Diabetes, insulins and oral hypoglycemics Flashcards
Glargine general picture?
Long lasting(24 hrs) insulin analogue with - NO peak
Only forms of insulins to be used IV?
Lispro and Regular
Primary route of administration for type II diabetics?
oral hypoglycemics
Sulfonylureas moa?
Sulfonylureas “acts” as ATP and blocks K+ - channels in the Beta - cells. This leads to membrane depolarization and Calcium influx which in turn results in Insulin release.
Type I diabetes and oral hypoglycemics?
No effect as they do not have beta cells!
first generation sulfonylureas?
- Acetohexamide(active metabolite and loooong duration)
- Tolbutamide(no worries for kidney)
- Chlorpropamide(disulfiram effects)
Second generation sulfonylureas?
- Glipizide(lower dose with hepatic dysfunction)
- Glyburide(active metabolite, lower dose with renal dysfunction)
Side effects oral hyperglycemics?
- Hypoglycemia
- Weight gain
- interactions with other drugs(increased hypoglycemia)
Methformin moa?
Increased tissue sensitivity to insulin. Methformin bypasses the insulin receptor and binds to PPARs - receptors tightly associated with the metabolic responses of insulin.
Methformin side effects?
Lactic acidosis and GI distress
Pioglitazone and Rosiglitazone moa?
bind to nuclear PPARs = sensitizes tissues to insulin.
Pioglitazone and Rosiglitazone side effects?
- less hypoglycemia than sufonylureas
- weight gain
- edema
Acarbose moa?
inhibits brush border ezymes uptake of glucose
Exenatide moa?
acts on GLP-1. This is an incretin released from the small intestines that augments glucose - dependent insulin secretion.
Exenatide side effects?
hypoglycemia when used with sulfonylureas
