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Names of rapid insulins
Lispro, Humalog, Aspart, Novolog, Gluisine, Apidra
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Names of short acting insulin
"regular"
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Names of intermediate acting insulin
NPH, Lente
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Names of long acting insulin
Detemir, Levemir
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Names of very long acting insulins
Glargine, Lantus
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avg. peak for rapid acting insulin
- ~1-3 hours
- (Lispro and Humalog is 1-1.5 hours)
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Peak for regular insulin?
2-4 hours
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Peak for Glargine/Lantus insulins?
No peak
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Why would you have an increased need for insulin?
- Body Growth
- Hormonal changes (like pregnancy)
- Increased food intake
- stress-physical or emotional
- Illness, even if they are not eating
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What would be reasons why you would need a decrease of insulin?
- Exercise
- Diseases (ex. end stage renal disease)
- Decreased food intake
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Diabenase-chlorpropamide
- (first generation)
- Sulfonylureas
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Micronase; Diabeta-glyburide
- (second generation)
- Sulfonylureas
-
Glucotrol- Glipizide
- (second generation)
- Sulfonylureas
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Glimepiride-Amaryl
Sulfonylureas
-
Glucophage (metformin)
Biguanides
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Action of Sulfonylureas
- Stimulate insulin production in the pancreas
- Increase receptor sensitivity
- ? Increase # of receptors
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Action of Biguanides
Reduces glucose production by the liver and absorption in the intestine. It also enhances uptake and use of glucose by peripheral tissues.
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Acarbose (Precose)
A-Glucosidase Inhibitors
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Miglitol (Glyset)
A-Glucosidase Inhibitors
-
Action of A-Glucosidase Inhibitors
Competitive, reversible inhibitor of pancreatic alpha-amylast, which hydrolyzes complex CHOs to oligosaccharides. By inhibiting this enzyme, Acarbose delays digestion of starches.
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drugs ending in "-glinide"
Nateglinide, Repaglinide
Meglinitinides
-
Action of Meglitinides
Stimulate the release of insulin
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drugs ending in "-glitazone"
ex: pioglitazone, rosiglitazone
Thiazolindinediones--Glitazones
-
Action of Thiazolidinediones--Glitazones
improves bodys ability to use insulin. Reverse insulin resistance at cellular level by agonizing the receptors that regulate insulin-uptake. Also decrease hepatic glucose output.
-
Pramlintide (Symlin)
Noninsulin Polypeptide Analogues
-
Action of Noninsulin Polypeptides Analogues
Slows gastric emptying, suppresses release of glucagon, suppresses appetite because increases feeling of satiety.
-
Gastric Inhibitory Peptide (GIP)
Incretin
-
Glucagon-like peptide (GLP-1)
Incretin
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Exenatide (Byetta)
Incretin Mimetic
-
Actions of Incretins
- Increase amount of insulin secreted
- Decrease amount of glucagon secreted
- Delay Gastric emptying
- Increase feeling of satiety
-
Sitagliptin (Januvia)
Incretin enhancer
-
Action of Glucagon
Increases BS through glycogenolysis and gluconeogenesis
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