Pharm 3.11 Diabetes
Terms
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- NPH insulin (Isophane)
- Synthetic insulin analog; takes 1-2 hours for onset, peaks in 8-12 hours
- Metformin
- For treatment of type II diabetes; Inhibits gluconeogenesis in the liver; reduces both fasting and postprandial hyperglycemia in type II diabetics; can cause lactic acidosis
- Pioglitazone, Rosiglitazone
- Decreases insulin resistance, enhancing insulin activity in liver, muscle, and fat cells; activates PPARγ, which activates insulin-responsive genes; thus decreasing gluconeogenesis in the liver (2)
- Insulin zinc extended
- Synthetic insulin analog; takes 3-4 hours for onset, peaks at 8-14 hours, lasts 36 hours
- Inhaled insulin (Exubera)
- Insulin form that does not require needles to administer
- Lispro insulin (Humalog)
- Synthetic insulin analog, differs from human insulin in having lysine and proline at positions 28 and 29; absorbed more rapidly than regular insulin following injection; can be taken right before meals
- Glipizide, Glyburide
- Second generation sulfonylureas (2); 200x more potent
- Insulin glargine
- Ultra-long acting, new synthetic insulin; differs from human insulin by 3 amino acids; provides a relatively constant concentration over 24 hours
- Sitagliptin phosphate
- Orally active inhibitor of the enzyme DPP-4, which breaks down endogenous glucagon-like peptide-1 (GLP-1)
- Tolbutamide
- Sulfonylurea, inhibits K+ efflux in pancreatic β-cells, causing influx of Ca2+ and release of insulin; half life of 6 hours
- Acarbose
- For treatment of type II diabetes; Alpha-glucosidase inhibitor that slows breakdown of carbohydrates in the intestine
- Captopril
- ACE inhibitor, reduces the rate of kidney failure by 50% in type I diabetes
- Repaglinide
- Oral hypoglycemic; not a sulfonylurea, but similar mechanism of action