Term
|
Definition
Binds to insulin receptor (tyrosine kinase)
Causes increased glucose stored as glycogen, fat stored as Triglyceride, increase protein synthesis
Used mainly for T1DM, sometimes T2DM
Toxicities:
Mainly Hypoglycemia
Lipodystrophy
Weight Gain |
|
|
Term
|
Definition
Second Generation:
Glyburide
Glimepiride
Glipizide
Causes blockage of K+ channel --> depolarizes cell membrane --> allows Ca to enter cells to release insulin from vesicles
Typically used first in early T2DM because pts still have functioning B-pancreatic cells
1st generations cause disulfiram effects |
|
|
Term
|
Definition
Metformin
MOA unknown, but it decreases GLUCONEOGENESIS. Insulin sensitizer
Can be combined with all other DM drugs. SAFE for pregnancy
Must Monitor:
LACTIC ACIDOSIS (because no gluconeogenesis)
Contraindicated in RENAL FAILURE Patients (check their serum [Cr]) |
|
|
Term
|
Definition
Pioglitazone
Rosiglitazone
Increases Insulin sensitivity by acting on the PPAR-Gamma genes(Peroxisome Proliforater Acivated Receptor Gamma)
Toxicities:
Hepatotoxicity, Weight Gain, Edema (worsens CHF) |
|
|
Term
| Alpha-Glucosidase inhibitors |
|
Definition
Acarbose
Miglitol
Inhibits intestinal brush-border enzymes (alpha glucosidases). Used to delay glucose absorption in gut and decrease post-prandial hyperglycemia
Adverse effects:
GI Upset - Diarrhea, flatulence and bloating (undigested sugar molecules) |
|
|
Term
|
Definition
Pramlintide
An amylin analog (cosecreted molecule of insulin), causes decreases glucagon
Hypoglycemia, nausea, vomiting |
|
|
Term
Glucagon Like Protein -1
Mimetics |
|
Definition
Exenidate
As a glucagon like protein, causes increases insulin (because glucose normally stimulates insulin release for homeostasis)
Adverse Reactions:
Nausea, vomiting, pancreatitis |
|
|
Term
| About Insulin and its effect on tissues... |
|
Definition
Endogenously cosecreted with C-Protein and Amylin polypeptide
Exogenously no C-Protein present...
Anabolic effects: Increase glucose transport, glycogen synthesis, protein synthesis, TG synthesis, cellular uptake of K+
Stimulates GLUT4 receptors to increase in numbers (found in SKELETAL muscle and ADIPOCYTES) |
|
|
Term
| Quick, intermediate, and long acting insulin |
|
Definition
Quick:
Insulin
Lispro
Aspart
Medium:
NPH
Long:
Glargine
Detemir |
|
|
