Diabetic drugs Flashcards
Insulin drugs: mechanism
Bind insulin receptor (tyrosine kinase activity)
Insulin drugs: clinical use
DM types I and II
Life-threatening hyperkalemia and stress-induced hyperglycemia
Insulin drugs: toxicities
Hypoglycemia Hypersensitivity reaction (rare)
Lispro: type
Short-acting insulin
Aspart: type
Short-acting insulin
NPH: type
Medium-acting insulin
Glargine: type
Long-acting insulin
Detemir: type
long-acting insulin
Sulfonylureas: action
Close K channel in beta-cell membrane (cell depolarizes leading to insulin realease)
Sulfonylureas: clinical use
Release of endogenous insulin in DM II
Sulfonylureas: toxicities
First gen: disulfiram-like effect
Second gen: hypoglycemia
Tolbutamide: type
1st gen sulfonylurea
Chlorpropamide: type
1st gen sulfonylurea
Glyburide: type
2nd gen sulfonylurea
Glimepride: type
2nd gen sulfonylurea
Glipizide: type
2nd gen sulfonylurea
Metformin: action
unknown, possibly decrease gluconeogenesis, increase glycolysis, decrease serum glucose levels.
Overall: insulin sensitizer
Metformin: clinical use
Oral hypoglycemic
Useful in patients without islet function
Metformin: toxicities
lactic acidosis (contraindicated in renal failure, do not use with contrast dye)
Glitazones/thiazolidinediones: action
Increase insulin sensitivity in peripheral tissue
bind PPAR-gamma, upregulate transcription of glucose and lipid metabolism factors (lowers insulin resistance)
Glitazones/thiazolidinediones: clinical use
Monotherapy in DM II or as augmenter of other drugs
Glitazones/thizolidinediones: 4 toxicities
Weight gain, edema, hepatotoxicity, CV toxicity
alpha-glucosidase inhibitors: action
Inhibit intestinal brush-border alpha glucosidases: delays sugar hydrolysis and glucose absorption
alpha-glucosidase inhibitors: clinical use
Monotherapy DM II or in combination
Alphaglucosidase inhibitors: toxicities
GI disturbances
acarbose: type
alpha-glucosidase inhibitor
miglitol: type
alphaglucosidase inhibitor
Pramlintide: action
lower glucagon
Pramlintide: use
DM II
Pramlintide: 3 toxicities
Hypoglycemia
Nausea
Diarrhea
Exenatide: action
Increase insulin, decrease glucagon
Exenatide: use
DM II
Exenatide: 3 toxicities
Nausea
Vomiting
Pancreatitis