Anti-glycemic Agents

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Can you name the Anti-glycemic Agents?

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Onset: 1-2 hours
SE: Increased plasma volume, edema, CHF, ovulation in PCO, mild anemia, rare liver toxicity, risk of fx in women. No hypoglycemia
Peak: 1 hour
MOA: Decreases insulin resistance, increase muscle and adipose tissue glucose uptake, decreased hepatic glucose output.
Apidra class
P-kinetics: Eliminated by renal filtration
Use: Combines rapid-acting and intermediate-acting insulin. Controls blood sugar at mealtime and all day and night
Novolin N class
Use: DM II. Most effective in lean patients.
SE: Similar to sulfonureas but with less risk of prolonged hypoglycemia.
Humulin Ultralente class
Metformin and glipizide combo
Humalog Mix 50/50 class
Humalog 50/50 class
Exenatide class
Duration 5-7 hours (6 - 8 hours)
MOA: Inhibit enzymatic degradation of incretin hormones. Unlike most PO meds for DM, does not promote wt gain, there may even be slight wt loss.
NPH Iletin III (Lilly) class
Novolog Mix 70/30 class
Repalinide class
MOA: Decreases hepatic glucose production, decreases peripheral insulin resistance, increases glucose uptake, decrease gluconeogenesis, decreases fatty liver,
Onset 1-4 hours
P-kinetics: Rapid absorption, short duration.
Novolog Mix 70/30 class
Humalog class
MOA: Binds to PPAR-gamma, a nuclear receptor regulating differentiation of cells (adipocytes, vascular tissue). Decreased plasma fatty acid levels, decreased central adiposity, res
Use: Controls blood sugar between meals and during sleep
Duration: 20-24 hours
Rosiglitazone and glimepiride combo
Metformin and glyburide combo
SE: GI effects, occasional low B12, rare lactic acidosis, ovulation in PCO
Glargine - Lantus class
Novolin 70/30 PenFill
Use: First-line for most DM II, esp. obese.
MOA: Lowers threshold for insulin release. Effective early; secondary failure common.
Humulin N (NPH) (Lilly) class
Regular Ileting II (Lilly) class
Glimepiride (Amaryl) class
Novolog class
Contraindications: Renal dz, liver dz, CHF, dehydration, shock, acidosis, alcoholism
Novolog Mix 70/30 PenFill class
Glusine - Apidra (Avemtis) class
Use: Controls blood sugar surges at mealtime
Duration: 18-20 hours
SE: Nausea, other GI effects, rare reports of pancreatitis
Humulin N class
Pioglitazone (Actos) class
Duration ~14 hours
Sitagliptin (Januvia) class
MOA: Similar to sulfonureas.
P-kinetics: 100 mg once daily
Glyburide (Micronase, Diabeta) class
Humalog Mix 75/25 class
Contraindications: Intestinal dz, cirrhosis, renal dz (creatinine > 2)
Nololin N (NPH) (Lilly) class
Rosiglitazone (Avandia) class
Nololin 70/30
Humulin 50/50
MOA: Lowers postprandial glucose rise by delaying CHO absorption. Decreases glucose absorption secondary to decreased digestion of carbohydrates.
SE: GI effects, increased transaminases (monitor). No hypoglycemia
Use: Onset and duration are rough within the range listed from person to person
Acarbose class
Novolin 70/30 class
Glipizide (Glucotrol; Glucotrol XL) class
MOA: Increases hepatic insulin sensitivity. Works through AMP dependent kinase, a mastor allosteric regulator of metabolism, that senses lack of energy substrates in cells.
Peak: None
Humulin Br class
Avapro - Novalog (Novo Nordisk) class
SE: Hypoglycemia, weight gain, GI effects.
Peak 2 - 5 hours
Peak 6-8 hours
Onset 30 minutes - 1 hour
MOA: GLP-1 agonist. Has all the properties of human GLP-1. 10 lb or greater wt loss in 1 yr
Use: Human insulin is made by recombinant technology
Detemir - Levemir class
Metformin class
Lispro - Humalog (Lilly) class
Duration 18-24 hours (12-16 hours)
Novolin R (Novo Nordisk) class
MOA: Effective in long-duration DM, weight loss, no hypoglycemia, lowers insuling, TG, LDL
Novolin R class
Miglitol class
Humalog 75/25 Mix class
Humulin 70/30
P-kinetics: Injected SQ BID
Onset 15-30 minutes
Nolvin N PenFill
Nolovin R PenFill
Sitagliptin and metformin combo
Pioglitazone and glimepiride combo
Duration 3 - 4 hours (4-5 hours)
Novolin R PenFill
Humulin L (Lente) (Lilly) class
Rosiglitazone and metformin combo
MOA: Bind to SU receptor on surface of beta cells, closing K+ATP channels -> to depolarization of cell membrane, allowing Ca++ to enter cell -> in insulin secretion.
SE: No hypoglycemia
Contraindications: Class III/IV CHF
Metformin and pioglitazone combo
Humulin R (Lilly) class

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Created Jan 16, 2012ReportNominate