Diabetic medications Flashcards
What are the types of diabetes?
Type 1: Absolute insulin deficiency
Type 2: Insulin deficiency/resistance
Type 3: Drug induced
Type 4: Gestational
What are the BM levels diagnostic of diabetes?
Random: >11
Fasting: >7
Glucose tolerance: >11
Where is insulin produced?
Beta cells in islets of Langerhan
What is the structure of insulin?
51 amino acids in 2 chains
2 disulphide bridges between chain A & B
Removal of C peptide from proinsulin produces insulin
What does insulin increase?
- Glucose uptake into muscle & fat
- Glycogen synthesis
- Fat synthesis
- Protein synthesis
- K+ uptake by cells
What does insulin decrease?
- Fat breakdown
- Ketone body synthesis
- Glycogen breakdown
- Gluconeogenesis
- Protein breakdown
What is the mechanism of action of sulphonylureas?
- Increase insulin release
- Displace bound insulin from pancreatic islet 13 cells
- Decrease peripheral insulin resistance
- Decrease glucagon secretion
- Decrease hepatic insulinase activity
What drugs inhibit Gliclazide?
Thiazides
Corticosteroids
Phenothiazines
What is the mechanism of action of Metformin?
- Decrease gluconeogenesis
- Increase peripheral insulin utilisation
- Delays glucose uptake from gut
How is Metformin excreted?
Unbound
Excreted unchanged in urine
How does Acarbose work?
- Delays intestinal glucose absorption
- Reduces post-prandial hyperglycaemia
How do Thiazolidinediones work?
Regulate genes involved in glucose & lipid metabolism improving insulin sensitivity
How do NSAIDs work?
- Inhibiting COX enzymes
- Block conversion of arachidonic acid to prostanoids thus more converted to leukotrienes
How does Acetazolamide work?
- Carbonic anhydrase inhibitor
- Act on proximal convoluted tubules
- Non-competitive inhibitors of enzyme affecting Na/H+ exchanger causing alkaline urine
What substances does activated charcoal not work against?
- Alcohol
- Metals
- Electrolytes
(polarised substances)
