Week 8: Biguanides and TZDs - Insulin Sensitizers Flashcards
Biguanides - Metformin (Glucophage) MOA
1) improves the sensitivity of insulin @ muscle cells
2) decreases hepatic glucose production (gluconeogenesis)
3) decreases intestinal absorption of glucose
Does not cause hypoglycemia - Weight negative
Metformin (Glucophage) contraindications
Renal failure - Serum Cr >1.5 males; >1/4 females
Biguanides/Metformin ADRs
GI- diarrhea/gas Lactic Acidosis (in dehydration)
Metformin pt counseling
Hold for 48 hours before and after radiologic studies with contrast
Thiazolidinediones (TZDs) - Pioglitazone (Actos) MOA
1) enhances insulin sensitivity
2) increases utilization of available insulin by the liver and muscle cells as well as adipose tissue.
3) decreases hepatic glucose production
* *works exactly like Metformin then went terribly wrong**
- Does not cause hypoglycemia - Weight positive
TZDs - Pioglitazone (Actos) ADRs
- peripheral edema
- small bone fracture
Pioglitazone (Actos) contraindications
- heart failure
- active liver dz
- hx of bladder cancer
Actos (TZDs) pt education
- monitor ALT