Mechanisms of Action Flashcards
Learn how the things do the thing. (30 cards)
SGLT2i
-flozin
Inhibits SGLT2 transporter in the kidneys, promoting glucose excretion.
Side effects- Weight loss, UTIs, Yeast infection
Low risk for hypoglycemia
GLP 1 agonist
-tide
-Stimulates insulin synthesis/ release in the presence of glucose
-Decreases glucagon secretion
-Slows gastric emptying
-Promotes Satiety and weight loss
Side effects- weight loss, nausea, vomiting
Low risk of hypoglycemia
Biguanide
Activates cAMP kinase
-Increases glucose uptake in peripheral tissues
-Decreases hepatic glucose production
-Decreases intestinal absorption of glucose
Side effects- B12 deficiency, D/C if GFR is low, weight neutral
No hypoglycemic risk
Sulfonylureas
Stimulates insulin release from Beta cells by binding to sulfonylurea receptors on ATP sensitive K+ channels
Side effects- Hypoglycemia and Weight gain
Metaglitinides
Stimulates insulin release from beta cells by binding to SUR ATP sensitive K+ Channels. Has a shorter duration and half life than sulfonylureas.
Side effects- Weight gain and Hypoglycemia
Good option for patients with renal impairment
DPP 4 Inhibitors
-gliptin
-Prevents the degradation of incretin hormones (GLP-1 and GIP)
-Stimulates the release/ Synthesis of insulin in the presence of glucose
-Inhibits glucagon secretion
Side effects- Weight neutral well tolerated overall
Low risk of hypoglycemia
Amylin Analog
-Decreases the secretion of glucagon
-Slows gastric emptying
-Increases satiety
Side effects- Weight loss, Nausea, Vomiting
Be careful if patient is already taking insulin!
Alpha Glucosidase Inhibitors
-Inhibits alpha glucosidase enzyme in GI tract to prevent the break down of complex carbs
-Delays the rise of blood glucose levels after meals
** Does not inhibit glucose absorption or insulin release**
Side effects- tolerated well, some GI upset
CI- IBS, GI, Kidney/ Liver disease
Thiazolidinediones (TZDs)
-azone
Selective agonist for PPARy, sensitizing tissues to insulin
-Stimulates adiponectin release
-Increasing glucose uptake via GLUT 4 transporter
-Decreases hepatic glucose production
Side effect- Fluid retention, weight gain, edema
CI- Chronic heart failure
Amylin Mimetics
-Slows gastric emptying
-Suppresses post prandial glucagon secretion
-Reduces food intake
Side effects- Weight loss, hypoglycemia, nausea
** do not use if pt has A1C >9%, or poor insulin adherence**
TNF alpha antagonist
Block the inflammatory effects of TNF alpha
Monitoring- Initial TB test, HBV/ HIV testing, CBC
Cons- Injection only, expensive, slow onset
Etanercept
Enbrel
Anti-TNF
Abatacept
Orencia
Anti-T cell
Anti-T cell
Blocks secondary signal for T cell activation
Rituximab
Rituxan
Anti-B cell antibody
Anti-B cell Antibody
mAb against CD20 on B cells.
Binding to CD20 activates CDCC and ADCC to kill B cells
Golimumab
Simponi
Anti-TNF
Anakinra
Kineret
IL-1 Receptor Antagonist
Tocilizumab
Actemra
IL-6 Receptor Antagonist
IL-6 Receptor Antagonist
Humanized mAB against IL-6 receptor blocking binding
Hydroxychloroquine
Plaquenil
Anti-inflammatory- agent inhibits immune cell trafficking, may decrease T cells and reduce immune response to self proteins.
Monitoring eye exam before starting therapy
Retinal toxicity (Retinopathy)
Sulfasalazine
Azulfidine
Anti-inflammatory agent
Prodrug cleaves into 5-ASA (active drug) which reduces inflamation
Monitoring
ADE- Yellow/ Orange skin, GI effects, Leukopenia, Anemia
Leflunomide
Arava Anti-inflammatory agent Prodrug inhibits DHODH and uridine synthesis. Limits T cell proliferation, ad B cell antibody production. Monitoring- LFTs, ALT, CBC ***make sure that pt is not pregnant***
Infliximab
Inflectra
Anti-TNF
half life 102hrs
