36. Treatment of DM with oral preps Flashcards
(24 cards)
What is the primary goal of managing Type 2 diabetes?
To control blood glucose levels using oral medications.
What are the classes of oral medications for diabetes management?
- Biguanides 2. Sulfonylureas 3. Meglitinides 4. Thiazolidinediones (TZDs) 5. Dipeptidyl Peptidase-4 (DPP-4) Inhibitors 6. Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors.
What is the mechanism of Biguanides?
Decreases hepatic glucose production and increases insulin sensitivity in peripheral tissues.
What are the benefits of Biguanides?
Effective, weight neutral, and low risk of hypoglycemia.
What are the side effects of Biguanides?
Gastrointestinal upset (nausea, diarrhea), risk of lactic acidosis in renal impairment.
What is the mechanism of Sulfonylureas?
Stimulate pancreatic beta cells to increase insulin secretion.
What are the benefits of Sulfonylureas?
Effective at lowering blood glucose.
What are the side effects of Sulfonylureas?
Risk of hypoglycemia, weight gain.
What is the mechanism of Meglitinides?
Stimulate rapid, short-acting insulin secretion from the pancreas.
What are the benefits of Meglitinides?
Flexibility in dosing around meals, less risk of prolonged hypoglycemia compared to sulfonylureas.
What are the side effects of Meglitinides?
Risk of hypoglycemia, weight gain.
What is the mechanism of Thiazolidinediones (TZDs)?
Improve insulin sensitivity in muscle and adipose tissue by activating PPAR-γ receptors.
What are the benefits of Thiazolidinediones (TZDs)?
Durable glucose-lowering effect, potential cardiovascular benefits with pioglitazone.
What are the side effects of Thiazolidinediones (TZDs)?
Weight gain, fluid retention, risk of heart failure exacerbation, potential increased risk of fractures.
What is the mechanism of Dipeptidyl Peptidase-4 (DPP-4) Inhibitors?
Increase incretin levels (GLP-1 and GIP), which inhibit glucagon release and increase insulin secretion.
What are the benefits of Dipeptidyl Peptidase-4 (DPP-4) Inhibitors?
Well-tolerated, weight neutral, low risk of hypoglycemia.
What are the side effects of Dipeptidyl Peptidase-4 (DPP-4) Inhibitors?
Rarely, can cause pancreatitis, joint pain.
What is the mechanism of Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors?
Increase urinary glucose excretion by inhibiting glucose reabsorption in the renal proximal tubules.
What are the benefits of Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors?
Weight loss, blood pressure reduction, cardiovascular and renal protective effects.
What are the side effects of Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors?
Increased risk of urinary tract and genital infections, dehydration, ketoacidosis in rare cases.
What is combination therapy in diabetes management?
Combining drugs from different classes can provide complementary mechanisms of action.
What are common combinations in diabetes treatment?
Metformin with sulfonylureas, SGLT2 inhibitors, DPP-4 inhibitors.
What is triple therapy in diabetes management?
Adding a third oral antidiabetic drug or nightly basal insulin.
What is combination injectable therapy in diabetes management?
Combining metformin, basal insulin, and mealtime insulin.
