L18/19: diabetes mellitus drug therapy Flashcards
(29 cards)
what are the symptoms of DM?
KETONEMIA
negative nitrogen balance
what are the microvascular complications of diabetes ?
artheosclerosis
dyslipidemia
what are the microvascular complications of DM?
neuropathy
nephropathy
retinopathy
type III diabetes is ___
drug induced
what’s the effect of insulin on glucose ?
conversation to glucose-6-phosphate
what are the adverse effects of subcutaneous insulin ?
lipodystrophy at site of injection
insulin resistance is characterized by no effect at what dose ?
100IU/ day
sulfonylurease all start with G
G drugs fr
what is the mechanism of sulfonylurease ?
competitively blocks SUR receptors on ATP-sensitive K channels located on pancreatic B cell membrane , resulting in insulin secretion
what are the adverse effects of sulfonylurease ?
hyperinsulinemia , hypoglycemia particularly in ealderly patients
weight gain due to fluid retention and edema
crosses placenta barrier , may cause fetal hypoglycemia
metformin is an example of which class of DM drug therapies?
biguanide
what are the mechanisms of metformin ?
-increased uptake and utilization of glucose (decrease insulin resistance )
-inhibition of hepatic and renal gluconeogenesis
-slowing glucose absorption from GIT
-promotion of insulin binding to its receptors
what are the advantages of metformin?
it does not result in any weight gain
lowers LDL and VLDL while increasing HDL
rarely causes hypoglycemia (anti-hyperglycemic effect )
what’s the drug of choice for type II DM patients ?
metformin
what are the adverse effects of metformin?
nausea , metallic taste , anorexia , diarrhea ,
long term use may decrease VIT B12 absorption
extended use of which drug could result in decreased Vitamin B12 deficiency ?
metformin
which drug is an example of an insulin sensitizers ?
pioglitazone
what is the mechanism of pioglitazone (insulin sensitizers)?
increases insulin sensitivity and reverses insulin resistance
what are the adverse effects of insulin sensitizers ?
weight gain due to fluid retention and rarely hepatotoxicity
what is an example of insulin secretagogues ?
repaglinide
what is the mechanism of DPP-4 inhibitors ?
inhibit DPP-4 which metabolizes GLP-1
what’s the action go GLP-1 in the body?
released from the gut in response to oral glucose . it enhances postprandial insulin release , surpasses glucagon, and delays gastric emptying and surpasses appetite
which anti diabetic drug therapy is used in combination with metformin/ SUR
DPP-4 inhibitors
what is an example of DPP-4 inhibitors ?
vildagliptin
