Insulin And Oral Hypoglycemic Agent

Front 1

C-peptide

Back 1

co-synthesized with insulin and is used to measure how much insulin is in patient

Front 2

Sulfonylureas

Back 2

inhibits ATP-sensitive K+ channeland stimulate insulin secretion.
they are insulin sparing and mostly used as combination drugs
(Glipizide, glyburide, glymepiride)
ironically may cause hypoglycemia

Front 3

Meglitinide

Back 3

closes k+ channel and induces beta-cell depolarization = insulin release
advantage of rapid onset and short duration.
insulin sparing
low rate of hypoglycemia
do not during pregnancy or diabetes 1

Front 4

Thiazolidinediones

Back 4

enhances insulin responsiveness (reduce insulin resistance) by stimulating GLUT4
REQUIRES insulin presence
site of action is target cells, not pancreas

Front 5

Biguanides

Back 5

metformin (glucophages) DOC.
activates 5'-AMP to reduce hepatic gluconeogensis
DOES NOT increase insulin release
directly inhibits class II HDACs (cells in liver)
has Renal side effects and cause LACTIC ACIDOSIS
for type 2

Front 6

Alpha-Glucosidase Inhibitors

Back 6

can be used for type 1 & 2
delays and reduce carbohydrate uptake from GI
competitive and reversible inhibitor
we want to reduce after meal glucose level.
Acarbose: non absorbable acts on intestine
Miglitol: absorbable and may act on other cells.

Front 7

SGLT2 inhibitors

Back 7

Canaglifozin
acts on the kidney: blocks reabsorption of glucose and increase glucose excretion
for type 2
not for type 1

Front 8

Dipeptidyl inhibitors

Back 8

prevent inactivation of GLP-1 and GIP (which potentiate glucose induced insulin secretion)
advantage: patient does not gain weight or retain water compared to Thiazolidinediones `
for type 2

Front 9

Exenatide

Back 9

derived from lizard saliva (exendin-4) which is similar to glucagon like peptide-1
stimulates insulin secretion and slows GI emptying

Front 10

INSULIN

Back 10

for type 1 and type 2 uncontrolled by diet/drug
Aspart & Lispro
these insulin have their dimers and hexamers increased by amino acid sequence changed for greater bioavailability.

Front 11

Insulin Glulisine

Back 11

is a rapid acting insulin analogue by changed asparagine position. it has no peak activity and is steady.

Front 12

Insulin Detemir

Back 12

long acting insulin derived from yeast for consistent absorption rate.

Front 13

Amylin

Back 13

promotes efficacy of insulin. both type 2 and 1 as an adjunct treatment
SYMLIN is an analog of Amylin, natural hormone from pancreatic beta cells.
helps suppress glucagon secretion and glucose release from liver, helps achieve lower blood glucose after meals.

Front 14

Streptozotocin (hyperglycemic agent)

Back 14

destroys islet beta cells by alkylating bases in DNA
used for insulin secreting tumors

Front 15

Diazoxide (hyperglycemic agent)

Back 15

opens K+ channels
used to control hypoglycemia from insulin secreting tumors.