Diabetes Drugs

Question 1

Metformin

Answer 1

• inhibits gluconeogenesis in liver, enhance tissue sensitivity to insulin
• does not cause hypoglycemia or weight gain (euglycemic)
• bypass insulin receptor and stimulates PPARs
  Side Effects: Lactic acidosis, GI distress

Question 2

Acarbose

Answer 2

alpha-glucoside inhibitor (small intestine brush border) - slows breakdown of carbs in intestine (slows sucrose -> glucose)
Side Effects: gas, bloating, diarrhea

Question 3

Pioglitazone

Answer 3

Decreases insulin resistance: activates PPARgamma

Question 4

Sitagliptin, Saxagliptin

Answer 4

Stimulates insulin release: inhibits dipeptidyl peptidase-4 (enzyme that breaks down GLP-1)

Question 5

Oral Sulfonylureas

Answer 5

1st gen: tolbutamide
2nd gen: glyburide (renal dysfunction), glipizide (liver dysfunction)
Repaglinide

Mechanism: Endogenous insulin release (inhibiting ATP-sensitive K+ efflux channel)

Side Effect: Hypoglycemia (fasting) (so treat w/ glucose), weight gain, allergies, drug interactions