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Antidiabetic Pharm

DrugMOAIndicationsSECINotes
Insulin Lispro: peak in 1hr, duration 3-4hrs. Regular Insulin: peak 2-3hrs; duration 5-7hrs. Semilente insulin: peak 6hrs; duration 10-12hrs. Lente insulin/NPH: peak 10hrs, duration 18hrs. Ultralente insulin: peak 12hrs, duration 24hrs. 1. Decr bld glucose by decr hepatic gluconeogenesis, incr glycogen syn, incr glucose uptake 2. Inhibit lypolysis 3. Incr AA uptake 4. Decr serum K (incr K uptake) T2DM Hypoglycemia Syn: proinsulin -> insulin + C-peptide in pancreatic B cell. Secr: glucose binds R on B-cell -> uptake and oxidized to ATP -> ATP binds K channel and inhibit K efflux -> depolarization -> incr Ca(i) -> insulin rel -> act on liver, muscle, adipose
Metformin 1. inh hepatic gluconeogenesis; 2. incr periph use of glucose by adipose and skeletal m; 3. decr abs of glucose from GI 1. non-insulin dependent T2DM; 2. polycystic ovarian syndrome 1. GI upset; 2. lactic acidosis; 3. impaired vit B12 abs. NO HYPOGLYCEMIA renal insufficiency
Rosiglitazone "-glitazones" bind PPAR-g -> upregulation of genes that decr insulin resistance T2DM (non-insulin dependent) hypoglycemia, edema Troglitazone drawn from market for liver toxicity, CI in hepatic insufficiency.
Sulfonylureas 1. bind K channels on B cell -> stim insulin release; 2. prolong binding of insulin to target tissue receptors; 3. decr serum glucagon T2DM hypoglycemia pregnancy (cross placenta and cause insulin depletion); use w/caution in renal and hepatic insufficiency
a-glucosidase inhibitors inhibit a-glucosidase (brush border of sm int) -> decr abs of postprandial carbs T2DM GI upset (flatulence, diarrhea)
Meglitinides "-glinides" binds K channel -> incr release of insulin T2DM wt gain, hypoglycemia
Dipeptidyl peptidase-4 (DPP-4) inhibitors "-gliptins" inhibit DDP-4 -> incr GLP-1 -> incr insulin, decr glucagon secr T2DM nausea
Glucagon-like peptide 1 (GLP-1) analog incr insulin and decr glucagon secr T2DM pancreatitis, hypoglycemia
Created by: lehk