Exam 7 Antidiabetic Drugs

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growth hormone / Afrezza
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growth hormone / Afrezza
Insulin is a ________ that decreases blood glucose levels. It is available as an injectable and inhalant (___________-)
Insulin Lispro, Insulin Aspart, Insulin Glulisine, Afrezza
What are the rapid acting insulins?
Regular Insulin
What are the short acting insulins?
NPH
What are the intermediate Acting insulins?
Insulin Glargine, Insulin Detemir, Insulin Degludec
What are the long acting insulins?
Binds to its receptor (tyrosine kinase) intracellular and extracellular (ligand binding domain) / Once it binds it activates IRS 1 and IRS2 by phosphorylation / then it activates MAPK
What is the MOA of insulin?
liver, adipose, and muscle
Insulin works in the ____________
inhibit the binding of insulin to the receptor which can cause hyperglycemia
How do steroids effect insulin?
Tolbutamide (first gen.) / Glyburide (second gen.) - Glyburide is preferred
What are the Sulfonylureas?
hypoglycemia and weight gain
All sulfonylureas cause ___________ and ___________
Target K+ channels in pancreatic B-Cells - they bind to the channel and close them which allows influx of calcium and depolarization = release of insulin / They also decrease plasma levels of glucagon by increasing release of somatostatin from D cells (inhibits release of glucagon)What is the MOA of the Sulfonylureas?type 2 diabetes / insulinMetformin is first line for ________ / and it is an ____________ sparing agentMetforminWhat drug is the Biguanides?1. activates AMP = increase glucose uptake 2. Direct stimulant of glycolysis in tissues 3. Inhibits hepatic and renal gluconeogenesis 4. slows glucose absorption from GI tract 5. reduce plasma glucagon levelsWhat is the MOA of the Biguanides?Pioglitazone and RosiglitazoneWhat drugs are the Thiazolidinediones?Decrease insulin resistance by binding to the PPAR gamma receptor and activating it which modulates the expression of genes (can also decrease triglyceride levels) (pioglitazone is better for binding to PPAR)What is the MOA of Thiazolidinediones?Pramlintide (inject SubQ) (insulin sparing like metfomrin)What drugs are the amylinomimetic agents?Bind to amylin receptor and activate it = slowed gastric emptying / increased satiety (full) / decreased glucose production in liverWhat is the MOA of amylinomimetic agents?Exenatide (SubQ)What drugs are the GLP-1 Receptor Agonists?acts like GLP-1 hormone and Binds to the GLP-1 receptor and activate it = stimulate insulin secretion and inhibit glucagon secretion (hypoglycemic factor)What is the MOA of the GLP-1 agonists?Sitagliptan (Januvia)What drug is the DPP-4 inhibitors?DPP-4 is what degrades GLP-1 / so they bind to and inhibit DPP-4 = more reduction in plasma levels of glucoseWhat is the MOA of the DPP-4 inhibitors?canagliflozinWhat are the SGLT-2 inhibitors?Inhibit SGLT-2 in the kidneys which = inhibition of glucose and Na+ (diuretic effect that can cause glucosuria)What is the MOA of the SGLT-2 inhibitors?SGLT-2 and SGLT-1 / kidneys and intestinesLow doses of SGLT-2 inhibitors are selective for SGLT-2_, and high doses lose selectivity and bind to ______________ which inhibits reabsorption in _______________