NURS 165 Study Guide - Final Guide: Exenatide, Hypotension, Ppar Agonist
Insulin Drugs
Drug
Class
MOA
Indication
Other
Side Effects
Other
Insulin
injectable
initiates glucose uptake
into cells
DM1, DM2, acute
hyperglycemia
hypoglycemia,
lipodystrophy
interacts with Etoh, oral
hypoglycemic agents,
Beta blockers
Pramlintide
amylin mimetics
(injectable)
analog of human amylin:
slows gastric emptying,
suppresses post-meal
glucagon release, increase
satiety
DM1 & insulin-
using-DM2
used with
insulin
nausea, headache,
hypoglycemia
caution gastroparesis,
hypoglycemia
unawareness
Glipizide
Sulfonylurea
promotes pancreatic
insulin release
DM2
long duration,
avoid in elderly
and renal
disease
hypoglycemia, weight
gain, hepatotoxicity, rash
avoid preg/lactation
interacts Etoh, Beta
blockers
Repaglinide
Meglitinide
promotes pancreatic
insulin release
DM2
rapid acting
hypoglycemia, weight
gain
Metformin
Biguanide
liver glucogenesis
peripheral glucose
uptake, improves insulin
sensitivity
(dec. liver glucose
production, inc. tissue
response to insulin)
DM2 (first line of
therapy),
polycystic ovary
syndrome
(prevents DM2 and
treats POS)
w/ calorie
restriction and
exercise
ANVD, lactic acidosis
avoid hepatic/renal
dysfunction
interacts Etoh,
sulfonylureas, vitB12,
folic acid (supplements)
Acarbose
alpha-
glucosidase
inhibitor
carbohydrate
absorption at GI tract by
inhibiting the breakdown
of glucose into absorbable
form
DM2
take right before
meals
abdominal distension,
cramps, flatulence,
diarrhea
caution bowel obstr.
interacts metformin, Fe
supp.
Rosiglitazone
thiazolidinedione
PPAR agonist, reduces
insulin resistance
DM2
takes weeks for
full effect
fluid retention, edema,
anemia, inc. LDL-C, risk
for CV events
caution HF, hepatic
dysfunction
interacts insulin
Sitagliptin
DPP-4 inhibitor
incretin hormones inc.
insulin synthesis and
release->DPP-4 enzyme
inactivates incretins-
>drug inhibits DPP-4, inc.
action of incretins->
inc. insulin, dec. glucagon
DM2
(can be used with
metformin or TZD)
NO
hypoglycemia
headache,
nasopharyngitis, URI,
hemorrhagic pancreatitis
Caution renal failure
(dec. dose), digoxin use
Canagliflozin
SGLT2-inhibitor
Na-glucose co-
transporters-2 (SGLT2)
DM2
oral agent
CV events (inc. LDL), UTI,
inc. urination,
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Document Summary
Dm1 & insulin- using-dm2 used with insulin nausea, headache, hypoglycemia. Acarbose alpha- glucosidase inhibitor analog of human amylin: slows gastric emptying, suppresses post-meal glucagon release, increase satiety promotes pancreatic insulin release promotes pancreatic insulin release. Peripheral glucose uptake, improves insulin sensitivity (dec. liver glucose production, inc. tissue response to insulin) Carbohydrate absorption at gi tract by inhibiting the breakdown of glucose into absorbable form. Dm2 insulin resistance incretin hormones inc. insulin synthesis and release->dpp-4 enzyme inactivates incretins- >drug inhibits dpp-4, inc. action of incretins-> inc. insulin, dec. glucagon. Dm2 (first line of therapy), polycystic ovary syndrome (prevents dm2 and treats pos) Dm2 long duration, avoid in elderly and renal disease rapid acting w/ calorie restriction and exercise hypoglycemia, weight gain, hepatotoxicity, rash avoid preg/lactation interacts etoh, beta blockers hypoglycemia, weight gain. Dm2 (can be used with metformin or tzd) Incretin mimetics (injectable) inhibitor in the kidney incretin-mimetic, inc. glucose-dependent insulin secretion, slows gastric emptying.
