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Diabetes drugs

Drug classTypesActionClinical useToxicities
Biguanides: Metformin Exact mechanism is unknown. Decrease gluconeogensis, increase glycolysis, decrease glucose. (insulin sensitizer) Oral hypoglycemic. (type 1,2) Lactic acidosis
Glitazones: Pioglitazone, Rosiglitazone Increase response to insulin by causing release of adiponectins monotherapy in type 2 Weight gain, edema. Hepatoxicity, CV toxicity
Alpha-glucosidase inhibitors Acarbose, Miglitol Inhibit intestinal brush-border alpha glucosidases. Type 1, 2 GI disturbances
Mimemtics Pramlintide decreased glucagon type 2 hypoglycemia, nausea, diarrhea
GLP-1 Exenatide increased insulin, decreased glucagon Type 2 Nausea, vomiting; pancreatitis
Orlistat Alters fat metabolism by inhibitng pancreatic lipases long-term obesity management (in conjunction with modified diet) Steatorrhea, GI discomfort, reduced absorption of fat-soluble vitamins, headache
Sibutramine sympathomimetic serotonin and NE reuptake inhibitor short-term, long-term obesity management HTN, tachycardia
Propylthiouracil, methimazole Inhibit organifiation and coupling of thyroid hormone synthesis. Decreased conversion of T4, T3 Hyperthyroidism Skin rash, agranulocytosis (rare), aplastic anemia
GH GH deficiency, Turner's syndrome
Somatostatin Acromegaly, carcinoid, gastrinoma, glucagonoma
Oxytocin stimulates labor, uterine contractions, milk let-down, controls uterine hemorrhage
ADH Pituitary (central, nephrogenic) DI
Levothyroxine, triiodothyronine Thyroxine replacement Hypothyroidism, myxedema Tachycardia, heat intolerance, tremors, arrythmias
Glucocorticoids Hydrocortisone, prednisone, triamcinolone, dexamethasone, beclomethasone decrease the production leukotrienes, PGE by inhibiting phospholipase A2 and expression COX-2 Addison's disease, inflammation, immune suppression, asthma Iatrogenic Cushing's synrome- buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruisability, OA, adrenocortical atrophy, peptic ulcers, diabetes (chronic)
Demeclocycline ADH antagonist (member of tetracycline) Diabetes insipidus, SIADH Photosensitivity, abnormalities of bone and teeth
Insulin: short, medium long acting Short acting: Lispro, Aspart, regular; intermediate: NPH, Long-acting: glargine, determir Bind insulin receptor; Liver: glycogenolysis, muscle: glycogenolysis, protein synthesis, K uptake, Fats: TG storage Type 1, 2. hyperkalemia, stress induced hyperglycemia Hypoglycemia, hypersensitivity
Sulfonylurea: 1st and 2nd generation 1st generation: Tolbutamide, Chlorpropamide; Second generation: Glyburid, Glimepiride, Glipizide Close K channel in B cell membrane, so cell depolarizes --> triggering of insulin release Stimulates release of endogenous insulin in type 2. Require some islet function (no DM 1) Bad for people with sulfa allergiesFirst generation: disulfiram-like effects; 2nd: hypoglycemia
Created by: ddecampo
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