Miscellaneous / Anti-glycemic Agents

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Can you name the Anti-glycemic Agents?

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

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