module 16 non-insulin meds Flashcards
sulfonylurea meds
glyburide
glipizide
glimeperide
sulfonylurea MOA
stimulate pancreatic insulin secretion
block ATP-sensitive K channels
-> depolarization -> Ca influx -> insulin release
sufonylurea admin
hepatically metabolized
- parent and active metabolite renally excreted
sulvonylurea AE
hypoglycemia
wt gain
sulfonylurea EDU
moderate-high A1C reducation: >1%
- good efficacy: short lived (combo therapy)
renal dysfunction/elderly: glipizide is drug of choice: short half life.
meglitinides meds
nateglinide
repaglinide
meglitinide MOA
stimulates pancreatic insulin secretion
meglitinide AE
hypoglycemia
wt gain
meglitinide admin
rapid oral absorption
short half life
- freq. dosing
- with meals
DDP-4 inhibitors meds
alogliptan
linagliptan
saxagliptan
sitagliptan
DDP-4 inhibitors MOA
inc. incretin action
- > inc. glucose dependent insulin release
- > dec. post-prandial glucagon release
DDP-4 nml activity
inactivates incretin
DDP-4 inhibitor AE
URI
nasopharyngitis
low risk hypoglycemia
rare: pancreatitis
DDP-4 inhbitor precaution
dose adjustment with renal impairment
DDP-4 inhibitor DI
3A4: saxagliptan, linagliptan
DDP-4 inhibitor EDU
modest A1C reduction: less than 1%
weight neutral
GLP-1 agonist meds
gulaglutide exenatide liraglutide lixisenatide semaglutide
GLP-1 agonist MOA
inc. incretin action
- activate GLP-1 Rc: inc. insulin, dec. glucagon
resistant to metabolism by DPP-4
GLP-1 agonist AE
nausea
diarrhea
rare: pancreatitis
low risk hypoglycemia
GLP-1 agonist admin
subQ
GLP-1 agonist EDU
cardiovascular benefits wt. loss - slows gastric emptying - dec. appetite moderate A1C reduction: ~1%
