Oral T2D Drugs Flashcards
Prototype sulfonylurea drug
Glimepiride
Sulfonylurea MOA
Increase insulin secretion (secretagogues)
Increase tissue sensitivity
Decrease glucagon secretion
Side effects of glimepiride
Hypoglycemia
Weight gain
Contraindications for sulfonylureas
Liver or kidney disease
First choice drug for most T2 diabetics
Metformin
Metformin MOA
Works primarily in liver to decrease glucose production and increase glucose uptake into cells
Increases insulin effectiveness but not insulin secretion
Contraindications of metformin
Kidney disease (renal excretion w/o metabolism)
Dehydration (need to be well hydrated)
Advantages of metformin
No hypoglycemia
No weight gain
Adverse effects of metformin
GI upset (diarrhea)
Risk of lactic acidosis
Acarbose MOA
Microbial sugar that reduce GI glucose formation and absorption
Alpha glucosidase inhibitors
Thiazolidinediones (TZDs) drugs
Pioglitazone
Rosiglitazone
TZD MOA
Bind and activate PPAR-y to enhance transcription of insulin-responsive genes and help endogenous insulin work better
TZDs increase glucose uptake and utilization in ____ and ___
Muscle
Fat
Adverse effects of TZDs
Liver toxicity
Weight gain
CV disease
Edema
Increase bladder cancer risk
Fracture risk
GLP-1 agonist required drug
Exenatide
GLP-1 agonist MOA
Analogs of incretin (GLP-1) that slow gastric emptying and promote satiety
DPP-IV inhibitor required drug (oral GLP-1 drug)
Sitagliptin
DPP-IV inhibitors inhibit what enzyme?
Di-peptidyl-peptidase-4
Sitagliptin is weight-___
Weight-neutral (no gain or loss)
SGLT2 inhibitor required drug
Canagliflozin
SGLT2 inhibitor MOA
Reduce glucose reabsorption in kidney
Increase glucose excretion in urine
Diuretic
Adverse effects of canagliflozin
Hypotension
Increase risk of UTI
Fracture risk
