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19 Cards in this Set
- Front
- Back
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Thiazolidinediones / Pioglitazone. MOA
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- increase levels of ADIPONECTIN
-decrease insulin resistance - increase target to intracellular nuclear receptor transcription / modulation 2 weeks to start effect |
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Thiazolidinediones / Pioglitazone. SE
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-weigth gain
-edema -liver toxic -CV toxic contraindicated in heart failure |
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SULFONILUREAS
MOA |
close K channel in Beta cell membrane, cell depolarizes, triggering of insulin release, via increase Ca influxx; target membrane ion channel increase C- peptide in serum
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SULFONILUREAS use
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Increase release of endogenous insulin.
type II DM |
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SULFONILUREAS
1st generation: SE tolbutamide chlorpropamide |
SE: disulfiram like effects
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SULFONILUREAS
2nd generation: SE Glyburide Glymepiride Glipizide |
SE: Hypoglycemia
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INSULIN . Short acting
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LISPRO
ASPART |
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INSULIN. intermediate
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NPH
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INSULIN. long acting
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Lente
Ultralente |
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INSULIN
MOA |
Surface tyrosine kinase couple receptor.
LIVER: increase glucose store like glycogen MUSCLE: increase Glycogen and protein synthesis, K+ uptake. FAT: Aids TG storage |
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INSULIN USE and SE
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DM type I
Hyperkalemia stress induced hyperglycemia SE: Hypoglycemia, Hypersensitivity |
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BIGUANIDES
METFORMIN MOA / USE |
Surface membrane bound EZ
intracellular microsomal EZ decrease gluconeogenesis increase glycolysis decrease serum glucose levels USE: DM type I and II |
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BIGUANIDES
METFORMIN SE |
Lactic Acidosis
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BIGUANIDES
METFORMIN Contraindications |
-liver failure
-CHF -Alcoholism -Sepsis -Renal Failure |
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ALPHA glucosidase inhibitors
ACARBOSE MIGLITOL MOA |
Surface membrane bound EZ
intracellular microsomal EZ INHIBIT intestinal BRUSH border delayed sugar hydrolysis decrease postpandrial hypoglycemia |
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ALPHA glucosidase inhibitors
ACARBOSE MIGLITOL USE / SE |
USE: type II DM
SE: GI disturbances |
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Exenatine
GLP-1 analog MOA / USE |
Target Adenylate Cyclase
-induce satiety -decrease gastric emptying -increase insulin release USE: Type II DM |
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INSULIN
BASAL LONG ACTING |
NPH
twice daily (12-18 hrs) Glargine once daily (24 hrs) Best option |
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INSULIN
SHORT ACTING |
REGULAR: peak 2-3 hrs. best for continues IV DKA
LISPRO peak: 30-90 minutes ASPART best option for post meal hyperglycemia |
