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DM Orals

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nelso418's version from 2017-03-03 03:20

Section

Question Answer
Acarbose-Precose ® a-glucosidase inhibitor
Miglitol-Glyset ® a-glucosidase inhibitor
Pramlintide-Symlin ® Amylin agonist
Metformin-Glucophage ® AMPK activator
Colesevelam-Welchol ® Bile acid sequestrant
Bromocriptine-Cycloset ® Dopamine agonist
Alogliptin-Nesina ® DPP-4 inhibitor
Linagliptin-Tradjenta ® DPP-4 inhibitor
Sitagliptin-Januvia ® DPP-4 inhibitor
Saxagliptin-Onglyza ® DPP-4 inhibitor
Albiglutide-Tanzeim ® GLP-1 agonist
Dulaglutide-Trulicity ® GLP-1 agonist
Exenatide-Byetta ® GLP-1 agonist
Exenatide XR- Bydurean ® GLP-1 agonist
Liraglutide-Victoza ® GLP-1 agonist
Lixisenatide-Adlyxin ® GLP-1 agonist
Canagliflozin-Invokana ® SGLT-2 Inhibitor
Dapagliflozin-Farxiga ® SGLT-2 Inhibitor
Empagliflozin-Jardiance ® SGLT-2 Inhibitor
Repaglinide-Prandin ® Short-acting secretagogue
Nateglinide-Starlix ® Short-acting secretagogue
Glipizide-Glucotrol ® Sulfonylureas
Glimepride-Amaryl ®Sulfonylureas - best in class d/t least chance of hypoglycemia
Glyburide-Glynase ® Sulfonylureas
Pioglitazone-Actos ® TZD (PPAR agonist)
Rosiglitazone-Avandia ® TZD (PPAR agonist)
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Question Answer
α-glucosidase inhibitors MOACompetitive and reversible inhibiton of pancreatic α-amylase, sucrase, and membrane bound intestinal α-glucosidase. Delays the absorption and digestion of ingested carbohydrates – reducing PPG
AMPK inhibitor MOA1. activates AMP-dependent protein kinase (AMPK) - enters cell through plasma membrane transporters (OCT1) - inhibits ATP generation - inc AMP stimulates AMPK - action to dec. lipids 2. inhibits fructose biphosphatase (FBPase) - dec gluconeogenesis in liver - dec glucose secretion from liver - biguanide structure
Dopamine agonist MOACentrally acting D2 dopamine agonist that affects patterns of food intake and nutrient storage - Drug brings back and supplements dopamine in our dopamine deficient T2DM patients
DPP-4 Inhibitors MOAInhibits DPP-IV which increases levels of endogenous GLP-1 and you receive the downstream benefits of GLP-1
GLP-1 agonists MOAPancreas: stimulates insulin release from beta cells and inc production of new insulin producing beta cells - inc insulin release is plasma glucose dependent - dec glucagon secretion from alpha cells in the pancreas; dec glucose secretion from liver - this action is plasma glucose dependent - liver: dec. glucose production - GI: dec gastric emptying, dec PPG glucose spikes - CNS: inc satiety and dec urge to eat - Muscle: acts to inc GLUT-4 transporters - CV: dec blood pressure, promote vasodilation, inc Na excretion - Improved lipid profile
SGLT-2 Inhibitors MOABlockade of the Na/glucose cotransporter in the proximal S1 tubule of the nephron - Allows for glucose excretion independent of insulin secretion - Blocks the SGLT-2 transporter preventing glucose reabsorption in the blood
Short Acting Secretagouges MOAMain effect: stimulate the release of endogenous insulin from functional beta cells - closes an ATP dependent K channel leading to longer Ca channel opening and insulin release - Acts on a different binding site on beta cells than sulfonylurease
Sulfonylureas MOAInsulin released from beta cells due to glucose. Is sensed enters through GLUT2 into beta cell then converted to energy in mitochondria. ATP release stops K from leaving cell. Leads to depolarization. Ca channels open and Ca enters cell leading to insulin secretion - Main effect: stimulate the relase of endogenous insulin from functional beta cells - Closes ATP-K channel which leads to longer Ca channel opening - Elicits insulin release regardless of plasma glucose concentrations
TZDs (PPAR agonists) MOAEndogenous ligands (ie Fatty acids, PG’s) binds to nuclear/cytoplasmic peroxisome proliferator activated receptors (PPAR) which attach to DNA and form activated complexes that initiate new protein synthesis
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Question Answer
α-glucosidase inhibitors↓PPG
Amylin agonist↓PPG
AMPK activator↓FBG and some PPG
Bile acid sequestrants↓FBG
Dopamine agonists↓PPG
DPP-4 Inhibitors↓PPG
GLP-1 agonists↓PPG > FBG
SGLT-2 Inhibitor↓FBG
Short-acting Secretagogue↓PPG
Sulfonylureas↓FBG > PPG
TZDs (PPAR agonists)↓FBG
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Question Answer
α-glucosidase inhibitorsneutral
Amylin agonistweight loss
AMPK activatorweight loss
Bile acid sequestrantsneutral
Dopamine agonistsneutral
DPP-4 Inhibitorsneutral
GLP-1 agonistsweight loss
SGLT-2 Inhibitorweight loss
Short-acting Secretagogueweight gain
Sulfonylureasweight gain
TZDs (PPAR agonists)weight gain
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