Oral Hypoglycemics

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Author:
mycards2014
ID:
130131
Filename:
Oral Hypoglycemics
Updated:
2012-01-23 22:31:22
Tags:
Block IV Gugliucci
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Description:
Diabetes drugs
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  1. Metformin
    • Biguanide to treat DM type 2
    • Improves glucose tolerance
    • -activates AMP kinase
    • -decreases gluconeogenesis
    • -stimulates direct tissue glycolysis
    • -decrease plasma glucagon
    • -decrease GI glucose absorption
    • Reduces microvascular complications
    • No weight gain
    • Adv Rxns: lactic acidosis, GI distress, decrease B12 absorption
  2. Sulfonylureas
    • Treat DM type 2
    • MOA: lowers threshold of beta cells by blocking SUR1 K+ receptors, which causes depolarization and insulin release
    • Adv Rxns: Hypoglycemia, weight gain, GI distress, SIADH
  3. Meglitinides
    • Nateglinide, Rapeglinide
    • Treat DM type 2
    • MOA: lowers threshold of islet beta cells by blocking SUR1 K+ receptors, which causes depolarization and insulin release
    • Faster onset and shorter duration than Sulfonylureas
    • Can be given to pts with sulfa allergies
    • Tox: Renal disease, increased transaminases
  4. Thiazolidinediones
    • Rosiglitazone, Pioglitazone
    • Treat DM type 2
    • Insulin sensitizer in peripheral tissues via PPAR gamma receptor (alters gene production in glucose metabolism)
    • Decreases gluconeogenesis
    • Increases glucose uptake in skeletal muscle
    • Tox: elevated liver enzymes, edema, HEART FAILURE
  5. Incretin Mimetics
    • Exanitide
    • Treat DM type 2
    • GLP-1 analogue: Increases insulin secretion
    • Tox: hypoglycemia, GI distress, decreased appetite, pancreatitis (rare)
  6. Sitagliptin
    • DPP-4 Inhibitor (DPP-4 is the enzyme that breaks down incretin)
    • Treat DM type 2
    • Add-on therapy with Metformin and Sulfonylureas
    • Tox: GI distress, nasopharyngitis, hypoglycemia
  7. Alpha-Glucosidase Inhibitors
    • Acarbose, Miglitol
    • Results in delayed carb digestion from GI and therefore decreases glucose absorbed
    • Tox: Abd pain, diarrhea, flatulence

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