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17 Cards in this Set
- Front
- Back
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What are the 5 Classes of Oral hypoglycemic agents?
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1. Sulfonylureas
2. Meglitinides 3. Alpha-glucosidase inhibitor 4. Thiazolidinediones 5. Biguanides |
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Patients w/ T2DM have 2 fundamental defects with metabolisim, they are:
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1. Defect in insulin secretion from the pancreatic beta cells
2. Insulin resistance |
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What are the functions of the medications developed to aid in the metabolism of glucose?
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- stimulate an increase in insulin secretion
- decrease insulin resistance - decrese hepatic production of glucose |
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Who requires initial insulin therapy?
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Patients presenting with high Fasting plasma glucoses (FPG)greater or equal to 280 mg/dL
- or - with random glucoses greater than equal to 400 mg/dL |
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A. What is the measurable goal for glycemic control?
B. When is pharmacological treatment indicated? |
A. Goal HBA1c < 7.0%
B. HBA1c >= 8.0% |
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What is the most studied combinatin therapy?
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Metformin & Sulfonylureas
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3 General principles in combining Oral Hypoglycemic drugs...
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1. Whent pt. fails OHM combining drugs is usually more effective than stoping one agent and substituting another
2. Adding another med is usually better than increasing the dosage of an agent that is already being given at near maximum dosage 3. Seconday failure of the 2 drug combo in patients with T2DM is expected eventually |
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Which oral hypoglycemic classes are considered ENDOGENOUS INSULIN SECRETAGOGUES?
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- sulfonylureas &
- meglitinides |
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What oral hypoglycemic classes improve endogenous insulin sensitivity?
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- biguanides
- thiazolidinediones or combinations |
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MOA of sulfonylureas?
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Action starts by binding with a specific sulfonylurea receptor on the B-cell of the pancreas
--> This leads to exocytosis of insulin-containing secretory granules |
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Name the three 2nd Generation sulfonylureas & daily dose range..
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glyburide 2.5 - 20 MAX
glypizide 2.5 - 40 MAX glimepride 1 - 8 MAX Doses: 1 - 2 times/day |
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Effect of sulfonylureas on HBA1c & FPG
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HBA1c - decreased avg. 0.8% - 1.7%
FPG - lowered by 50 - 70 mg/dL |
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What are the two subclasses of meglitinides & daily doses?
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Repaglinide 1.5 - 16 MAX
Nateglinide 60 - 120 MAX |
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What are the alpha glucosidase inhibitor medications & daily doses?
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Acarbose & Miglitol
both 75 - 300 |
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Which drugs represent the class of drugs commonly known as non-sulfonylurea insulin secretagogues?
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- the meglitinides -
repaglinide & nateglinide |
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MOA of meglitinides?
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starts by binding to a different receptor on the b-cell of the pancreas causing increased endogenous insulin secretions
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Repaglinide & nateglinide both have an absorption time of?
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15 - 30 minutes and a half life of 1 hour
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