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27 Cards in this Set
- Front
- Back
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Biguanide (metformin)
Mechanism |
Biguanide (metformin) mechanism
Decr hepatic gluconeogenesis Incr insulin activity Decr hyperlipidemia |
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Biguande (metformin)
Side effects |
Biguande (metformin ) side effects
Rare lactic acidosis GI disturbance Contraindicated in renal & hepatic insufficiency |
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Sulfonylureas
drug names |
Sulfonylurea
glyburide glipizide tolbutamide |
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Sulfonylurea mechanism |
Secretagogue= Stimulates insulin release so need functioning pancreas Decr glucagon Incr binding of insulin to cell receptors |
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Sulfonylurea side effects |
Sulfonylurea side effects Hypoglycemia lasting as long as 24 h Contraindicated in hepatic or renal insufficiency |
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TZDs -glitazones Mechanism |
TZDs. -glitazones Thiazolidinediones Incr tissue sensitivity to insulin Incr tissue uptake of glucose Decr hepatic gluconeogenesis |
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Decr hepatic gluconeogenesis
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Biguanides
Glitazones |
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Hypoglycemia side effect
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Sulfonylurea
Meglitinides -glinide (secretagogues) |
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Contraindicated in hepatic / renal insufficiency
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Biguanide
Sulfonylurea |
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TZDs. (-glitazones ) Side effects |
Weight gain Incr LDL Fluid retention Incr risk MI |
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Contraindicated in heart failure
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TZDs (-glitazones)
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Alpha glucosidase inhibitors
Mechanism |
Acarbose
Decr GI absorption or starch and disaccharides |
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Alpha glucosidase inhibitors
use |
Mono therapy in pt with good dietary control of DM
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Alpha glucosidase inhibitor
side effects |
Diarrhea
Flatulence GI disturbance |
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Most common first line therapy in DM2
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Biguanides (metformin)
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Meglitinides (-glinide)
Mechanism of action |
Stimulate insulin release
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Meglitinides (-glinides)
Side effects |
Hypoglycemia
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Gliptins (2) |
Sitagliptan = Januvia Saxagliptin = Onglyza |
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Gliptins (2) |
Sitagliptan = Januvia Saxagliptin = Onglyza |
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Gliptins Mechanism |
Gliptins Inhibitors of DPP-IV which affects GLP-1 Prolongs incretin --> decreases glucagon secretion Incr insulin secretions Delays gastric emptying |
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DPP-IV |
Dipeptidyl peptidase Affects GLP-1 and other incretins Prolongs action of incretins |
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-tides Exenatide Liraglutide |
Exenatide = Byetta
Liraglutide = Victoza |
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Exenatide Liraglutide Mechanism |
Exenatide analogue of exendin which acts like GLP-1
Liraglutide synthetic analog of GLP-1
Mimic action of incretins --> decr glucagon secretion Incr insulin secretions |
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Exenatide
Liraglutide
Mechanism |
Mimic action of incretins --> decr glucagon secretion Incr insulin secretions |
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For renal disease |
TZDs |
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DM 2 Drug choice Start with Add |
DM 2
Start with Metformin Add Sulfonylurea or TZD |
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Hold Metformin |
Prior to CT contrast |
