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OADs function (3):
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3 types of OADs & functions:
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DM OADs
Drugs
| Question | Answer |
|---|---|
| OADs function (3): | 1) Help the liver to produce less glucose, 2) help the pancreas to release more insulin, 3) may stimulate Beta cells to produce insulin to: increase receptor sites on cell membrane, increase receptor site sensitivity |
| 3 types of OADs & functions: | 1) Insulin Secretagogues: stimulate insulin release from pancreas, 2) Insulin Sensitizers: increase insulin sensitivity in tissues & hepatic glucose production, 3) Alpha-Glucosidose Inhibitors: block and delay CHO absorption in the gut |
| Old Class I | Sulfanylureas |
| Sulfanylureas 4 brand/generic names | Amaryl (Glimepiride), Diabeta, Glynase, Micronase (Glyburide), Glucotrol, Glucotrol XL (Glipizide), Diabinese (Chlorpropamide) |
| Sulfonylureas (important facts) | * These drugs help the pancreas release more insulin, which lowers BG, * A1C = 1.5 - 2 % drop, * This class is not 1st line anymore |
| Sulfonylureas (side effects, drug interactions) | hypoglycemia, wt gain, photosensitivity, rash, GI upset, headaches DON'T USE IF ALLERGIC TO SULFA, Do Not crush Glucotrol, ETOH depresses liver production of glucose, Drug Interactions: Diflucan - Increases Sulfonylureas concent. severe hypoglycemia |
| Newer Class 1 Meglitinides 2 brand/generic | Prandin (Repaglinide), Starlix (Nateglinide) |
| Meglitinides (important facts) | *These drugs increase release in response to food, keeping BG from rising too hi after meals, stimulates pancreas to produce insulinlike sulfanylureas, but contains no sulfa |
| Meglitinides (more facts) | *tailered to meal, faster acting than sulfonylureas, goal to control post-prandial BG, remember give 15-30 mins prior to meal b/c it is so fast actin |
| Class 2 | Biguanides |
| Class 2 Biguanides 1 brand/generic | Glucophage, Glucophage XR (Metaformin) |
| Biguanides (important facts) | Metformin keeps liver from releasing too much glucose, is active in the liver; makes liver more sensitive - so blocks glucose from being produce in liver, pos effect on CHO, insulin sensitizers, no wt gain (lose 5-10), decrease risk of hypoglycemia |
| Side effects of Glucophage/Metaformin: | GI, Lactic acidosis, fatal if too much in the body, take with food to avoid GI upset, 500 mg at first then increase 2-3 wk/ to reduce GI upset |
| Risk factors for Lactic acidosis: | *Renal insufficiency, hepatic disease, CHF, ETOH abuse, IV contrast dye is hard on kidneys |
| Class 2: Insulin sensitizers | Thiazolidinediones |
| Thiazolidinediones 2 brand/generic | Avandia (Rosilitazone), Actos (Pioglitazone) |
| Thiazolidinediones (facts) | These drugs improve insulin sensitivity, aiding cells to use BG for energy, low risk of hypoglycemia, wt gain/peri edema, take 12 wks to see effect, very expensive but effective, monitor liver function |
| Class 3 | Alpha-Glucosidase Inhibitors |
| Alpha-Glucosidase Inhibitors 2 brand/generic | Precose (Acarbose), Glyset (Miglitol) |
| Alpha-Glucosidase Inhibitors facts: | These drugs slow digestion of CHOs, keeping BG from rising too hi after meals, GI side effects d/t delay of absorption of CHOs (diarrhea) |
| Alpha-Glucosidose Inhibitors con'd: | goal to conrol post-prandial BG, Remember: Must take with FIRST bite of each meal, GI side effects: most common: diarrhea, hypoglycemia must be treated with dextrose |
| Drugs which cause hyperglycemia: | Glucocorticoids, TPN, Atypical antipsychotics (zyprezxa, risperodone), Beta blockers (Inderal, Tenormin, Loppressor, Toprol XL, Coreg), Thiazide diuretics, Ca+ channel blockers, sympathommimetics (decongestants), phentoin (dilantin), |
Created by:
dcastro
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