Anti-glycemic Agents

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Can you name the Anti-glycemic Agents?

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P-kinetics: Injected SQ BID
Duration: 18-20 hours
SE: No hypoglycemia
Metformin and glyburide combo
P-kinetics: Eliminated by renal filtration
Peak: 1 hour
Novolin R PenFill
Novolin R class
Rosiglitazone and metformin combo
Novolog class
MOA: GLP-1 agonist. Has all the properties of human GLP-1. 10 lb or greater wt loss in 1 yr
Use: First-line for most DM II, esp. obese.
Nolovin R PenFill
SE: Nausea, other GI effects, rare reports of pancreatitis
Lispro - Humalog (Lilly) class
SE: Increased plasma volume, edema, CHF, ovulation in PCO, mild anemia, rare liver toxicity, risk of fx in women. No hypoglycemia
Contraindications: Renal dz, liver dz, CHF, dehydration, shock, acidosis, alcoholism
Novolin 70/30 PenFill
Duration 18-24 hours (12-16 hours)
Metformin and pioglitazone combo
Humulin R (Lilly) class
Humulin 50/50
Novolog Mix 70/30 class
Glyburide (Micronase, Diabeta) class
P-kinetics: Rapid absorption, short duration.
Detemir - Levemir class
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.
Nololin N (NPH) (Lilly) class
Novolin N class
Apidra class
Onset 15-30 minutes
SE: Hypoglycemia, weight gain, GI effects.
MOA: Decreases hepatic glucose production, decreases peripheral insulin resistance, increases glucose uptake, decrease gluconeogenesis, decreases fatty liver,
HintAnswer
Novolin R (Novo Nordisk) class
Peak 6-8 hours
Glusine - Apidra (Avemtis) class
Humulin Br class
Onset 30 minutes - 1 hour
Miglitol class
Glimepiride (Amaryl) class
Duration ~14 hours
Duration 5-7 hours (6 - 8 hours)
Repalinide class
Use: DM II. Most effective in lean patients.
Use: Combines rapid-acting and intermediate-acting insulin. Controls blood sugar at mealtime and all day and night
Nololin 70/30
MOA: Decreases insulin resistance, increase muscle and adipose tissue glucose uptake, decreased hepatic glucose output.
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.
Pioglitazone (Actos) class
Exenatide class
Humalog 50/50 class
Metformin and glipizide combo
SE: Similar to sulfonureas but with less risk of prolonged hypoglycemia.
Pioglitazone and glimepiride combo
SE: GI effects, occasional low B12, rare lactic acidosis, ovulation in PCO
MOA: Binds to PPAR-gamma, a nuclear receptor regulating differentiation of cells (adipocytes, vascular tissue). Decreased plasma fatty acid levels, decreased central adiposity, res
Novolog Mix 70/30 class
Humalog Mix 75/25 class
Humulin L (Lente) (Lilly) class
Use: Onset and duration are rough within the range listed from person to person
Use: Human insulin is made by recombinant technology
NPH Iletin III (Lilly) class
Metformin class
Rosiglitazone and glimepiride combo
MOA: Lowers threshold for insulin release. Effective early; secondary failure common.
MOA: Lowers postprandial glucose rise by delaying CHO absorption. Decreases glucose absorption secondary to decreased digestion of carbohydrates.
HintAnswer
Humalog Mix 50/50 class
Humalog class
Onset 1-4 hours
Duration: 20-24 hours
Duration 3 - 4 hours (4-5 hours)
Humulin N class
Humulin N (NPH) (Lilly) class
Use: Controls blood sugar surges at mealtime
Humulin Ultralente class
Contraindications: Class III/IV CHF
Rosiglitazone (Avandia) class
Contraindications: Intestinal dz, cirrhosis, renal dz (creatinine > 2)
SE: GI effects, increased transaminases (monitor). No hypoglycemia
Glipizide (Glucotrol; Glucotrol XL) class
Humulin 70/30
Onset: 1-2 hours
Sitagliptin and metformin combo
Regular Ileting II (Lilly) class
Novolog Mix 70/30 PenFill class
Novolin 70/30 class
MOA: Similar to sulfonureas.
MOA: Effective in long-duration DM, weight loss, no hypoglycemia, lowers insuling, TG, LDL
Sitagliptin (Januvia) class
Acarbose class
Humalog 75/25 Mix 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.
Avapro - Novalog (Novo Nordisk) class
Nolvin N PenFill
Peak 2 - 5 hours
Glargine - Lantus class
P-kinetics: 100 mg once daily
Peak: None
Use: Controls blood sugar between meals and during sleep

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