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10 Cards in this Set
- Front
- Back
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Type 1
Insulin Preps |
Rapid - 10-30 mins - peaks 30-60 mins - for 3-5 hrs - Lispro Insulin, Aspart
Short - 30-60 mins - peaks 1-2 hrs - for 5-7 hrs - regular insulin Intermediate - 1-2 hrs - peaks 6-12 hrs - for 18-24 hrs - NPH/Lente insulin Long - 4-6 hrs - peaks 16-18 hrs - for 24-36 hrs - Ultralente/Glargine (most resemble to pump) |
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Insulin
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DOC for DM in pregnancy, DKA, T1DM
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Sulfonylureas
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Clorpropamide - also tx's DI
Glyburide - CI CVD and elderly Glipizide - preferred in elderly Glimepiride - more potent Tolbutamide - safe in elderly MOA: Binds to the SUR1 subunit of the ATP-sensitive K channel on beta cells and inactivates the channel, analogous to the response in the fed state (BLOCKS K EFFLUX) AE: hypoglycemia, wt gain CI: pregnancy |
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Thiazoladinediones
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Rosiglitazone
Pioglitazone MOA: selective agonist of PPARgamma, Heterodimerizes with RXR receptor -> Activation of insulin-responsive genes that regulate carbohydrate and lipid metabolism -Primary site of action is fat, but also muscle and liver Uses: combo with insulin, biguanides or sulfonylureas - prevents postprandial hyperglycemia - NO HYPOGLYCEMIA AE: diarrhea, URTIs CI: severe heart failure (BLACK BOX) |
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Meglitinides
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Repaglinide - NON SULFA
MOA - stim insulin by closing ATP-dep K channels in pancretic beta cells (FAST ONSET) - alone or with metformin AE - hypoglycemic rxn, URTI, N/V CI - severe hepatic dz, pregs |
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Biguanides
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Metformin
MOA - --| hepatic gluconeogenesis -antihyperglycemic, not hypoglycemic; dec triglycerides AE - anorexia, metallic state, N/V/D, lactic acidosis, Vit B12 def |
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alpha-glucosidase inhibitors
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Acarbose
Miglitol MOA - competitively --| intestinal brush border enzyme alpha-glucosidase -> absorption of monosaccharides from duodenum and upper jejunum is reduced - no hypoglycemia - alone or with sulfonylurea or insulin AE - flatulence, diarrhea CI - IBD, gas, renal dz, hepatic dz |
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Glucagon
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MOA - inc cAMP
- profound relax of intestinal smooth muscle AE - N/V, hypoTN Dx use - x-ray visualization of bowel; test pancreatic B cell secretory reserve USES - emergency tx of severe hyoglycemic rxn; reverse cardiac effect of betablocker OD |
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Incretin mimetic: Exenatide
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MOA:
-GLP-1 receptor agonist -Glucose-dependent insulinotropic polypeptide (GIP-1), Glucagon-like peptide (GLP-1) – “incretins” -“Glucose-dependent” insulin secretion -Suppresses glucagon secretion -Slows gastric emptying -Decreases appetite -INJECTION |
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Sitagliptin
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MOA - --| dipeptidyl peptidase-4 (DDP-4) therefore inc GLP-1 and GIP
-> dec post prandial glucose excursions; inc insulin, dec glucagon - given alone or combined AE - nasopharyngitis, URTIs, HA |
