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DM drugs Step 1 USMLE Review


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MOA Insulin?
binds to insulin receptor via Tyrosine Kinase
MOA of Insulin in Liver?
increases storage of glucose
as glycogen
MOA of Insulin in Muscle?
stimulates glycogen and protein synthesis
K+ uptake
MOA of Insulin in Adipose Tissue?
Facilitates TG (triglyceride) storage
WHat are the clinical uses of insulin? 3
1) DM usually type 1
2) Hyperkalemia (life threatening)
3) Stress-induced hyperglycemia
Toxicities of insulin?
HyperSensitivity (rare)
MOA Of sulfonylureas?
Close K+ chn. in B-cell membrane ----> Cell depolirizes----> insulin release triggered owing to Increase Ca+ Influx
What are the sulfonylureas?
Tolbutamide 1st gen
Chlorpropamide 1st gen
glyburide 2nd.
glypizide 2nd.
What do sulfonylureas do in the body?
stimulate the release of endogenous insulin in NIDDM(type 2)
Toxicities for Sulfonylurea?
Disulfiram-like (more common in 2nd Gen.)
Hypoglycemia (not seen in 2nd generation)
What is the MOA of metformin?
inhibits gluconeogenesis in the liver decreasing glucose
A/E of Metformin?
Lactic Acidosis
WHat are the Glitazones? Name 3
1) Pioglitazone
2) Rosiglitazone
3) Troglitazone
What is the MOA of Glitazones?
increase target cell response to insulin
What is importance of Glitazones?
Used as monotherapy type 2 DM
What A/E of glitazone?
Weight Gain
Hepatotoxic (troglitazone)
What are the alfa-glucosidase inhibitor? 2
What is the MOA of alpha-glucosidase inhibitors?
Inhibit intestial absorption of glucose

brush border enzyme alpha-glucosidase inhibited
What is important about alpha-glucosidase inhibitor?
Toxicity of alpha-glucosidase inhibitors?
GI disturbance

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