Insulin

Front 1

Insulin

Back 1

- Synthesis occurs in the Beta cells
- MOA: Activates recptors that lead to phosphorylation and activation of GTP (basically makes proteins to put the glucose into the cell.

Front 2

Regular Insulin

Back 2

-Crystalline zinc or Lispro
- Humulin or Humalog
- Short Acting 5-7 hrs

Front 3

Intermediate acting

Back 3

Insulin zinc suspension (lente)
Isophane insulin suspension (NPH)
18-24 hrs

Front 4

Long Acting

Back 4

Extended insulin Suspension (Humulin U)
Insulin Glargine (Lantus)
36 hrs

Front 5

Sulfonylurase

Back 5

MOA - Stimulates the release of insulin and increases the sensitivity of beta cells to glucose. Basically increases Ca inside a cell - releasing Insulin.
Tolbutamide (Orinase)
Newer agents – more frequent use today
Glipizide (Glucotrol)
Glyburide (Micronase)
Glimepiride (Amaryl)

Front 6

Side affects of Sulfonylureas

Back 6

Hypoglycemia (can be profound)
Nausea
Rash
Blood disorders
Jaundice
Muscle weakness and ataxia
Dizziness and mental confusion

Front 7

Secretagogues

Back 7

Repaglinide (Prandin) and nateglinide (Starlix)
MOA -stimulates insulin release from active beta cells
Short duration – used only preprandially
Can cause hypoglycemia (less likely than sulfas), nausea, dyspepsia, and diarrhea

Front 8

Biguanides

Back 8

Metformin (Glucophage)
- Decreases glucose production and increases insulin action on muscle
- Lactic Acidosis !!
- Commonly – diarrhea, nausea, other GIT symptoms

Front 9

Alpha-glucosidase inhibitors

Back 9

Acarbose (Glucobay) (Precose)
Miglitol (Glyset)
MOA - Inhibits GIT enzymes that breakdowns complex carbohydrates
Side affects - GIT disturbances, diarrhea, pain, and gas

Front 10

rosiglitazone (Avandia)
pioglitazone (Actos)

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- Increasing the sensitivity of insulin receptors
- Common side effect is weight gain and fluid retention.
Significant but infrequent toxicities include; hepatotoxicity, and congestive heart failure