Antidiabetic Agents

Front 1

Regular Insulin

Back 1

Class: Insulin Preparations
Use: A) used i.v. in emergencies, subQ for general maintenance
MOA: A) promotes glucose uptake into tissue (liver - GLUT 2, muscle - GLUT 4, fat - GLUT 4)
SFx: A) severe hypoglycemia B) immune rxn w/ formation of insulin antibodies C) local lipodystrophy D) weight gain
PK: A) soluble, injectable B) Rapid onset, short-acting

Front 2

Insulin Aspart

Back 2

Class: Insulin Preparations
Use: A) same as Regular Insulin, but faster acting
MOA: A) promotes glucose uptake into tissue (liver - GLUT 2, muscle - GLUT 4, fat - GLUT 4)
SFx: A) severe hypoglycemia B) immune rxn w/ formation of insulin antibodies C) local lipodystrophy D) weight gain

Front 3

NPH Insulin

Back 3

Class: Insulin Preparations
Use: A) subQ injection (not soluble...so can't be given i.v. for emergencies) B) may be supplemented w/ rapid/short-acting forms of insulin throughout day (to better meet periodic carb. intake w/ meals)
MOA: A) promotes glucose uptake into tissue (liver - GLUT 2, muscle - GLUT 4, fat - GLUT 4)
SFx: A) severe hypoglycemia B) immune rxn w/ formation of insulin antibodies C) local lipodystrophy D) weight gain
PK: A) given once in morning, once in evening = provides basal level for 24 hrs. B) Intermediate-acting

Front 4

Insulin Glargine

Back 4

Class: Insulin Preparations
Use: A) subQ injection (but not soluble, not given i.v.) B) may be supplemented w/ rapid/short-acting forms of insulin throughout day (to better meet periodic carb. intake w/ meals)
MOA: A) promotes glucose uptake into tissue (liver - GLUT 2, muscle - GLUT 4, fat - GLUT 4)
SFx: A) severe hypoglycemia B) immune rxn w/ formation of insulin antibodies C) local lipodystrophy D) weight gain
PK: A) slow-onset B) longest acting insulin analog C) possibly given 1x/day, provide basal level for 24 hrs

Front 5

Glyburide
Glipizide

Back 5

Class: Insulin Secretory Drugs
Use: A) Type I diabetics B) type II diabetics that no longer produce enough endogenous insulin
MOA: A) stimulate release of endogenous insulin (independent of blood glucose level)
SFx: A) hypoglycemia (overdose) B) weight gain C) sulfonamide-like drug allergy
PK: A) 2nd generation sulfonylurea (more potent than 1st gen.) B) oral

Front 6

Repaglinide
Nateglinide

Back 6

Class: Insulin Secretory Drugs
Use: A) Type I diabetics B) type II diabetics that no longer produce enough endogenous insulin
MOA: A) stimulate insulin release (in glucose conc.-dependent manner)
SFx: A) hypoglycemia (overdose) B) weight gain
PK: A) meglitinides B) oral

Front 7

Metformin

Back 7

Class: Insulin-Sensitizing
Use: A) Type II DM B) pts. w/ combined DM, HTN &/or hyperlipidemia (lowers blood pressure & serum lipids)
MOA: A) decreases hepatic glucose output B) improves sensitivity of peripheral tissues to insulin action on glucose uptake & storage
SFx: A) GI B) lactic acidosis C) no wt. gain (some lose wt.)
PK: A) requires good renal function B) oral

Front 8

Rosiglitazone
Pioglitazone

Back 8

Class: Insulin-Sensitizing
Use: A) type II diabetes ("correct" insulin resistance in certain tissue) B) decreases triglycerides & BP, increases HDL
MOA: A) activate PPAR gamma (receptors) ---> synthesis of glucose transport molecules in nucleus of insulin resistant tissues ---> increased uptake of glucose ---> decreased blood glucose
SFx: A) less hyperinsulinemia B) fluid retention/edema (not used in diabetics w/ CHF) C) potential liver injury D) weight gain
PK: A) oral

Front 9

Acarbose

Back 9

Class: a-Glucosidase Inhibitor
Use: A) type I & type II diabetics (smooth out postprandial glucose peaks)...adjunctive therapy
MOA: A) reversibly inhibit intestinal a-glucosidase enzymes (digest complex carbs. & disaccharides down to absorbable monosacch...i.e. glucose) B) so, delay postprandial absorption of glucose
SFx: A) GI B) don't use in pts w/ IBS, intestinal obstruction, absorption disorders C) concurrent use of insulin/insulin secretagogues may cause hypoglycemia...treated w/ glucose, not sucrose (breakdown to glucose blocked)
PK: A) oral

Front 10

Exenatide

Back 10

Class: Incretin Mimetics
Use: A) type II diabetics (adjunctive)
MOA: A) activates glucagon-like peptide-1 (GLP-1) receptors ---> enhances insulin secretion (in presence of high glucose) ---> inhibits glucagon secretion, slows gastric emptying, increases satiety
SFx: A) GI B) hypoglycemia (when combined w/ a sulfonylurea)
PK: A) subQ injections before meals

Front 11

Pramlintide

Back 11

Class: Amylin Analog
Use: A) type I & type II diabetics
MOA: A) slows gastric empyting, inhibits glucagon secretion, increases satiety
SFx: A) hypoglycemia (if combined w/ insulin) B) GI
PK: A) subQ injections before meals

Front 12

Sitagliptin

Back 12

Class: Depeptidyl Peptidase IV Inhibitor
Use: A) type II diabetics (adjunctive)...often have increased DPP-IV activity
MOA: A) inhibit DPP-IV enzyme that inactivates incretin hormones (released from intestine...increase insulin, decrease glucogon)
SFx: A) URI, pharyngitis, HA B) hypoglycemia (when combined w/ a sulfonylurea)
PK: A) oral