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Pharm 4 - Endo

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gsafsaf's version from 2015-06-10 21:59

Oral hypoglycemic drugs

Question Answer
BiguanidesMetformin
MetforminExact MOA not understood
Metformindecrease gluconeogenesis, increase glycolysis, increase peripheral glucose uptake
MetforminIncrease insulin sensitivity in DM2
MetforminFirst-line in DM2 Rx for PCOS
MetforminContraindicated in renal insufficiency
MetforminCan be used in pts without islet function
MetforminGI upset, lactic acidosis
Sulfonylureas - First generationChlorpropamide
Sulfonylureas - First generationTolbutamide
Sulfonylureas - First generationDisulfiram-like effects
Sulfonylureas - Second generationGlimepiride
Sulfonylureas - Second generationGlipizide
Sulfonylureas - Second generationGlyburide
Sulfonylureas - Second generationHypoglycemia - long lasting
SulfonylureasClose K+ channel in ß-cell membrane; cell depolarization; Ca2+ influx; insulin release
SulfonylureasStimulate endogenous insulin release in DM2
TZDsPioglitazone
TZDsRosiglitazone
TZDsIncrease insulin sensitivity in DM2
TZDsBind to PPAR-gamma nuclear TF
TZDsWeight gain
TZDsRisk of edema + HF -c/i in CHF pts
TZDsHepatotoxicity
TZDsRisk of fractures
GLP1-analogsExenatide
GLP1-analogsLiraglutide
GLP1-analogsIncrease insulin release, decrease glucagon release - DM2
GLP1-analogsGlucose dependent so if glucose decreases, they lose their effects - don't cause hypoglycemia
GLP1-analogsS/e of acute pancreatitis, N/V
DPP-4 inhibitorsLinagliptin
DPP-4 inhibitorsSaxagliptin
DPP-4 inhibitorsSitagliptin
DPP-4 inhibitorsIncrease insulin release, decrease glucagon release - DM2
DPP-4 inhibitorsS/e of mild urinary or respiratory infections
Amylin analogsPramlintide
PramlintideInjection w each meal
PramlintideDecreases gastric emptying, decreases glucagon
PramlintideDM1 or DM2
PramlintideS/e of hypoglycemia, nausea, diarrhea
SGLT-2 InhibitorsCanagliflozin
CanagliflozinBlocks reabsorption of glucose in PCT-rely on normal renal function
CanagliflozinS/e of glucosuria, UTIs, vaginal yeast infxns
alpha-glucosidase inhibitorsAcarbose
alpha-glucosidase inhibitorsMiglitol
alpha-glucosidase inhibitorsInhibit intestinal brush-border enzymes - decreases postprandial hyperglycemia
MiglitolHepatotoxicity
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Insulin

Question Answer
AspartRapid acting
GlulisineRapid acting
LisproRapid acting
NPHIntermediate acting
DetemirLong acting
GlargineLong acting
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