Pond RS 1- Diabetic Drug Overview Flashcards
What is diabetes insipidus? What are the two types of diabetes insipidus?
Inability of the kidneys to conserve water. No issues with glucose
Central: ADH deficiency
Nephrogenic: Kidneys cannot respond to ADH
What is the goal of Type I diabetes treatment? Type II?
Type 1: Replace insulin
Type II: Help the body use native insulin efficiently to keep blood glucose levels normal. Also, address diet and prescribe increased exercise when possible.
What is the is the intermediate insulin we need to know? The two long acting?
Intermediate-duration acting->NPH Insulin: It’s components form an insoluble complex which delays absorption and onset, extending duration of action
Long-acting->Detemir: Binds to albumin, then slowly disassociates from it
Glargine: Amino acid substitution makes drug more polar and delays it’s degradation (less likely to enter cells). It precipitates at the injection site, causing a depot
Note: Both of these drugs are not for IV use, since they form depots
How do amylinomimetics work?
They are analogues of amylin, a hormone co-secreted with insulin in response to high blood glucose levels. It complements insulins actions.
Note: It inhibits glucagon secretion, delays gastric emptying, and acts as a satiety agent
What is the mechanism of action of sulfonylureas?
Promote already-made insulin release via exocytosis of pre-made granules.
What is the mechanism of action for meglitinides?
Promote already-made insulin release via exocytosis of pre-made granules.
How do biguanides work? What is the biguanide we need to know?
Promote the translocation of GLUT4 receptors to the cell surface of muscle and adipose tissue.
Increase glucose absorption by these tissues, inhibit GI glucose absorption and decrease hepatic glucose output.
METFORMIN
How do thiazolidinediones work ?
They are insulin sensitizers that activate insulin responsive genes. Specifically, they cause adipocytes to store more fatty acids, thereby making cells more dependent of oxidative phosphorylation
How do α -glucosidase inhibitors work?
Inhibit α-glucosidase enzyme in the brush border of the small intestine. This leads to less readily absorbable monosaccharaide. This blunts the increase of glucose after a meal.
What drug classes would lead to an increase in incretins/incretin actions?
Didpeptidyl-peptidase 4 inhibitors. (inhibits enzyme that degrades incretins)
Glucagon-Like Peptide-1 receptor agonists
Both cause an increase in insulin, because incretins increase insulin.
What are SGLT2 Inhibitors and how do they work?
Inhibit SGLT2 proteins, which reabsorb a large proportion of glucose that gets reabsorbed back to the blood by renal system. Lead to more glucose being excreted in urine.
What drugs are intended for type 1 diabetics
Insulins (NPH, glargine, demetir)
Amylinomimetics
