Meglitiniedes/Phenylalanines

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Meglitinides/phenylalanines in combination

repaglinide and nateglinide often used in combo with metformin and TZDs
meglitinides MOA
- stimulates insulin release from beta cells
- insulin levels rise with postprandial glucose peak at:
- nateglinide 45 min (DOA 3-4h)
- repaglinide 60 min (DOA 4-6h)
meglitinides target fasting or post prandial

post prandial
meglitinides insulin release glucose dependent or independent

dependent - less hypoglycemia
meglitinides compared to sulfs
- shorter duration of action
- more glucose dependent stimulation of insulin release --> less hypoglycemia
repaglinide metabolism and elimination
- metabolism: liver (inactive metabolites)
- elimination: feces
nateglinide metabolism and elimination

metabolism: liver (less potent metabolites)

elimination: urine
nateglinide vs. repaglinide
onset/DOA
potency
- nateglinide more rapid onset and shorter DOA
- repaglinide more potent
meglitinide contraindications
- type 1 dm
- diabetic ketoacidosis
- repaglinide + gemfibrozil
repaglinide has DDI with what? why?
gemfibrozil
- rep metabolized by CYP 2C8
- gem is CYP 2C8 inhibitor
- --> 8x inc in repaglinide; 3x t1/2
meglitinides side effects
- hypoglycemia (less than sulf; great with repaglinide+gemfibrozil)
- weight gain
- headache
- URI
- dizziness
- neuromuscular (arthralgia, back pain, paresthesia)
- GI (N/D/C, epigastric fullness, heartburn)
when to take a meglitinide

take 15 min bf a meal (can be taken up to 30 min before the meal)
missing a meal with meglitinide
- skip a dose if meal is skipped
- add dose if extra meal eaten

Author

jcu1

236088

Card Set

Meglitiniedes/Phenylalanines

Description

Dr. Drab

Updated

2013-09-21T04:51:55Z

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