Diabetes Drugs Flashcards
Rapid acting Insulin
Insulin Lispro
Insulin Aspart
Insulin Glulisine
SC, IV, 15 m prior to meal- last 2-4 hours
AE: hypoglycemia, allergic reaction, lipodystrophy, cough if inhaled
Short acting soluble crystalline zinc insulin
Regular Insulin
DOC for control of diabetes in pregnancy
SC (IV emergencies) 30m before meal Lasts 3-6hrs
AE: hypoglycemia, allergic reaction, lipodystrophy, cough if inhaled
Indeterminate acting Insulin
Neutral
protamine
Hagedorn (NPH)
(Isophane insulin)
Used for basal control & given with rapid/short acting insulin for meal-time control
SC Last 10-16h, Cloudy Solution
AE: hypoglycemia, allergic reaction, lipodystrophy, cough if inhaled
Glargine
Long Acting Insulin
SC- 1x/day Lasts 20-24hrs Sustained peakless absorption profile
Detmir
Long Acting Insulin
Bind reversibly to albumin through fatty acid chain
SC- 1x/day Lasts 20-24hrs Sustained peakless absorption profile
Chlopropamide
Class: 1st class, Sulfonylureas
USE: decreases fasting plasma glucose, glycemic control in Type 2 DM
MOA:Bind to SUR1 subunità
block ATP-sensitive K+
channels in β-cell
membranes
decreases glucagon
AE. Hypoglycemia & Hyperemic flush , Contraindicated in elderly patients with renal insufficiency
Glyburide,Glipizide, Glimepiride
Class: 2nd, Sulfonylureas
USE: decreases fasting plasma glucose, glycemic control in Type 2 DM
MOA:Bind to SUR1 subunità
block ATP-sensitive K+
channels in β-cell
decreases glucagon
AE. Hypoglycemia(most likely in Glyburide) & Hyperemic flush , Contraindicated in elderly patients with renal insufficiency
Repaglinide, Nateglinide
Class: Meglitinides
USES-not as effective as sulfonylureas(so use in patient with sulfur allergies ) , glycemic control in Type 2 DM
MOA:Bind to SUR1 subunità
block ATP-sensitive K+
channels in β-cell
decreases glucagon
AE:Hypoglycemia, must be taken before meals(rapidy absorbed & cleared)
Metformin
Class: Biguanides
USES: DOC Type 2 DM
MOA:Actions mediated by AMPK:
AE:Maily GI, Contraindicated in pts with renal/hepatic disease, alcoholism or conditions leading to hypoxia
Pioglitazone
Rosiglitazone
Class:Thiazolidinediones (Tzds)
USES: Type 2 DM, PCOS inferity( not FDA approved)
MOA:-PPAR-γ agonist with
intracellular nuclear receptors
found in muscle, fat & liver, Promotes uptake and utilization of glucose in adipose tissue.
AE:Fluid retention, weight gain, edema
May Exacerbate CHF→
contraindicated in pts with class III or IV heart failure
CVS risk Rosiglitazone
Acarbose
Miglitol
Class: a-glucosidase inhibitor
USES: Type 2 DM where glycemic effect is additive
MOA: Competitive intestinal α-glucosidase inhibitorà
¯postprandial digestion/ absorption of starch and disaccharides
AE:Flatulence diarrhea, abdominal pain (¯with congoing use) -Hypoglycemia w/ concurrent sulfonylurea txt -Acarbose: reversible liver enzymeelevationà monitor LFT’s periodically
Exenatide
Class:Incretin Analog
-GLP-1 (glucagon like polypeptide) full agonist
USES: improve glycemic control in adults with Type 2 DM
MOA:Incretins are released from gut, increases insulin secretion
AE:GI: N/V/D
Acute pancreatitis
Contraindicated in pts w/
gastroparesis
Sitagliptin
Class:Selective inhibitor of DPP- IV
USES: Improve glycemic control in adults w/ Type 2 DM , Increases GLP- increase increase insulin decreases glucagon
AE:Pancreatitis
HSN rxns: urticaria, angioedema,
anaphylaxis, & skin rxn such as Steven-Johnson syndrome
Pramlintide
CLass:Synthetic amylin analog
Uses: Adjunct to insulin, controls intake/influx decreases food intake, decreases gastric emptying and increases glucagon secretion
AE: N/V/D, anorexia, HA
Severe hypoglycemia
Contraindicated in pts w/
gastroparesis
Colesevelam
Class: Bile acid sequestrant
Uses:adjunct for Type 2 DM
Decreases LDL
AE:Constipations, nausea, dyspepsia, TAG
