Week 2 Flashcards
MOA
Metformin
Clinical Use
Reduces hepatic glucose production(inhibits MIT enymes); Increase glucose absorption in muscle; increase insulin sensitivity; decrease intestinal glucose absorption
Type 2
AE
Metformin
No hypoglycemia, weight neutral or slight weight loss. GI side effects (N/V/D) are common so start with low doses and titrate up.
ROA Metformin
Oral, available as IR (dosed twice a day) or XR (once daily); contraindicated if eGFR <30
MOA
Glipizide
Clinical Use/
, second gen Insulin secretagogue; binds sulfonylurea receptor on β-cell and causes insulin secretion. Block ATP pump. Build up of K+. shortest half life.
T2D
AE Glipizide
Hypoglycemia, weight gain; Rare=photosensitivity, rash
ROA/pharmicokinetics of Glipizide
Duration: 14-16 hours (IR), 24 hours (XL); no active metabolites
MOA
Canagliflozin
Block reabsorption of glucose by SGLT in the proximal tubule of kidney causing glycosuria
AE
Canagliflozin
No hypoglycemia, weight neutral or slight weight loss, urinary/genital infections, amputations, euglycemic DKA, reduced bone density, reduce blood pressure, monitor serum creatinine and potassium
ROA/PHarmkinetics Canaglifozin
Oral, once daily dosing; avoid if eGFR <45
MOA
Liraglutide/semaglutide
Clinical Use
Analog of GLP1- stimulates glucose-induced insulin secretion, suppresses glucagon, delays gastric emptying, possible improved beta cell function, causes weight loss
decreases appetite and enhances satiety
Clinical Use: Type 2 Diabetes
Adverse Effects
Liraglutide/semaglutide
Weight loss, GI side effects: N/V/D/constipation/bloating (30%), low risk for hypoglycemia, acute pancreatitis, thyroid tumors?, injection site issues
ROA/pharmkinetics Liraglutide
Subcutaneous injection once a day; caution if eGFR <50
MOA
Rosuvastatin, Atorvastatin, Simvastatin
Clinical Use
Reversible competitive inhibitors of 3-hydroxy-3methylglutaryl-coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol synthesis; increase synthesis and reduces degradation of LDL receptors; more LDL receptors on surface of hepatocytes=increased removal of LDL from blood
Clinical Use: Hyperlipidemia, Diabetes,CAD, history of MI, past stroke
Advers Effects
Rosuvastatin, Atorvastatin, Simvastatin
Rare hepatotoxicity, myalgia/myopathia, increase LFT possible, new onset diaetes, neurocognitive effects?
MOA
Ezetimibe
Clincal Use
Selective inhibition of cholesterol absorption from the small intestine via the sterol transporter NPC1L
used with statins decreases LDL levels by 25% than with statin alone
Clinical Use: Hyperlipidemia, Diabetes,CAD, history of MI, past stroke
Adverse Effects
Ezetimibe
Usually well tolerated; headache, diarrhea, or increase LFT possible
MOA
Alirocumab
Clinical Use
*Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a protein that binds to the LDL receptor, reduces the LDL receptor density, and increases circulating LDL. PCSK9 inhibitors are human monoclonal antibodies that block this process, increase LDL receptors and decrease circulating LDL.
Clinical Use: Hyperlipidemia, Diabetes,CAD, history of MI, past stroke
Adverse Effects
Alirocumab
Injection site reactions, nasopharyngitis, diarrhea, flu-like symptoms, myalgias, neurocognitive effects?
MOA
Fenofibrate
Clinical Use
Agonist for the nuclear transcription factor PPAR-α which increases lipolysis and decreases TG. (increases LPL activity)
fibric acid derivate
ClinicaL Use: Hypertriglyceridemia
Adverse Effects
Fenofibrate
Myalgia, GI upset, increase LFT possible, increased risk for gallstones
MOA
Phentermine
Clinical Use
sympathomimetic Amine
promotes activation of central and nervous system
Decreases appetite
Weight Loss
Advesrse Effects
phentermine
contraindicated for patients with CAD, mania, bipolar, gluacoma
palpitations, dry mouth, constipatoin, insomnia
MOA
Orlistat
pacreatic Lipase inhibitor (causes excretion of 25-30% of ingested fat in stool. decreases fat absoprtion
Adverse effects
Orlistat
flatuence, fatty diarrhea
MOA
phentermine/topiramate
noradrenaline release and modulator of GABA/carbonic anhydrase inhibitor
decrease appetite and cravings
adverse effects
phenterimine
palpatations, dry mout, parasthesia, dizziness, mental fogginess, renal stones, teratogenic
moa
Bupropion/Naltrexone
inhibitor of dopamine and noradrenaline reuptake
decresases appetite and cravings
adverse effects
bupropion/naltrexone
nausea, constipation, headache, dizziness, vomiting, dry mouth, anxiety
MOA
Gelesis100
senssation of fullness- hydrogel which absorbs water and mixes w/ ingested foods. fills about 1/4 of stomach volume.
adverse effects
gelesis
safety profile similar to placebo
MOA
tirzeptide
GLP1- receptor agonist, stronger affinity to gip RECEPTORS- decreases appetite and enhances satiety
ADVERSE EFFECTS
tirzeptide
nausea, diarrhea, constipation, vomiting, abd pain, headache, fatigue, dyspepsia
MOA
setmelanotide
melanocortin 4 receptor agaonist for the treatment of obesity due to 3 rare gentic conditions related to mutaion on POMC, PCSK1, OR lepr- decreases appetite and enhances satiety
moa
sitagliptin
Inhibits the enzyme that breaks down GLP-1, raises GLP-1 levels
adverse effects
sitagliptin
Low risk of hypoglycemia, weight neutral, allergic reactions (urticaria), acute pancreatitis, pancreatic cancer (animals), headache, Infections-nasopharyngitis, URI, UTI
