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  • AntiDM Drug 56789

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    Wasuchon Chaichan
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    dm

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    © All Rights Reserved
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    2 views4 pages

    AntiDM Drug 56789

    Uploaded by

    Wasuchon Chaichan
    dm

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 4
    aivess9 HiTMeCOUIELS Diabotes Drugs STEP1 Endocrine - Step 1 Laws [averse | coms | com | vier | rose | com | Embryo Mire ormone TH) Aerenonensl Sma sypealdesteroni Con's Syrasome Mutipe Enecesne Nesolaias Povyardue Daeincy ‘Thyroid eorders Ungual Thy porta xz roe (Grn) try Sick Syeame (E85) Path State ards Endo Gl ne -MSK Neuro Diabetes Drugs Overview Goals of diabetes treatment * lower serum glucase to physiologic range © keep insulin levels in physiologic range « eliminate insulin resistance Modalities of diabetes treatment type |DM * insulin * low-sugar diet © type DM = diet * insulin = 6 classes of drugs shown below Payeh Renal {Insulin Insulin | Glucose || Glucose Madbullats.cam Repro. Pulm Anatomy Pharm a7 ae Topic updated on 1205 1488 Activity Profiles of Dierent Type of insulin [oles Example secretion utilization production absorption #9" Hypoglycemia, Insulin Insulin 1 SulfonylureasGlyburide ++ + = + Biguanides Metformin * + None Glitazones Pioglitazone ae * (thiazolidinediones) glucosidase Acarbose # None inhibitors GLP mimetics Exenatide ++ * ls (incratia mimetics) ‘Amylin analog Pramiintide + * * Insulin is only given parenterally (subcutaneous ar 1V) Various preparations have different durations of action Other preparations include aspart (rapid), detemir (Jong) Proparation Onset (hrs) Peak (hrs) Lispro (rapid-acting) _ 18 min 05-45 Regular (short-acting) 0.5-1 24 NPH (intermediate) 1-2 6-12 Glargine (long-acting) 1 None Mechanism ® bind transmembrane insulin receptor ' activate tyrosine kinase Duration (ars) 34 57 18-24 324 = phosphorylate speciic substrates in each tissue type « liver = T alycogenesis = slore glucose as glycogen © muscle = T glycogen and protein synthesis, = KY uptake ° fat «= increase triglyceride storage Clinical use type DM ® type DM « life-threatening hyperkalemia + increases intracellular K* «stress-induced hyperglycemia Toxicity © hypoglycemia ° hypersensitivity reaction (very rare) Insulin Synthesis, ® first generated as preproinsulin with an A chain and B chain connected by a C peptide. © cepeptide is cleaved fram proinsulin after packaging into vesicles leaving behind the A and B chains @ hitp:iwww.medbullets.comistep -endocrine!@03éidiabetes- acarbose © migitol + Mechanism « inhibit c-glucosidases in intestinal brush border = delayed sugar hydrolysis 1 delayed glucose absorption 4 postprandial hyperglycemia = [insulin demand + Clinical use © type DM ‘= a monotherapy or in combination with other agents + Toxicty © no hypoglycemia © Glupset Amylin mimetics + Drugs © pramilintide + Mechanism «synthetic analogue of human amylin that acts in conjunction with insulin © [release of glucagon © delays gastric emptying + Clinical use ® type land Il DM. + Toxicty © hypoglycemia = ifgiven with insulin © diarrhea GLP-1 analogs + Drugs * exenatide + Mechanism © GLP+1 is an incretin released from the small intestine that aids glucose«dependent insulin secretion "basis for drug mechanism is the observation that more insulin secreted with oral glucose load compared to IV © exenalide is a GLP-1 agonist = Tlnsulin * | glucagon release «© the class of cipeptidy! peptidase inhibitors | degradation of endogenous GLP-1 = eg.) sitagiptin, -giptins 2 + Clinical use * type ll DM + Toxicity © nausea, vomiting © pancreatitis © hypoglycemia 'ifgiven with sulfonylureas ‘SGLT-2 Inhibitors + Drugs © canagitiozin © empagifozin + Mechanism «© glucose is reabsorbed in the proximal tubule of the nephron by the sodiu-glucose cotransporter 2 (SGLT2) + SGLTZ-inhibitors lower serum glucose by increasing urinary glucose excretion «the mechanism of action is independent of insulin secretion or action + Clinical use © type Il DM. + Toxicity © dehydration ¢ urinary and genital infections dot tke NERASES001 Qbank (7 Questions) uaton Fett (aaa) hitpsiwww.medbullets.comistep -endocrine!903éidiabetes- Review Topic 4. OD ke>40 2, Nav> 140 3, 0 KC03-> 30 4, Glucose > 300 5. Creatine > 20 RED RESPONSE > Recent Videos Mnemonic for Diabetes Drugs w2azons ‘Step 1 Endostnology -Eoucatonal Prseratin- betes rags 18 views Darybut fin memonic Evidence & References show Retsnoes Topic Comments ‘subserbo sts: Gon @ oft Plasalop oad comment hitpsiwww.medbullets.comistep -endocrine!9036idiabetes-

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