Exogenous and Endogenous Insulin
Sulfonylureas 1st Gen (-amides), 2nd Gen (-ride): Increase insulin release
Chloropromide (Diabenese)
Tolbutamide
Glimeprimide (Amaryl)
Gilbenclamide (Daonil)
Glipizide (Glibenese, Glucotrol, Minodiab)
Meglitinides:
Repaglinide: (Prandin, Novonorm, Enyglid)
Nateglinide: (Starlix)
Depolarizes beta cell in pancreas by blocking Potassium channels on Beta cell.
Causes Calcium influx
A/E: Hypoglycemia
Insulin (short acting, intermediate and long term)
GLP-1 analogues: released by L-cells in intestine to release insulin from pancreas
DPP-4 inhibitors: prevents DPP-4 from deactivating GLP-1
Signs of hypoglycemia:
Autonomic hyperactivity: Sypmathetic: tachycardia, sweating, palpatations and nausea.
Er sympathetic: nausea and hunger, can lead to convulsions and coma.
Biguanide: Metformin (Fortamet and Glumetza)- increases insulin sensitivity
Inhibits mitochondrial enzyme to stop hepatic gluconeogenesis. It increases glycolysis and peripheral glucose uptake
A/E: Lactic acidosis, renal insufficiency, weight loss, vitamin B12 deficiency
Thiazolidinediones: -glits - increases insulin sensitivity and adiponectin levels
SGLT-2 inhibitors: -glifs- blocks reabsorption of glucose in PCT
Alpha glucosidase inhibitors - inhibits intestinal alpha glucosidase to stop glucose reabsorption
Amylin analogue - decreases glucagon release and gastric emptying
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