Anti-glycemic Agents

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Can you name the Anti-glycemic Agents?

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

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