Diabetes Drugs Flashcards by David Goldrich

NPH (Neutral Protamin Hagedorn, Isophane) Insulin

Intermediate acting insulin

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Rapid Acting Insulins (3)

Insulin Lispro
Insulin Aspart
Insulin Glulisine

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Long acting Insulins (3)

Glargine
Detemir
Degludec

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Inhalable Insulin (1)

Afrezza

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Indications for insulin (diseases to use for)

ß-cell failure: type I DM, pancreatitis, post-pancreatectomy
type II DM after other meds fail
Gestational DM
Unstable diabetes- DKA, non-ketotic coma, hyperglycemia

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Insulin side effects & drug interactions (3)

Hypoglycemia
para/sympathetic activity (GI, tachycardia, sweating, trembling, confusion, coma, convulsions)
Weight gain
Insulin allergy (rare)

Drugs:

glucocorticoids
oral contraceptives
ß agonists/antagonists

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10 diabetes med classes

1) Insulin secretagogues (
- sulfonylureas: glyburide, glipizide, glimepiride
- meglitinides (repaglinide, netaglinide)

2) Biguanides (metformin)
3) GLP-1 agonists (exenatide, liraglutide, lixisenatide, dulaglutide, albiglutide)
4) DPP-4 Inhibitors (sitagliptin, saxagliptin, linagliptin, alogliptin)
5) SGLT2 Inhibitors (Canagliflozin, dapagliflozin, empagliflozin)
6) Amylin agonists (pramlintide)
7) Thiazolidinediones (pioglitazone, rosiglitazone)
8) å-glucosidase inhibitors (acarbose, miglitol)
9) Bile Acid Binding Resins (Colesevelam)
10) Dopamine Receptor agonists (Bromocriptine)

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Metformin (class, mechanism, use, side effects)

Class: Biguanide
Mechanism: decrease hepatic glucose output- anti-hyperglycemic but not hypoglycemic
Use: first line t2 DM
Side effects: GI disturbance, decreased B12 absorption

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Sulfonylureas (drugs, mechanism, use, side effects, drug interactions)

Mechanism: block K+ channel to cause ß-cell depolarization and insulin release
Drugs: glyburide, glipizide, glimepiride (gl-)
Use: T2 DM (need functional ß-cells)
Side effects: weight gain, hypoglycemia
Drug interactions: CYP3A4 inducers (barbiturates, rifampin) and glucocorticoids, oral contraceptives, thiazides, phenytoin, ß-agonists

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Glyburide (class, mechanism, use, side effects, drug interactions)

Class: Sulfonylurea (insulin secretagogue)
Mechanism: block K+ channel to cause ß-cell depolarization and insulin release
Use: T2 DM (need functional ß-cells)
Side effects: weight gain, hypoglycemia
Drug interactions: CYP3A4 inducers (barbiturates, rifampin) and glucocorticoids, oral contraceptives, thiazides, phenytoin, ß-agonists

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Glipizide (class, mechanism, use, side effects, drug interactions)

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Glimepiride (class, mechanism, use, side effects, drug interactions)

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Meglitinides (class, drugs, mechanism, side effects)

Class: insulin secretagogue
Mechanism: block K+ channel to cause ß-cell depolarization and insulin release (same as sulfonylureas but unrelated structure)
Drugs: repaglinide, nateglinide (-glinide)
Use: reduce postprandial hyperglycemia, take with meals
Side effects: weight gain, hypoglycemia

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Nateglinide (class, mechanism, use, side effects, drug interactions)

Class: insulin secretagogue (meglitinides)
Mechanism: block K+ channel to cause ß-cell depolarization and insulin release (same as sulfonylureas but unrelated structure)
Use: reduce postprandial hyperglycemia, take with meals
Side effects: weight gain, hypoglycemia
Drug interactions:

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Repaglinide (class, mechanism, use, side effects, drug interactions)

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SGL2 Inhibitors (Drugs, mechanism, uses, side effects)

Drugs: canagliflozin, dapagliflozin, empagliflozin (-gliflozins)
Mechanism: inhibit kidney SGLT2, reducing glucose reabsorption, so excrete glucose in urine
Use: t2DM, not in ppl with renal impairment
Side effects: increase DKA risk, yeast infection, UTI, orthostatic HTN (due to osmotic diuresis–>HTN) and dizziness/fainting

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Canagliflozin (Class, mechanism, uses, side effects)

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Class: SGLT-2 Inhibitors
Mechanism: inhibit kidney SGLT2, reducing glucose reabsorption, so excrete glucose in urine
Use: t2DM, not in ppl with renal impairment
Side effects: increase DKA risk, yeast infection, UTI, orthostatic HTN (due to osmotic diuresis–>HTN) and dizziness/fainting

Dapagliflozin (Class, mechanism, uses, side effects)

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Dapagliflozin (Class, mechanism, uses, side effects)

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GLP-1 Agonists (Drugs, mechanism, use, side effects)

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Drugs: Exenatide, liraglutide, lixisenatide, dulaglutide, albiglutide (-natides and -glutides)
Mechanism: incretin released after meals that stimulates insulin secretion, inhibits appetite and glucagon
Use: t2DM
Side effects: GI

Exenatide (Class, mechanism, use, side effects)

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Class: GLP-1 Agonist
Mechanism: incretin released after meals that stimulates insulin secretion, inhibits appetite and glucagon
Use: t2DM
Side effects: GI

