Week 8: Biguanides and TZDs - Insulin Sensitizers Flashcards

1
Q

Biguanides - Metformin (Glucophage) MOA

A

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

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2
Q

Metformin (Glucophage) contraindications

A

Renal failure - Serum Cr >1.5 males; >1/4 females

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3
Q

Biguanides/Metformin ADRs

A
GI- diarrhea/gas
Lactic Acidosis (in dehydration)
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4
Q

Metformin pt counseling

A

Hold for 48 hours before and after radiologic studies with contrast

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5
Q

Thiazolidinediones (TZDs) - Pioglitazone (Actos) MOA

A

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

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6
Q

TZDs - Pioglitazone (Actos) ADRs

A
  • peripheral edema

- small bone fracture

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7
Q

Pioglitazone (Actos) contraindications

A
  • heart failure
  • active liver dz
  • hx of bladder cancer
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8
Q

Actos (TZDs) pt education

A
  • monitor ALT
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