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24 Cards in this Set
- Front
- Back
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3 Drugs
Ultra-Rapid Onset Short DOA |
1. Insulin lispro (Humalog)
2. Insulin aspart (Novolog) 3. insulin glulisine (Apidra) |
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1 Drug
Rapid Onset Short DOA |
Regular Insulin (crystalline zinc)
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Intermediate Onset
Intermediate DOA |
1. Neutral Protamine Hagedorn*
(phosphate buffer) 2. Lente (acetate buffer) –has been discontinued |
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Slow Onset
Extended DOA |
Ultralente Insulin (Humulin U)-
has been discontinued |
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Intermediate Onset
Extended DOA |
Insulin glargine (Lantus)
Insulin detemir (Levemir) |
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1st Generation Sulfonylureas
(Drugs) |
Tolbutamide (Orinase)
Chlorpropamide (Diabinese) Tolazamide (Tolinase) Acetohexamide (Dymelor) |
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Define 1st Generation Sulfonylureas-mech?
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• Potent hypoglycemic agents
• MOA:Close K+ channel (no need for ATP) = depolarization of β-cell = open Ca+ channel = insulin release • S.E. =hypoglycemia, weight gain, dermatological (sulfa) allergies |
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2nd Generation Sulfonylureas(Drugs)
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Glyburide (Micronase)
Glipizide (Glucotrol) Glucotrol XL* Glimepiride (Amaryl) |
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Define 2nd Generation Sulfonylureas-Mech?
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• Longer DOA than 1st generation
• 100x more potent hypoglycemic agents than 1st generation agents (Bad if OD) • Same side effects as 1st generation agents |
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Meglinitides-Drugs?
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Repaglinide (Prandin)
Nateglinide (Starlix) |
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Define Meglinitides
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• MOA: Close K+ channel (no need for ATP) = depolarization of β-cell = open Ca+ channel = insulin release
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Meglinities specific info?
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• Hypoglycemic agents
• Use: Reduce post-prandial glucose (take b/f meal) • Short t1/2’s • S.E. = Weight gain • No sulfa allergy |
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Biguanides )Drug)
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Metformin (Glucophage)
• Can be used in combinations with sulfonylureas, glitazones & insulin |
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Biguanide-specific info?
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• NOT hypoglycemic agent
• #1 agent forType-2 • Modest weight loss- • Increases HDL • “Anti-hyperglycemic” • Possible lactic acidosis (don’t use in kidney/liver diseased patients) • S.E. = GI disturbances (diarrhea) → releases 5-HT in gut |
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Alpha Glucosidase Inhibitors-Drugs?
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Acarbose (Precose)
Miglitol (Glyset) |
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Define Alpha Glucosidase Inhibitors
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• MOA: Compete with enzyme to prevent breakdown of complex carbohydrates (delay digestion of carbs = delay glucose absorption)
• Slow glucose peak in blood |
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Alpha Glucosidase Inhibitors Specific info
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• Taken TID with 1st bite of each meal
• Modest therapeut. action • Prevent sucrose breakdn • S.E. = gas • Poorly tolerated ! (gas) |
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Thiazolidinediones-TZD (Drugs)
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Rosiglitazone (Avandia)
Pioglitazone (Actos |
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Define TZD
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• MOA: Sensitize tissue to insulin = enhance the uptake of fatty acids and glucose from plasma to fat/muscle
• Dependent on presence of insulin • Activate nuclear receptor PPAR-γ • Increase expression of LPL, fatty acid transport protein & GLUT-4 |
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TZD-Specific info?
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• Similar MAO as fibrates
• Activate PPAR-γ which increases transcription of LPL, GLUT-4, others • Monitor LFTs every 2 months for 1st year • Slow onset ~ 2 months • S.E. = weight gain / fluid retention (Bad if CHF pt) • ↑MI incidence with rosigl. |
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Incretin Mimetic Agent (Drug)? Define?
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Exenatide (Byetta)
• MOA: Glucagon-like peptide - GLP-1 (7-36 amide) agonist; potentiates glucose-dependent insulin secretion, inhibits glucagon secretion, slows gastric emptying, decreases appetite, may?? increase beta cell proliferation long-term |
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Incretin Mimetic Agent (Specific info)
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• Type-2 Diabetics ONLY
• NOT indicated for use with insulin • Peptide (inject sc) • NO weight gain • Weight loss possible • Nausea • Drug interactions because it slows gastric emptying |
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Amylin agonist (Drug?, Define)
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Pramlintide (Symlin)
• MOA: Slows gastric emptying, suppresses post-prandial glucagon, decreases appetite |
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Amylin agonist-Specific info?
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• Type-1/Type-2 Diabetics
who use insulin at mealtime • Peptide (SC before meals) • NO weight gain • Nausea (28-48%) → titrate dose to avoid • Caution in patients with diabetic gastroparesis • Drug interactions because it slows gastric emptying → don’t co-administer anti-cholinergics, acarbose or Miglitol |
