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10 Cards in this Set

  • Front
  • Back
Sulfonylureas

-MOA
-uses
-drugs
MOA: Increase insulin secretion by activating sulfonylurea receptor on islet cell

-used for relative insulinopenia and in lean patients (causes weight gain)

-1st gen: chlorpropamide, golbutamide. tolazamide, acetohexamide
-2nd gen: glyburide, glipizide, glimeperide
Biguanides

-MOA
-uses
-drugs
MOA: decrease hepatic gluconeogenesis which may reduce peripheral insulin resistance

-used for obesity plus insulin resistance, hypoglycemia due to SUs and PCOS

-Metformin
Thiazolidinediones

-MOA
-uses
-drugs
MOA: decrease peripheral insulin resistance by increasing GLUT 4 proteins - reduces fatty acids as well

-used for insulin resistance and PCOS

-pioglitazone, rosiglitazone
Meglitinides

-MOA
-uses
-drugs
MOA: increase insulin secretion when glucose exceeds threshold level - glucose dependent so it does not induce insulin release in fasting state

-used in relative insulinopenia

-repaglinide, nateglinide
alpha-Glucosidase inhibitors

-MOA
-uses
-drugs
MOA: slow the breakdown of complex CHO in GI tract - slow absorption of CHO

-used in postprandial hyperglycemia - rarely ever used

-acarbose, miglitol
Which T2DM medications (2) are contraindicated in renal insufficiency?
1. Metformin (biguanide)
2. Glyburide (sulfonylurea)
Which T2DM medications (2) are contraindicated in CHF?
1. Metformin (biguanide)
2. Thiazolidinediones
Which T2DM medications (2) should be used if the patient has a history of hypoglycemia?
Use medications that don't increase insulin release:

1. Metformin (inhibits gluconeogenesis)
2. TZDs (increase GLUT 4 - decrease insulin resistance)

Sulfonylureas and meglitinides increase insulin secretion
T1DM

-what is the best approach for treatment?
Best insulin therapy regiments mimic physiologic insulin release - spike after every meal
Insulin

-rapid acting
-intermediate acting
-long acting
Rapid: aspart, lispro, glulisine

Intermediate: NPH

Long: glargine, detemir