What are sulfonylureas?
- -Increases insulin production from pancreas
- -decreases chance of prolonged hypoglycemia
- -10% experience decreased effectiveness after prolonged use
- -Glipizide (Glucotrol), Glimepiride (Amaryl), glyburide (Diabeta, Micronase, Glynase PresTab)
- SE: weight gain, hypoglycemia
What are Meglitinides?
- -Increase insulin production from pancreas
- -Taken 30 minutes before each meal up to tiem of meal
- -Do not take if meal is skipped
- -Repaglinide (prandin), Nateglinide (Starlix)
- -SE: weight gain, hypoglycemia
What are Biguanides?
- -Reduce glucose production by liver
- -Enhance insulin sensitivity at tissues
- -Improve glucose transport into cells
- -Does not promote weight gain
- -Metformin (Glucophage)
- -SE: diarrhea, lactic acidosis, need to hold 1-2 before IV contrast media is given and 48 hr after
What are a-glucosidase inhibitors?
- -Starch blockers, slow down absorption of carbs into small intestine
- -Acarbose (precose), miglitol (glyset)
- -SE: Gas, ab pain, diarrhea
What are Thiazolidinesdoines?
- -Most effective in those with insulin resistance
- -Improve insulin sensitivity, transport, and utilization at target tissues
- -Pioglitazone (actos), Rosiglitazone (Avandia-off market)
- -SE: weight gain, edema, increased risk for cardio problems
What are Dipeptidyl peptidase-4 (DDP-4) inhibitor?
- -Slows the inactivation of incretin hormones
- -Potential for hypoglycemia
- -Sitagliptin (Januvia), Saxagliptin (Onglyza)
- -Absence of weight gain as a SE
- -SE: Upper respiratory tract infection, sore throat, HA, UTI, diarrhea
What is Amylin analog?
- -Hormone secreted by B cells of pancreas
- -Co-secreted with insulin
- -indicated for type 1 and type 2 diabetes
- -Administered Sub-q into thigh or ab, not arm
- -Slows gastic emptying, reduces postprandial glucagon secretion, increases satiety
- -Do not mix with insulin, but can be taken during same period of time to decrease hypoglycemia
- - Pramlintide (Symlin)
What are B-adrenergic Blockers?
- -Mask symptoms of hypoglycemia
- -Prolong hypoglycemic effects of insulin
- -Lower blood glucose
What are Thiazide/Loop diuretics?
-Can potentiate hyperglycemia by inducing potassium loss