Diabetes Drugs Flashcards
Stimulants of insulin release
increase in blood glucose, AA, vagal stimulation, sulfonyl ureas
Amplifiers of release
Gastric hormones and adrenergic stimulation
Inhibitors of insulin
Somatostatin, drugs, catecholamines
Acarbose is what?
Alpha-glucosidase inhibitors
Porcine insulin is how many Amino Acids different than human
1
Bovine and Ovine is how many amino acids different?
3
Short acting insulin
rapid onset of action, short half life, intermediate, long acting
Short acting insulin, called regular insulin, is the only type that can be given IV
ok
Insulin is injected twice daily, Called Lente insulin (30% short and 70% long acting zinc insulin crystals)
ok
Insulin demetir
Isoelectric point has been modified to increase half life. Has a twice daily dosing with low peak insulin concentration that decreases chance of nocturnal hypoglycemia. Forms a precipitate.
Insulin Glargine
Like Insulin Demetir
Metformin
Decreases hepatic gluconeogenesis, Doesn;t affect insulin secretion at all. Used in type 2. Oral no metab. BELONGS TO THE BIGUANIDE CLASS
Repaglinide
Benzoic acid derivative. Increases insulin secretion, Rapid GI absorption. Taken before meals to control post-prandial Blood glucose
Pioglytizone
GLUT 4 GOES UP. Increases insulin sensitivity by increaseing glucose uptake to tissues.
Pioglytizone binds to what
Peroxisome Proliferator- Activator Receptor
Acarbose
Its an alpha glucosidase inhibitor. Reduce intestinal absorption of starch and disaccharides by inhibiting brush border alpha glucosidase. Reduces post-prandial glucose glucose elevation. DONT USE ALONE
Colesevelam
bile acid sequestrant. Lowers cholesterol. Useful in Type 2 Diabetes Mellitus pts who are taking other meds. Interrupts enterohepatic cycling
Exanatide GLP-1 agonist
Know that shit
Increase in GLUT-4, increase in insulin uptake into tissues?
PIOGLOTIZINE
Increases insulin secretion. Used pre-prandially. Has Rapid GI absorption
Repaglinide
Semilente
short acting, longer half life
sitagliptin
inhibits enzymes that degrade incretins. These enzymes are called dipeptyl-peptidase 4, therefore sitagliptin is a dipeptidyl peptidase 4 inhibitor.
What are incretins
things that raise insulin secretion.
The major incretin we talked about
GLP-1….secreted by endothelial cells in the epithelium of the small intestine
Why is there no risk of hypoglycemia in a pt taking metformin
It does virtually nothing to insulin secretion.
Major drug on our list for increasing insulin sensitivity?
Pioglitazone…Binds PPARy and increases GLUT 4 transport of glucose into tissues (this is the mechanism by which insulin works)
Which Diabetes drug should be taken before a mean because it increases insulin release
Repaglinide. It is absorbed rapidly in the GI tract. Benzoic acid derivative.
Sitagliptin
Dipeptide Peptidase 4 inhibitor…prevents breakdown of incretins which increase GLP1 function. May be good to use with Exanatide?
