Professional Documents
Culture Documents
Drug Class
Mechanism of action
Insulin lispro
Insulin aspart
Insulin glulisine
ShortActing Insulins
Bolus dosing
Regular insulin
NPH insulin
Insulin glargine
Interme
diate/LongActing Insulins
Insulin detimir
Glipizide
Glyburide
Glimepiride
Nateglinide
Repaglinide
ureas
ides
Sulfonyl
Meglitin
Biguani
Intermediate/long
acting insulin analogues
Basal dosing
Taken regularly
independent of food intake
Bind to the
sulfonylurea receptor
(SUR1), closing the ATPdependent potassium channel
Kir6.2
Increased insulin
secretion.
Expected decrease in
A1c 1 to 2%
Similar MOA as
sulfonylureas, but shorter
acting. (bolus)
Increases insulin
sensitivity, esp liver.
Pharmacokinetics
Duration 2-4 hr
Commonly used in
insulin pumps
Duration 2-4 hr
Onset in 30 min
Duration 2-4 hr
Used IV in hospital
2x day dosing
Onset in 2 hr
Duration 18-28 hr
Peak 6-10 hr
1x day dosing
Onset in 2 hr
Duration 20-24 hr
1 or 2x day dosing
Onset in 2 hr
Duration 6-24 hr
meal
Short acting.
Dosed orally with each
Adverse effects
Hypoglycemia
Local injection reactions
Weight gain
Contraindications
None
None
Hypoglycemia
Weight gain
Hypoglycemia (mild)
10
Endocrine
Learning
Objectives
Rosiglitazone
Pioglitazone
Thiazoli
dinediones
TZD
Acarbose
aGlucosidase
Inhibitors
Exenatide
Liraglutide
Incretin
Mimetics
Sitaglipin
Saxaglipin
DPP-4
Inhibitors
Glucagon
Agonist @ PPAR g
receptor
Sensitizes skeletal
muscle to insulin
Increased glucose
uptake incr GLUT-4
transporters
Slows gastric
emptying
hypoglycemia
Pioglitizone improves
lipid profile
used
Weight gain
Edema/fluid retention
Risk of osteoporosis/fractures
Rosiglitizone may be
associated with increased risk of
CV events
Flatulence/diarrhea
Not well tolerated, not widely
GI symptoms (nausea,
vomiting)
None
None
None
None