
pramlintide
amylin analog(s.c.inj)
fxn:
delays gastric emptying
decrease post prandial glucagon secretion
improves satiety
name incretins
GLP:glucagon like peptide
GIP:glucose dependant insulotropic peptide
moa of GLP1 agonists
- inc glucose dep insulin secretion
2. rest same as amylin analog
exanetide and liraglutide
GLP 1 receptor agonists
SE of incretin mimetics
n/v
diarrhoea
constipation
pancreatitis
moa of sulfonaylurea
insulin secretagogues (block the ATP sensitive K channels-depolarisation-Ca influx-exocytosis )
also
inc insulin sensitivity
dec hepatic glucose production
glyburide
should not be given in renal impairment (glimperide, glipizide give)
can be used as an alt to insulin pregnancy
major SE of sulfonylureas
- weight gain
2. hyperinsulinemia/hypoglycemia
moa of glinides
similar to sulfonylureas
but rapid and short duration of action
post prandial glucose regulatot
SE of glinides
similar to sulfonylureas
interactions becoz metabolized by CYP
moa of biguanides
MAIN: dec hepatic gluconeogenesis
SE of metformin
git
Contraindicated in renal dysfxn due to risk of LACTIC ACIDOSIS
phkinetics: not protein bound , not metabolised , exn via kidneys
any process that dec renal fxn has the risk of LACTIC ACIDOSIS
- MI
- Heart failure
- sepsis
- i.v. radiocontrast
long term use- dec VIT B12 absorption
any other use of metformin
PCOD
dec insulin resistance
ovulation occurs
also thiozolidenediones
insulin sensitisers
biguanides
thiozolidenediones
thiozolidenediones moa
acting as agoinst of PPAR- gamma(peroxisome proliferator activated receptor)
regulates the transcription of insulin responsive genes in liver , adipose and skeletal m
effect thiozolidenediones on blood lipid levels
rosi- inc LDL and TGs
pio- dec TGs
BOTH INC HDL
pio is preffered due to better CVS effects
SE of thiozolidenediones
CVS- rosi
fluid retention so should not be used in HF
wt gain- inc s.c. fat and fluid retention
pio- bladder cancer
alpha glucosidase inh
acarbose
miglitol
moa of glucosidase inh
reversibly inhibits this enz in intestinal brush border
dec in carb digestion and post prandial glucose levels.
taken before meals
SE OF GLUCOSIDASE INH
flatulence
abdominal pain
diarrhoea
CI
colonic ulceration
IBD
intestinal obs
why glucose given in glucosidase inh toxicity
sucrose not given as sucrase is also inhibited
DDP4 inh moa
inh DDP4 which is responsible for incretin inactivation
inc insulin release
no feelimg of SATIETY/FULLNESS and WT GAIN as in incretin analogues
se of DDP4 inh(gliptans)
nasopharyngitis
headache
pancreatitis
SGLT 2 inh (gliflozin) moa
inhibits glucose and Na reqbsortion from filterate
SE of SGLT2 inh
hypotension- osmotic diuresis (na and glucose)
vulvovaginal inf
uti
urinary frequecy
