Diabetic Drugs Flashcards
Metformin
biguanides
- inhibits gluconeogensis enzymes and reduces hepatic uptake of gluconeogenic substrates (lactate)
- reduces lipolysis in adipocytes and glucose absorption from intestine
S.E. = diarrhea (gradual decrease), lactic acidosis (serious) -> avoid in renal failure
Sulfonylureas
Glimepiride
- insulin secretagogues (require some beta-cell function) –> useless in type 1 diabetes
- bind to SUR1 subunit of ATP-sensitive K channel -> close -> activates Ca channels -> fusion and release of insulin vesicles
S.E. = hypoglycemia, weight gain, disulfiram rxn
Glargine, Detemir
long-acting insulin
Lispro, Aspart, Glulisine
rapid-acting insulin
Regular
short-acting insulin
NPH
intermediate-acting insulin
Insulin analogs
S.E. = hypoglycemia, allergic reactions
Incretins (exenatide, liraglutide)
GLP-1 -> stimulates insulin and inhibits glucagon secretion, delays gastric emptying, induces satiety
S.E. = N/V, pancreatitis
used for Type 2
DDP-4 Inhibitors (sitagliptin, linagliptin, sitagliptin)
DDP-4 degrades incretins
- inhibitors enhance incretin activity (increase insulin and decrease glucagon)
Meglitinides (repaglinide, Nateglinide)
insulin secretagogues –> require beta-cell function
- K channel blocker
alpha-glucosidase inhibitors (Acarbose, Miglitol)
inhibit intestinal brush-border alpha-glucosidases
- delayed sugar hydrolysis and glucose absorption
- type 2 diabetes
GI side effects
Amylin Analogs (pramlintide)
binds to amylin receptors -> decreases gastric emptying, decreases glucagon, increases satiety
- type 1 and 2
- S.E. = hypoglycemia, nausea, diarrhea
Thiazolidinediones (Pioglitazone, Rosiglitazone)
PPARgamma agonists –> increase glucose uptake and utilization by increasing synthesis and tranport of GLUT transporters (increases insulin sensitivity)
- used for type 2
S.E. = weight gain, edema, hepatotoxicity, heart failure
