Term
alpha-glucosidase inhibitors (AGIs)
Generic/trade name
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Definition
-delays intestinal absorption of glucose
-DA: flatulence, diarrhea, less efficacy frequent dosing
-A: safety, postprandial effect
Acarbose/precose
miglitol/glyset
voglibose/ volix |
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Term
Amylin analogs (injectable)
Generic/trade name |
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Definition
-delays gastric emptying, decreases postprandial glucagon release, suppresses appetite
-Increased risk of hypoglycemia
- DA: Gi complaints, must seperate syringe
- improves long term control (A1c), weight loss
Pramlintide/symlin
Acetate/---- |
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Term
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Definition
-decreases hepatic glucose production, increases insulin uptake in muscles
-DA: transient diarrhea, nausea, bloating, anorexia, flatulence, B-12 deficiency
-A: weight control, no hypoglycemia
Metformin/glucophage |
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Term
| Incretin Mimetics (injectable) |
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Definition
-mimics glucose-dependent insulin secretion, suppresses elevated glucagon secretion, delays gastric emptying
-Can cause hypoglycemia when used with sulfonylurea
-DA: may decrease apsortion of orally administered drugs (i.e contraceptives)
-A: better glycemic control
Exenatide/byetta |
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Term
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Definition
-stimulates insulin secretion in presence of glucose, short-acting
-DA: frequent dosing, expensive, hypoglycemia
A: short action with less hypoglycemia at night (postprandial effect)
Repaglinde/prandin
nateglinide/starlix |
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Term
Sulfonylurea
1st generation |
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Definition
-stimulates insulin secretion
-Risk of hypoglycemia, weight gain, contraindicated in renal insufficiency
- A: inexpensive long history of effectiveness, usually only needed once a day
Generic: acetohexamide, chlorpropamide, tolazamide
Trade: dymelor, diabinese, tolinase
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Term
Sulfonylurea
2nd generation |
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Definition
-stimulates insulin secretion
-Risk of hypoglycemia, weight gain, contraindicated in renal insufficiency
- A: inexpensive long history of effectiveness, usually only needed once a day
Generic: glipizide, glipized-GITS, Glyburide, Glimepride
Trade: Glucotrol, Glucotrol XL, Diabeta, Amaryl |
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Term
Thiazolidinediones
(TZDs) |
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Definition
-decreases insulin resistance
- DA: weight gain, edema, worsened CHF, most expensive, slow onset of action
A: very effective in highly insulin resistant individals, potential CV benefit, usually need only once a day
Pioglitazone/Actos
Rosiglitazone/ Avandia |
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