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31 Cards in this Set
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Reading: Basic and Clinical Pharmacology, Chapter 41, pp 683 – 704, 2007
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what are the pancreatic hormones?
(in this lecture) |
insulin, amylin, glucagon
(also somatostatin) |
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What are the antidiabetic drugs ?
(in this lecture) |
thiazolidinedione derivatives, amylin analogs, GLP-1 analogs, drug combinations
(also biguanides) |
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How do TZDs work?
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Bind to PPARs in nucleus
* insulin resistance is decreased * adipocyte differentiation is modified * VEGF-induced angiogenesis is inhibited (abstract). * Leptin levels decrease (leading to an increased appetite) * Levels of certain interleukins (e.g. IL-6) fall * Adiponectin levels rise |
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How do GLP-1 analogs work?
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Glucagon like peptide
* increases insulin secretion from the pancreas in a glucose-dependent manner. * decreases glucagon secretion from the pancreas. * increases beta cells mass and insulin gene expression. * inhibits acid secretion and gastric emptying in the stomach. * decreases food intake by increasing satiety. |
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What does amylin do?
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* inhibits the secretion of glucagon;
* slows the emptying of the stomach; * sends a satiety signal to the brain. |
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What are the side effects of thiazolidinedione ?
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fluid retention, leading to edema, weight gain, and potentially aggravating heart failure. Therefore, thiazolidinediones should not be prescribed in patients with decreased ventricular function (NYHA grade III or IV heart failure).
risk of drug induced hepatitis |
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What makes you hungry?
a) TZDs b) GLP-1s |
TZDs
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How do you treat gestational diabetes?
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keep blood glucose levels equal to those of pregnant women who don't have gestational diabetes
diet, exercise, insulin, GLYBURIDE (Diabeta®, Glynase™, Micronase®) |
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Some meds that help to stimulate insulin release from the pancreas-
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Sulfonylureas, Repaglinide, Nateglinide
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Brand name for Pioglitazone
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Actos
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Brand name for Rosiglitazone
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Avandia
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Rosiglitazone plus metformin
Brand name |
Avandamet
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Glyburide plus metformin
Brand name |
Glucovance
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Glipizide plus metformin
Brand name |
Metaglip
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Rosiglitazone plus glimeperide
Brand name |
Avandaryl
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Where does GLP-1 come from normally?
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L-cells of the gut
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Amylin analog is called what?
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Pramlintide
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Pramlintide brand name
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(Symlin ®)
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How (3 ways) does symlin work?
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Slows gastric emptying
Increases satiety Inhibits glucagon secretion from pancreatic alpha cells Results in decreased conversion of hepatic glycogen to glucose |
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Pramlintide is injected with insulin. How does this change the insulin dose (why)?
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Insulin is decreased to avoid hypoglycemia
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Side effects of symlin
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Nausea, vomiting, abdominal pain, headache, fatigue, dizziness
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What kind of drug is Exenatide (Byetta)
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Glucagon Like Peptide -1 (GLP-1) (Incretin Hormone)
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GLP-1 lowers glucose
a)after meal b) before meal |
a) after meal
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Side effects of Exenatide (Byetta)
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Weight loss
Stomach upset |
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Give example of
DiPeptidyl Peptidase 4 (DPP-4) Inhibitors (Incretin Hormone) |
Sitagliptin (Januvia)
Alone With metformin With sulfonylurea |
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side effect(s)
of Sitagliptin (Januvia) |
Stuffy, runny nose
Headache Hypersensitivity reaction |
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What drug is used for treating severe hypoglycemic reactions in Type 1 diabetes
Sometimes in beta –blocking poisoning |
Glucagon
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adverse reactions of glucagon
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nausea & vomiting
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What's macrosomia?
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excessive birth weight. it could result from gestational diabetes
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What kind of drug is GLYBURIDE (Diabeta®, Glynase™, Micronase®)
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sulfonylurea used for gestational diabetes
alternative to insulin |
