non insulin drugs

Question 1

sulfonylureas

Answer 1

increase insulin secretion by mimicking the effects of glucose (depolarize B cells)

Glipizide, glyburide (low kidney ex), glimepiride

sulfonylurea SE: hyponatremia, Rashes, diarrhea, drg interactions, hypoglycemia, tachyphylaxis after a while

lowers glucose, HgbA1C

Question 2

meglitinides

Answer 2

different binding site than sulfonylreas ( faster acting, pre meal admin)

repaglinide

SE: hypoglycemia

not strong

Question 3

Metformin

Answer 3

reduces insulin resistance specifically in the liver via AMP-K increased activity

SE: GI, lactic acidosis (contraindicated in renal insufficiency, elderly, liver dysfunction, heart failure)

Question 4

Thiazolineddiones

Answer 4

pioglitazone, insulin sensitizer
fat and muscle more insulin sensitive

SE: wt gain, fluid retension (contraindicated in heart failure)

Question 5

glucosidase inhibitor

Answer 5

acarbose, inhibits brushborder of intestinal lining a-glucosidase, partial malabsorption of carbs)

SE: bloating, GI

Question 6

GLP-1 analogs

Answer 6

injectable, exenatide augments glucagon secretion, wt loss

SE: nausea, emesis, diarrhea, headaches, pacreatitis (thyroid cancer contraindication)

liraglutide (CV risk reduction)

Question 7

DPP-4 blockers

Answer 7

oral, sitagliptin (increase half life of GLP-1) augment insulin secretion

SE: arthralgia, pancreatitis, renalfailure

Question 8

sglt2 inhibitor

Answer 8

cause glycosuria

SE: gential yeast infections, UI, dehydration and hypotension

canaglifozin, empaglifozin (CV risk reduction

Question 9

how drugs are given

Answer 9

either and drug that increases insulin or insulin itself

plus

metformin or thiazolideniodine