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diabetic pharm

anti-diabetic agents

diazoxide increases blood glucose levels by inhibiting insulin secretion, used for insulinoma, amy cause sodium retnetion, GI irritation and changes in circulating WBC's
glucagon single chain polypeptide which is inhibted by elevated glucose, insulin and somatostatin, stimulated by amino acids and sympathetic stimulation
glucagon used in hypoglycemic crisis, provides intestinal relaxation for radiologic studies, used to asses pancreatic reserves
glucagon adverse effects are nausea and vomiting
troglitazone increases tissue sensitivity to insulin, increases glucose uptake and decreases insulin levels in the liver, increases glucose uptake in muscle
troglitazone reduces plasma glucose and triglycerides and does not cause hypoglycemia
alpha glucosidase inhibitors acarbose
acarbose is an oligosacharide which competitely and reversible inhibits alpha amylase in lumen of intestine
acarbose prolongs digestion of carbohydrates and reduces peak plasma glucose levels, rarely causes hypoglycemia
biguanine metformin
metformin reduces hepatic glucose production, increases peripheral insulin sensitivity
metformin sometimes used with sulfonylureas, rarely causes hypoglycemia or weight gain
metformin adverse effects include lactic acidosis
long acting sulfonylureas chloropropamide and flimepiride
ong acting sulfonylureas reabsored in kidney, contraindicated in elderly, adverse effects- water retention and disulfiram like reactions
intermediate acting sulfonylureas acetohexamide( useful in pateints with gout), tolazamide and glyburide( mild diuretic efects), glipizide(largly protein bound)
short acting sulfonylureas tolbutamide
tolbutamide adverse effects- hypoglycemia, GI disturbances and dermatologic disorders, associated with 2.5 fold increase in cardiovascular mortality
sulfonylureas increases secreation of insulin by blockin K channels
sulfonylureas increases sensitivity to insulin, decreases serum glucagon
Insulin adverse reactions-hypoglycemia and immune disorders ( anti-insulin antibodies, hypersensitivity, lipodystrophy or hypertrophy at injection site)
long acting insulin protamine-zinc insulin and ultralente
intermediate acting insulin Isophane insulin, lente insulin
fast acting insulin regular insulin, semilente insulin
actions of insulin on liver inhibits glucose production and glycogenolysis, stimulates glycolysis and glycogen synthesis, increases synthesis of proteins and triglycerides
actions insulin on muscle increases glucose transport, glycolysis, glycogen deposition and protein synthesis
actions of insulin on adipose tissue increases glucose transport, lipogenesis and lipoprotein lipase and decreases intracellular lypolysis
insulin promotes systemic cellular K uptake
Created by: swohlers



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