Katzung Insulin and Oral Diabetic Agents
Terms
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- insulin lispro
- rapid acting, low chance of forming auto-dimers, better insulin control than reg insulin
- insulin aspart
- rapid acting, inhibits auto-aggrigation,
- regular insulin
- short acting, dose dependant, IV useable, good for IV ketoacidosis or post surgery
- Lentate insulin
- intermediate acting, dose dependant
- NPH insulin
- intermediate acting, dose dependant
- ultralentate insulin
- used in combo w injections of rapid acting insulin. Human insulin. tid.
- insulin glargine
- peakless, ultralong acting, background insulin replacement, low immunogenicity
- human insulin benefits
- less immunogenic
- insulin therapy complications
- hypoglycemia, insulin allergy (IgE), insulin resistance (IgG), lipodystrophy at injection site
- Tolbutamide
- sulfonurea, short half-life, best for older diabetics
- Sulfonureas
- up insulin release, down serum glucagon, close extrapancreatic potassium channels
- chlorpropamide
- sulfonurea. contraindicated in hepatic or renal inssuffic. prolonged hypogycemia rxns in elderly, hyperemic flush after alcohol ingestion, rare hematological toxicity.
- tolazamide
- sulfonurea. more slowly absorbed, tid.
- glyburide
- sulfonurea, potential hypoglycemia, rare flushing, up free water clearance. Coontra in renal insuff and hepatic impairment.
- glipizide
- sulfonurea. shortest halflife, less likely to cause hypoglycemia, contra in hepatic and renal impairment.
- Glimepiride
- sulfonurea, lowest dose,
- repaglinide
- meglitinide, fast onset, hypoglycemia w/ skipped meal, good for type II w/ sulfur allergy
- nateglinide
- insulin secretagogue, d-phenylalanie deriv, partially restores insulin release, low incidence of hypoglycemia, safe for renal impairment
- metformin
- biguanide, good for insulin resistance, se: anorexia, n/v, diarrhea contra:renal disease, hepatic disease
- Thiazolidinediones (Tzds)
- ligands of perioxisome proliferator activated gamma receptors (PPAR-gamma), effect lipid glucose metabolism, se: weight gainfluid retention, down LDL up HDL
- Pioglitazone
- Tzd, for type II
- rosiglitazone
- tzd, for type II
- alpha-glucosidease inhibitors
- Acarbose and miglitol. prevents absorption of some sugars. se: flatulence, abd pain, hypoglycemia. contra: renal impairment