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Flashcards in Diabetes Medications (non-insulin) Deck (16)
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1

Biguanides

Metformin
750 mg to 2g daily
divided into 2-3 doses

2

Sulfonyureas

Glimipiride (Amaryl)
Glyburide (Diabeta, Micronase)
Glipizide (Glucotrol; Glucotrol XL)
Micronized Glyburide (Glynase)

3

GLP-1 agonists

Exenatide (Bydureon, Byetta) 5 mcg BID (up to 10 mcg BID)
Liraglutide (Victoza) 0.6 mg QD for 1 week then increase to 1.2mg QD; may go to 1.8 mg QD
Dulaglutide (Trulicity) 0.75 mg once weekly; increase to 1.5 once weekly

4

SGLT-2 inhibitors

Canagliflozin (Invokana) (Not in pt w/ CVD) 100 mg QD
Empagliflozin (Jardiance) 10mg QD
Dapagliflozin (Farxiga) 5 mg QD

5

DPP-4 inhibitors

Sitagliptin (Januvia)
Saxaglipton (Onglyza)
Linagliptin (Tradjenta)

6

Thiazolidinediones (TZDs)

Pioglitazone (Actos)
Rosiglitazone (Avandia)

7

Meglitinides

Repaglinide (Prandin)
Nateglinide (Starlix) [derivative]

8

Alpha-glucosidase inhibitors

Acarbose (Precose)
Miglitol (Glyset)

9

Mechanism of Action? Biguanides

Works on:
Intestine - increases anaerobic glucose metabolism
Liver - decreases gluconeogenesis, glycogenolysis, & fatty acid oxidation
Skeletal muscle - increase insulin-mediated glucose updake, increase glycogenesis, decrease fatty acid oxidation

10

Mechanism of Action? Sulfonyureas

Stimulate insulin secretion from pancreatic beta-cell plasma membrane and decrease in hepatic clearance of insulin; blocking the inflow of K+ through the ATP-dependent channel

11

Mechanism of Action? GLP-1 agonists

Slow glucose absorption from the gut; increase insulin secretion from the pancreas; slows gastric emptying

12

Mechanism of Action? SGLT-2 inhibitors

Prevent reabsorption of glucose in proximal renal tubule and facilitate excretion in urine

13

Mechanism of Action? DPP-4 inhibitors

Increase incretin levels (GLP-1 and GIP) which inhibit glucagon release, increasing insulin secretion, decreasing gastric emptying

14

Mechanism of Action? Thiazolidinediones (TZDs)

Bind to peroxisome proliferator-activated receptor gamma in adipocytes to promote adiposenesis and fatty acid uptake (in peripheral fat)

15

Mechanism of Action? Meglitinides

Non-sulfonylurea secretagogue that binds ATP-dependent K+ channel on the cell membrane of pancreatic beta cells

16

Mechanism of Action? Alpha-glucosidase inhibitors

blocks pancreatic alpha-amylase and inhibits membrane-bound alpha-glucosidase; reduces ate of digestion of carbohydrates