Hypoglycemic drugs + dopamine agonist Flashcards
Hypoglycemic drugs (2 groups)
Sulfonylurea drugs
Meglitinide drugs
2nd generation sulfonylureas (3 drugs)
Glimepiride
Glipizide
Glyburide
Sulfonylurea drugs - MOA
1) Inh ATP-sensitive potassium channels, activation of pulsatile insulin secretion. No effect on basal insulin secretion.
2) Decreasing glucagon secretion by ⇑ insulin and pancreatic somatostatin secretion.
3) Increase insulin sensitivity in DM2
Can sulfonylurea drugs be combined with metformin?
Yeah
Sulfonylurea drugs - adverse effects
Weight gain
Hypoglycemia
Cholestasis
Hematologic reactions
The effectiveness of sulfonylurea drugs is decreased by (5 drugs)
Thiazide diuretics Corticosteroids Estrogens Thyroid hormones Phenytoin
The hypoglycemic effect of sulfonylurea drugs is increased by (5 drugs)
ACE-inhibitors Sulfonamides Salicylates + other NSAIDs Gemfibrozil Alcohol
What should be avoided in sulfonylurea treatment?
High alcohol consumption - disulfiram-like reaction
Meglitinide drugs (2 drugs)
Repaglinide
Nateglinide
Meglitinide drugs- MOA
Inh ATP-sensitive potassium channels, preventing K+-efflux and causing Ca2+-influx and activation of pulsatile insulin secretion. No effect on basal insulin secretion.
Meglitinides - indications
Postprandial glycemia
DM2 (1st line)
Can meglitinides be used with metformin?
Yaas
Meglitinides should not be used with
Other oral antidiabetic drugs or insulin. (metformin is ok)
First-line drugs for DM2 (4 drugs/groups)
Metformin
Incretin mimetics
Sulfonylureas
Meglitinides
Dopamine agonist that is studied for its effect in DM
Bromocriptine
