Insulin Agents Flashcards
what are glucose dependent insulin agents
GLP-1 agonists, DPP-4 inhibitors
what are glucose independent insulin agents
sulfonylurea, meglitinides
what is the moa of glucose dependent agents
Insulin secretion is stimulated by elevated blood glucose levels
what is the moa of glucose independant agents
Insulin is secreted regardless of the blood glucose level, even if blood glucose levels are low
what is the moa of Sulfonylureas
Block ATP-sensitive potassium channels of the pancreatic β cells → depolarization of the cell membrane → calcium influx → insulin secretion
what are first generation Sulfonylureas
Chlorpropamide
Tolbutamide
what are second generation Sulfonylureas
Glyburide
Glimepiride
Glipizide
what are side effects of Sulfonylureas
hypoglycaemia
weight gain
agranulocytosis
what interactions are common with Sulfonylureas
using biguanides can cause increase in cardiovascular diseases
what are types of meglitinides
Nateglinide
Repaglinide
what is the moa of meglitinides
Block ATP-sensitive potassium channels of the pancreatic β cells → depolarization of the cell membrane → calcium influx → insulin secretion
what side effects of meglitinides
Risk of hypoglycemia
Weight gain
what are contraindications of Sulfonylureas
cardiovascular diseases
obesity
renal failure
liver failure
what contraindications when using meglitinides
renal failure
what are drug interactions with meglitinides
Sulfonylureas: ↑ risk of hypoglycemia
what are types of DPP4-inhibitors
Saxagliptin
Sitagliptin
Linagliptin
what is the moa of DPP4-inhibitors
Inhibit GLP-1 degradation → ↑ glucose-dependent insulin secretion
what are side effects of DPP4-inhibitors
Gastrointestinal symptoms
Pancreatitis
Nasopharyngitis, upper respiratory tract infection
Headache, dizziness
Arthralgia
Edema
what are contraindications of DPP4
Liver failure
Moderate to severe renal failure
what are drug interations of DPP4
CYP3A4/5 inhibitors: ↑ concentration of saxagliptin [1]
what are types of GLP-1
Exenatide
Liraglutide
Albiglutide
Semaglutide
what are the MOA of GLP-1
Stimulate the GLP-1 receptor directly
what are the side effects of GLP-1
Risk of pancreatitis and possibly pancreatic cancer
Nausea
what are drug interactions of GLP-2
warfarin
what are contraindications of sulfonyreus
Beta-blockers may mask the warning signs of hypoglycemia (e.g., tachycardia) and decrease serum glucose levels even further (see hypoglycemia). Since sulfonylureas also increase the risk of hypoglycemia, the combination of these two substances should be avoided
what are the indications of sufonylureus
Patients who are not overweight, do not consume alcohol, and adhere to a consistent dietary routine
indications for Meglitinides
particularly suitable for patients with postprandial peaks in blood glucose levels, but overall rarely prescribed
when should meglitinides be taken?
should be taken shortly before meals.