Liraglutide (Class, mechanism, use, side effects)

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Class: GLP-1 Agonist
Mechanism: incretin released after meals that stimulates insulin secretion, inhibits appetite and glucagon
Use: t2DM
Side effects: GI

Lixisenatide (Class, mechanism, use, side effects)

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Class: GLP-1 Agonist
Mechanism: incretin released after meals that stimulates insulin secretion, inhibits appetite and glucagon
Use: t2DM
Side effects: GI

Dulaglutide (Class, mechanism, use, side effects)

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Class: GLP-1 Agonist
Mechanism: incretin released after meals that stimulates insulin secretion, inhibits appetite and glucagon
Use: t2DM
Side effects: GI

Albiglutide (Class, mechanism, use, side effects)

Class: GLP-1 Agonist Mechanism: incretin released after meals that stimulates insulin secretion, inhibits appetite and glucagon Use: t2DM Side effects: GI

DPP-4 Inhibitors (drugs, mechanism, use, drug interaction)

Drugs: sitagliptin, saxagliptin, linagliptin, alogliptin (-gliptins) Mechanism: inhibit DPP-4, increasing GLP-1, increasing insulin secretion, decreases glucagon and appetite Use: t2DM Drug interaction: CYP3A4

Sitagliptin (Class, mechanism, use, drug interaction)

Class: DPP-4 inhibitor Mechanism: inhibit DPP-4, increasing GLP-1, increasing insulin secretion, decreases glucagon and appetite Use: t2DM Drug interaction: CYP3A4

Saxagliptin (Class, mechanism, use, drug interaction)

Class: DPP-4 inhibitor Mechanism: inhibit DPP-4, increasing GLP-1, increasing insulin secretion, decreases glucagon and appetite Use: t2DM Drug interaction: CYP3A4

Linagliptin (Class, mechanism, use, drug interaction)

Class: DPP-4 inhibitor Mechanism: inhibit DPP-4, increasing GLP-1, increasing insulin secretion, decreases glucagon and appetite Use: t2DM Drug interaction: CYP3A4

Alogliptin (Class, mechanism, use, drug interaction)

Class: DPP-4 inhibitor Mechanism: inhibit DPP-4, increasing GLP-1, increasing insulin secretion, decreases glucagon and appetite Use: t2DM Drug interaction: CYP3A4

Thiazolidinediones (drugs, mechanism, use, side effects, drug interactions)

Drugs: pioglitazone, rosiglitazone (-glitazones) Mechanism: causes redistribution of fat from abdominal/skeletal muscle/liver, reducing insulin resistance and hepatic gluconeogenesis Use: t2DM Side effects: weight gain, anemia, cholesterol/triglycerides, liver damage Drug interactions: CYP3A4, oral contraceptives

Pioglitazone (class, mechanism, use, side effects, drug interactions)

Class: thiazolidinediones Mechanism: causes redistribution of fat from abdominal/skeletal muscle/liver, reducing insulin resistance and hepatic gluconeogenesis Use: t2DM Side effects: weight gain, anemia, cholesterol/triglycerides, liver damage Drug interactions: CYP3A4, oral contraceptives

Rosiglitazone (class, mechanism, use, side effects, drug interactions)

Å-glucosidase inhibitors (Drugs, mechanism, use, side effects)

Drugs: acarbose, miglitol Mechanism: competitive inhibitors of intestinal å-glucosidase, which digest starches/dissacharides-->monosaccharides, thus decreasing postprandial glucose rise. Use: Side effects: GI (GAS, diarrhea, abdominal pain), dont use if GI disease

Acarbose (Class, mechanism, use, side effects)

Class: Å-glucosidase inhibitors Mechanism: competitive inhibitors of intestinal å-glucosidase, which digest starches/dissacharides-->monosaccharides, thus decreasing postprandial glucose rise. Use: Side effects: GI (GAS, diarrhea, abdominal pain), dont use if GI disease

Miglitol (Class, mechanism, use, side effects)

Amyline agonists (Drugs, mechanism, use, side effects, drug interactions)

Drugs: Pramlintide Mechanism: Amylin agonists slows gastric emptying/increase satiety/suppress postrandial glucagon Use: t1/2DM second line drug Side effects: nausea, hypoglycemia. Drug interactions: anything affecting GI motility

Pramlintide (Class, mechanism, use, side effects, drug interactions)

Class: Amylin agonist Mechanism: Amylin agonists slows gastric emptying/increase satiety/suppress postrandial glucagon Use: t1/2DM second line drug Side effects: nausea, hypoglycemia. Drug interactions: anything affecting GI motility

Bile Acid Resins (drugs, mechanism, use, side effects, drug interactions)

Drugs: Colesevelam Mechanism: hypercholesterolemia drug repurposed, unclear Use: Side effects: GI, increase triglycerides Drug interaction: interferes with some drug absorptions

Colesevelam (Class, mechanism, use, side effects, drug interactions)

Class: bile acid binding resin Mechanism: hypercholesterolemia drug repurposed, unclear Use: Side effects: GI, increase triglycerides Drug interaction: interferes with some drug absorptions

Dopamine Receptor agonist (Drug, mechanism, use, side effects)

Drug: bromocriptine Mechanism: Used for parkinsons and hyperprolactinemia, dopamine agonist

Diabetes Drugs Flashcards

(41 cards)