Drugs for DM Flashcards
what is the MOA of insulin
binds to insulin receptors on plasma membrane and activates tyrosine kinase which allows for glucose up take into the cells
what are the types of cells that insulin impacts
1) Muscle
2) liver
3) adipose tissue
how does insulin impact the liver
stimulates: it promotes storage of glucose as glycogen
inhibits: gluconeogenesis thus decreasing glucose output from the liver and decreasing protein catabolism
how does insulin impact the muscle
stimulates: glycogen synthesis using GLUT 4
inhibits: protein catabolism
how does insulin impact the adipose tissue
Stimulates: storage of triglyceride by activating the plasm lipoprotein liase and increasing the glucose uptake through GULT 4
inhibits: intracellular lipolysis
what are the common adverse effects of insulin
- hypoglycemia
- allergic reaction/injection
- lipodystrophy
- seizures and coma
what are fast acting insulin time line
3-5 hours
lispro
fast acting insulin
aspart
fast acting insulin
glulisine
fast acting insulin
what is the time line for short acting insulin
7-10 hrs
regular crystalline
short acting insulin
what is the timeline for intermediate acting insulin
16-20 hrs
NPH (isophane)
intermediate acting insulin
Lente (insulin zinc)
intermediate acting insulin
what is the time line for long acting insulin
over 20 hours
detemir
long acting insulin
glargine
long acting insulin
what are the 8 types of oral anti-diabetic classes of drugs
1) Sulfonylureas
2) Meglitindes
3) Metform (biguanides)
4) Thiazolidediones
5) Alpha-Glucosidase Inhibitor
6) DPP-4 inhibitor
7) GLP-1 analogs
8)Sodium-Glucose Transporter Inhibitors (SGLT-2)
what is the suffix for generation 1 sulfonylureas
(-amide)
what is the suffix for generation 2 and 2 sulfonylureas
(Gl-ide)
what is the MOA of sulfonylureas
increases insulin secretion from pancreatic B cells by blocking SURI and K+ channels
what are the side effects of sulfonylureas
1) hypoglycemia
2) cholestatic jaudice
3) wt gain
4) fetal hypoglycemia
what is the suffix for meglitnides
(glinide)
what is the MOA of meglitnides
stimulates rapid short lived insulin release
what are the side effects with meglitnides
- hypoglycemia
- wt gain
- must be taken with a meal
what is the drug under the Biguanides class
metformin
what is the MOA of Biguanides/Metformin
reduces liver glucose production and increases insulin sensitivity in the muscle
what are the side effects of Biguanides/Metformin
- wt loss
- decrease LDL and increase HDL
- GI side effects
- lactic acidosis
what are the drugs under the thiazolidediones
(-litazone)
what is the MOA of thiazolidediones (TDZs)
increases insulin sensitivity in the peripheral tissues though enhancing glucose metabolism through action of PPAR 4 and increase in GLUT 4
what are the side effects of thiazolidediones (TDZs)
- wt gain
- fluid retention
- risk of fx
- edema
what are the drugs in the alpha glucosidase inhibitor class
acarbose and miglitol
what is the MOA of alpha glucosidase inhibitors
delaying the absorption of glucose from the intestine
what are the side effects of alpha glucosidase inhibitors
- flatulence
- diarrhea
- abdominal pain
what is the suffix for the drugs in the DDP 4 inhibitor class
(-gliptin)
what is the MOA for DDP 4 inhibitors
increases and prolongs the action of the incretin hormones, enhancing insulin secretion and decreasing glucagon secretion
what are the side effects of DDP 4 inhibitors
- Nasopharyngitis (upper respiratory tract inflection)
- Headache
- Pancreatitis
GLP-1 analogs drug suffix
(-tide)
what is the MOA of GLP-1 analogs
increase glucose dependent insulin secretion and reduces glucose excretion
what are the side effects for GLP-1 analogs
- GI issues
- injection site reactions
- pancreatitis
what is the suffix for sodium-glucose transporter inhibitor (SGLT-2)
-gliflozin
what is the MOA of sodium-glucose transporter inhibitor
inhibit SGLT-2 in kidney which decreases glucose reabsorption leading to increase glucose excretion
what are the side effect of sodium-glucose transporter inhibitor (SGLT-2)
- genital yeast inflection
- UTI
- bone fx
- ketoacidosis