| Drug class | Types | Action | Clinical use | Toxicities |
| 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 |
