pharm anti-diabetic drugs pt 2 Flashcards
oral antihyperglycemics are usually for type __ diabetes
2
target of oral hyperglycemics
lower hemoglobin A1c to less than 7%
if A1C exceeds 9%
combination therapy, two drugs from 2 different classes.
other treatments for type 2
- lifestyle changes
- monitoring of blood glucose
- drug therapy
- treatments of associated conditions: hypertension and high cholesterol
new onset type 2 treatment drug name
biguanide metformin
if modifications dont work with metformin after 3-6 months..
additional treatment with DPP-4 inhibitors and GLP-1 receptor agonists, or insulin
biguanide metformin mechanism of action (pancreas)
doesnt increase insulin secreion form pancreas, doesn’t casue hypoglycemia
metformin decreases____
hepatic glucose production and intestinal absorption of glucose
metformin improves uptake of glucose in the ____
skeletal muscle, adipose and liver for energy
metformin can be used with ____ & ____ if mono therapy is unsuccessful
sulfonylureas and thiazolidinediones
adverse effects of metformin
-abdominal bloating, nausea, etc
-metallic taste, hypoglycemia, reduced vit B12
extremely rare complication of metformin use
lactic acidosis
if undergoing a radiological test with iodine test….
discontinue metformin the day of the test and 48 hours after. can lead to acute kidney injury and lactic acidosis
metformin is contraindicated in pts with
kidney disease or kidney dysfunction
sulfonylureas MOA
stimulate insulin secretion from B cells and enhances action of insulin in muscle, liver and adipose tissue
sulfonylureas enhace action of insulin in
liver, adipose and pancreas
usually use the first generation of sulfonylureas T or F
false, second generation
gliclazide adverse effects
hypoglycemia, weight gain, skin rash , nausea, epigastric fullness
gliclazide MOA
sulfonylurea
rapid onset of action, acts as pasncreas would after a meal to increase insulin rapidly
contraindications of gliclazide
- liver and kidney disease
- active hypoglycemia
-not used in pregnancy
-cross allergic reaction if used with sulfa drugs
gliclazide interactions increased effects
increased hypoglycemia ( w/ use of alc, anabolic steroids, MAOIs, ginger, ginseng)
gliclazide interactions: decreased effects
adrenergics, coticosteroids, thiazides, thyroid drugs
other antidiabetics
thiazolidinediones, glinides, dipeptyl petidase 4 inhibitors (DPP-4)
thiazolidinediones (glitazones) MOA
insulin sensitizing drugs, enhance receptor sensitivity, slow onset: up to months.
