Drugs Used In Diabetes Flashcards
What are biguanides.
E.g. Metformin.
Usually twice daily or three times daily.
Dose initially 500mg daily, then 500mg BD can be increased to 850mg daily. Maximum dose is 2550mg daily.
Taken in divided doses with meals. Titrate slowly to minimise gastrointestinal side effects.
Stop the liver from producing new glucose.
Decreases insulin resistance, by making insulin carry glucose into muscle/fat cells effectively.
Side effects: gastrointestinal side effects, which usually wear off after the initial stages of treatment, or can wear off when taken with food.
Only usually works when there are some residual functioning pancreatic cells.
First line drug of choice for treating type 2 diabetes.
What are Sulphonylureas?
E.g. Gliclazide.
Usually once or twice daily.
Dose initially 40-80mg, increased to 320mg daily (maximum).
Doses of 320mg are usually split into single doses of 160mg. Highest dose at one time to be 160mg.
Contraindications with Chlopromazine - increases blood glucose levels as it reduces the release of insulin. Give the patient advice on monitoring blood glucose levels regularly.
Stimulate the cells in the pancreas to make more insulin.
Helps insulin to work more effectively in the body.
Selectively binds to sulfonylurea receptors on the surface of pancreatic beta cells.
Side effects: nausea, weight gain, hypoglycaemia.
What are Prandial Glucose Regulators?
E.g. Repaglinide.
Taken up to three times daily.
Usual dose 0.5mg orally with meals if patient has HBA1c less than 8%.
Patients with equal to or higher than 8% HBA1c are given 1mg-2mg with meals.
Maximum dose 4mg QDS.
Doses should be determined by the blood glucose response.
They stimulate the pancreas to make more insulin.
Usually taken at meal times only in aim to reduce the risk of hypoglycaemia.
Flexible doses can help to limit weight gain from this medication.
Side effects: gastrointestinal, rashes.
What are Alpha Glucosidase Inhibitors?
E.g. Acarbose.
Usually taken three times daily.
Initial dose 25mg TDS.
Maximum dose for patient below 60kg in weight is 50mg TDS.
Maximum dose for patient above 60kg is 100mg TDS.
Slow down the absorption of starchy foods from the intestine - which slows down the rise of blood glucose after meals.
Side effects: flatulence, diarrhoea, feeling full.
What are Thiazolidinediones (Glitazones)?
E.g. Rosiglitazone
Usually taken once daily or twice daily.
Initial dose is 4mg daily.
Maximum dose is 8mg daily.
They overcome insulin resistance, enabling the body to use its own natural insulin effectively.
Side effects: headaches, oedema, weight gain.
What is Rapid Acting Analogue Insulin?
E.g. Humalog
Taken 5-15 minutes before having food, with food or immediately after food.
It usually lasts around 2.5 hours.
What is Short Acting Insulin?
E.g. Actrapid.
Usually taken 15-30 minutes before food to prevent raised glucose that occurs when having meals.
It usually lasts for up to 8 hours.
What is Long Acting Analogue Insulin?
E.g. Levimir.
Taken once daily in the evening.
Lasts up to 24 hours.
What is Medium-Long Acting Insulin?
Lasts 8-30 hours.
Controls blood glucose levels between meals.
Usually used in combination with short acting insulin.
