drug categories Flashcards
Insulin
category
MOA
DM1?
SE
For Who
d
Bigunnides
category
MOA
DM1?
SE
For Who
Biguanides (metformin)
Metformin increases hepatic adenosine monophosphate-activated protein kinase activity, thus reducing hepatic gluconeogenesis and lipogenesis, as well as increasing insulin-mediated uptake of glucose in muscles.
Thiazolidinediones
category
MOA
DM1?
SE
For Who
- ↑cell sensitivity to insulin 2. insulin sensitizer 3. ↑new fat cells, ↑sensitivity, ↓fat conc 4. ?
Thiazolidinediones (rosiglitazone, pioglitazone)
Thiazolidinediones activate peroxisome proliferator-activated receptor gamma (PPAR-γ), a nuclear receptor, to increase insulin sensitivity and resultant peripheral uptake of glucose, and also increase the level of adiponectin, a fat tissue-secreted cytokine, that increases not only the number of insulin-sensitive adipocytes but also stimulate fatty acid oxidation.
Thiazolidinediones SE
bind to PPRA-gamma receptor -peroxisome proliferator activated receptor-gamma in adipocytes (fat cells) –promote maturation of fat cells and deposition of fat into peripheral tissues. ↑stim of new fat cells ↓circulating fat concentrations new fat cells have ↑sensitivy
Sulfonylureas
category
MOA
DM1?
SE
For Who
- stim insulin release from β cells 2. secretegogues 3. blocking ATP sensitive K+ channels in β cells ↓ K+ permeability. ↑depolarization , ↑ calcium entry, ↑insulin secretion. 4. DM1 - NO
Sulfonylureas (glipizide, glyburide, gliclazide, glimepiride)
Sulfonylureas bind to adenosine triphosphate-sensitive potassium channels (K-ATP channels) in the beta cells of the pancreas; this leads to the inhibition of those channels and alters the resting membrane potential of the cell, causing an influx of calcium and the stimulation of insulin secretion.
Megaglintides
category
MOA
DM1?
SE
For Who
Meglitinides (repaglinide and nateglinide)
Meglitinides exerts its effects via different pancreatic beta-cell receptors, but they act similar to sulfonylureas by regulating adenosine triphosphate-sensitive potassium channels in pancreatic beta cells, thereby causing an increase in insulin secretion.
AGI
category
MOA
DM1?
SE
For Who
alpha-glucosidase inhibitors
α-Glucosidase inhibitors (acarbose, miglitol, voglibose)
Alpha-glucosidase inhibitors competitively inhibit alpha-glucosidase enzymes in the intestinal brush border cells that digest the dietary starch, thus inhibiting the polysaccharide reabsorption as well as the metabolism of sucrose to glucose and fructose.
GP1
category
MOA
DM1?
SE
For Who
DPP-4
category
MOA
DM1?
SE
For Who
Dipeptidyl Peptidase-4 Inhibitors
DPP-4 inhibitors
DPP-4 inhibitors (sitagliptin, saxagliptin, vildagliptin, linagliptin, alogliptin)
DPP-4 inhibitors inhibit the enzyme dipeptidyl peptidase 4 (DPP- 4). These deactivate glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1), among others. Therefore, these influence glucose control through multiple effects, such as decreasing glucagon release and increasing glucose-dependent insulin release, decreasing gastric emptying, and increasing satiety.
SGLT-2
category
MOA
DM1?
SE
For Who
SGLT2 inhibitors
SGLT2 inhibitors (dapagliflozin and canagliflozin)
SGLT2 inhibitors inhibit sodium-glucose co-transporter 2 (SGLT-2) in proximal tubules of renal glomeruli, causing inhibition of 90% glucose reabsorption and resulting in glycosuria in people with diabetes which in turn lowers the plasma glucose levels.
Other
category
MOA
DM1?
SE
For Who
Cycloset (bromocriptine)
Cycloset, a sympatholytic dopamine D2 receptor agonist, that reset the hypothalamic circadian rhythm, which might have been altered by obesity. This action results in the reversal of insulin resistance and a decrease in glucose production.
https://www.ncbi.nlm.nih.gov/books/NBK482386/
Amylin Analogues
Amylin Analogues
