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13 Cards in this Set
- Front
- Back
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List classes of oral hypoglycaemic agents |
Gliptins Biguanidines Sulphonylureas Thiazolidinedones Acarbose Meglitinides |
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Biguanidines - MOA |
Eg Metformin Increases insulin sensitivity and promotes genetic expression: Decreases glucose gut uptake Increases skeletal muscle uptake Decreases GNG in liver Increases fatty oxidation and reduces TG/plasma cholesterol |
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Biguanidines - SE |
GI disturbance - usually transient Can decrease appetite Rare but serious Lactic acidosis - more common in renal failure, dehyrdated |
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Sulphonylureas - MOA |
Depolarise insulin beta cells via K-ATPase pump inhibition --> Ca++ influx --> insulin release May decrease peripheral insulin resistance over time Requires functioning pancreas |
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Sulphonylureas - SEs |
GI disturbance Wt gain Hypoglycaemia Accumulation in renal failure Rarer: Hepatic derangement Blood dyscrasias |
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Acarbose - MOA |
Blocks degradation of polysaccharides in gut --> reduced absorption --> prevents post prandial rise |
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Acarbose - SE |
GI disturbance - increased sucrose reaching gut flora Hepatic enzyme derangement |
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Thiazolidinedones eg - Pioglitazone MOA |
Activates gene transcription via nuclear receptor to increase insulin sensitivity - mainly pro insulin effects - takes 1-2 months to have effect |
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Thiazolidinedones - SEs |
Fluid retention
- Na absorption in collecting duct Wt gain Rosiglitazone - removed due to increased rates of MI |
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Gliptins - Sitagliptin |
Decreases rate of breakdown of incretins - by blocking DPP4 action. (substances released by GI in response to glucose in diet which stimulate insulin release) |
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Gliptins - SEs |
No weight gain GI disturbance rarely Hepatic dysfn Pancreatitis Exacerbation of CCF |
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Meglitinides: - Repaglinide - MOA |
increases insulin release by inhibting K-ATPase function |
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Meglitinides - Side effects |
Causes hypoglycaemias reduced risk as causes |
