Pharm 30 Part II Flashcards
MOA: carbohydrate analogues that bind avidly to alpha glucosidase, slowing the breakdown and absorption of of dietary carbohydrates such as dextrin and dissaccharides.
alphaglucosidase inhibitors
MOA: the classic anabolic hormone, insulin promotes carbohydrate metabolism and facilitates glucose, amino acid, and TG uptake and storage in liver, cardiac and skeletal muscle and adipose tissue
Exogenous Insulin
MOA: inhibit the Beta cell K/ATP pump at the SUR1 subunit, thereby stimulating insulin release and increasing circulating levels to levels that are able to overcome insulin resistance
Sulfonylureas and Meglitinides
MOA: Activates AMPK to block synthesis of FAs to inhibit hepatic gluconeogenesis and glycogenolysis; increases insulin receptor activity and metabolic responsiveness in liver and skeletal muscle
Biguanides
MOA: co released with insulin , acts on receptors of the CNS to slow gastric emptying, reduce glucose and glucagon release and promote satiety
Pramlintide
MOA: enhance glucose dependent insulin release delay gastric emptying, inhibit glucagon secretion, decrease appetite by inhibiting degradation by DPP-4 inhibitors or agonizing GLP-1 receptor
Incretins
bind and stimulates PPARgamma, thereby increasing insulin sensitivity in adipose tissue liver and muscle
TZDs
binds to SUR1 subunit of K+/ATP channel in pancreatic Beta cells and stabalizes ATP bound open state of the channel so b cell membrane remains HYPERpolarized, decreasing insuling secretion
Diazoxide
modest increase in plasma TGs, aminotransferase levels should be monitered and is most useful for pts with postprandial hyperglycemia and for new-onset pts with mild hyperglycemia
alpha-glucosidases
rapid acting analogues of inslulin
lispro, aspart, glulisine
long - acting anlogues of insulin
glargine and detemir
major dange of insulin therapy …
hypoglycemia in pts not taking in enough carbohydrates
mainstay of Tx for Type II diabetes
Sulfonylureas
can cause weight gain so better suited for nonobese pts, first generations have lower affinity than 2nd .
sulfonylureas
can decrease weight, GI distrbances, lactic acidosis
Metformin