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5 Cards in this Set
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Insulin secretion enhancers |
1.sufonylurease--glibenclamide,glizipid ,glimepirid;binds to suphonylurea rec. of b cells---insulin release.Has a long lasting action,decresed serum glucagon.Good oral absorption,strong PPB,interaction w/ sulfonamide due to similar structure,excreted by the kidney & acn get into the placenta & milk. Use:early stage of 2DM. SE:hypoglycemia,increasing appetite,GIT disturbance,allergy bone marrow depression 2.Acts as sulfonylurease--repaglinide, nateglinide;non sulfonylurease,but they bind to its rec. and has similar mode of action.Used immediately before meal,to inhibit increase of glucose level. 3.dipeptidyl peptidase-4 inhibitors: vildagliptin,sitagliptin;inhibit dgredation of incretin which stimulates insulin secretion,decrease the HbA1C level,has no effect on body weight. 4.GLP agnists:exenatide;glucagon like peptide,decreases HbA1C level & decrease bodyweight.given s.c |
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Biguanides |
Metformin,butformin:inhibits glucose absorption from GIT,increase insulin sensitivity in skeletal muscle cells to increase uptake,they dont cause hypoglycemia. Use:2DM of fat ppl,doesnt increase appetite. SE:lactic acidosis due to glucose absorption inhibition,hypoxic pulmonary disease,heart failure |
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Thiazolidinedions(glitazone) |
Pioglitazone,rosiglitazone:insulin senstizer,binds to PPAR-y for dimerization w/ RXR--increase GLUT4. It had a acandal due to its CV risk. Use: im metabolic X syndrome |
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a-glucosidase inhibitors |
Acarbose,miglitol:inhibits carbohydrate absorption in GIT,may cause cramp.Reduces postprandial plasma glucose enhancement. SE:abdominal pain due to carbohydrate absorption inhibition. Contraindication:IBD,Kidney failure |
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SLGT-2 inhibitors (sodium glucose transporter) |
Canagliflozin,dapagliflozin:SLGT-2 is a cotransporter found in proximal tubule--responsible for glucose absorption.Inhibiting it blocks glucose absorption. SE:rapid weight loss & tiredness,dehydration (glucose acts as osmotic diuresis) |
