Drugs For The Treatment Of Diabetes PDF

 Drup for the Treatment of Diabetes Intro to Diabetes disease characterized blood due > - chronic by...

 Drup for the Treatment of Diabetes Intro to Diabetes disease characterized blood due > - chronic by 4 glucose inability to produce insulin , or not being able to use Insulin produced Regulation of Blood Glucose normal blood glucose below 5 6 fasting stake between 6 7-7 82 hrs after meal > - =. in.. a , Types of Diabetes Mellitus > - Type 1 : Insulin Dependant ↳ characterized by pancreatic beta all destruction , leading to Insulin deficiency ↳ 5-10 % of people wh diabetes ↳ of onset age - 2 : ↳ characterized by pancreatic bota all dysfunction leading , to insulin resistance ↳ 90 % of people wh diabetes ↳ age of onset > 40 and associated wh obesity yrs = > - other causes 2 pancreatitis and drug therapy > - gestational diabete anyabnormalityingluenotedurnypregnancy vesis an : a  Complications of Diabetes o acute ↳ diabchre ketoacidosis ↳ caused by Inadequate or absent insulin replacement ↳ treatment involves administered Insulin intravenously ↳ huperosmolar hyperglycemic syndrome diagnosal ↳ type in I , characterized by severe hyperglycemia and dehydration -treatment involves slow rehydration and restoration of and electrolyte geocose homeostasis · Chronic ↳ chrome Kidney disease ↳ foot problems ↳ retinopathy ↳ nerve damage ↳ heart attack stroke discuss , , coronary artery Benefits of Blood Glucose > - long-term Controlling benefits slowing , progression of complications : ↳ diabetic disease eye , kidney , herve recommended that normal blood glucose targeting > - intensive glycemic control should become standard therapy patients w/ renal disease ↳ exception and risk of elderly = in as hypoglycemia may outweigh benifit of glycemic control Treatment of Diabetes importance of blood glucose , to self monitor nutrition lowering how > - exercise , , and medication used are all important > - d is mmana Insulin > - depending on severity of z may ,managed throughbe cal activity and meal medication such as cral mu planning , may require hypoglycemic , agents (function to glucose) Imbood Insulin TherapyI for all diabetics and for treatment of diabetic heloacidosis type > - necessary (when medications providing adequate blood glucre), > - be used for other control of may type of are not Infection) diabetes stressful conditions (e.. g , or gestational Injection multiph > - sources exist > - administration = subcutaneous intravenous or intramuscular or alternative methods such as , Insulin pump , transdermal parch or oral formulation (resists digestion in Gl tract) Subcutaneous ↳ standard mode Injection ↳ muummu of therapy using disposable needles and syringes, or portable pen injector closes ↳ absorption is highly variable (among different patients and factors affecting ↳ absorption : blood flow to the of site injection · site of · injection ↳ abdomen, arm , buttock , thigh · depth of injection · exersize and massage of the area increase absorption ↳ goal is to replicate the background/basal Covernight fasting , , between meal and bolus/prandial (mealtime) insui ↳ normal secration physiologic Complications of Insulin > - Hemia is most dangerous Therapy complication Lusally a result of unusal physical exertion , too large of a dose , Insulin allergy Crare) , Insulin resistance hypoglycemia ↳ of symptoms : · tachycardia & palpitations sweating · tremulousness shaking · or · naused hunger · OvHygge > - 5 classes : Biguanides > - Insulin Secretagogues > - > - GLP-1 agonists > - DDP-4 Inhibitors > - Salt2 Inhibitors Biguanides of the liver > - prevent production glucose in > - only one approved for clinical use = Metformin w ↳ cases gluconeogenesis in the liver and increases num Immunophane by shelated muscle , decreasing blood levels glocose ↳ first line therapy for type a diabetes - can wh other be used In combo hypoglycemic drags or insulin in type & diabetics when monotherapy is inadequate ↳ advantage (because in no hypoglycemia = does not aler insulin levels ↳ adverse effect gastrointestinal toxicity = 180 % of patients), anorexia , nausea , metallic taste and lactic acidosis lacidification of blood Insulin Secretagogues > - medicines that increase insulin secretion from pancreas (responsible for Stimulation of cells of the pancreas producing insulin > - mod = beta > - two types : ① Sulfonylureas iPatiumanne on beta ↳ cells cell , causing depolarization , entry , mrelease ↳ patient must have functional beta cells , so useful in type 2  sulfonylureas teratogenic ↳ are and thus contraindicated In pregnancy ↳ adverse effect : hypoglycemia ↳ ↳ disturbance gastrointestinal ↳ jaundice ↳ allergic skin reactions ↳ ex. glyburide Meglitinides short acting insulin to sulfonylureas function & > - mun secretagogues , Aurabolized and compound > - by the body are excreted by kidneys as active ↳ / hoor as a result , duration of action is short (half life = ↳ indicated for type 2 , can be combined wh metformin ↳ adverse reactions rare but can include hypoglycemia , ↳ ex. repaglinide Glucagon-Like Polypeptide Agonists DGLP-1 GLP-1 essential gut contributing folerance > - to is an hormone glucose type decreased after leading Inadequate glucagon > - In 2 GLP-1 is meal to , , suppression and increated glocose output > - synthetic analogs of GLP-1 bind to GLP-1 receptors , restoring Gup-1 activity > - of GLP-1 ↑ releas decrease release Injection glucagon = Insulin in , loss of all of which level contribute lowering blood glocse to appetite , > - adverse effects : ↳ nausea ↳ vomiting ↳ diarrhea ↳ lose weight > - adjunct therapy Dipeptidyl Deptidas 4 Inhibitors (App-4) - Dpp-4 serine protease (cleaves bonds proteins) critical for of GLP-1 mmmutation > - is a in nu > - by inhibiting of GLP-1 of active alp-1 Inactivation , they increase the amount , increasing the effect > - adjuncttreatment and administed orally > - common adverse effects : > ↳ upper resp infections ↳ headaches ↳ hypoglycemia ↳ acute pancresities ↳ severe allergic reactions ex Sitagliptin > -. Sodium-Glucose Linked Transporter Inhibitors (Sact) > - family of glucose transporters in intestine and Kidney > - SALT-2 found the proximal tubule of contributes to subclate is in the nephron and glucose reabsorption In the Kidney administered the transporter protein and SaLT-2 antagonize prevent > - can be to the reabsorption of glucose , decreasing blood sugar levels > - adverse effects Urination ↓ BP lose weight = , , low risk of hypoglycemia > - Combination Therapy dbain multiplemedicatione mayberequem with metformin then if needed other oral , hypoglycemic agente or insulin can be added Other > - used Drugs in the Management of Diabetes as preventative measures : · Statins > - lipid-lowering , protects vascular system · Alf Inhibitors to ↓ BP protect kidneys , · Low dose acetylsalicylic acid -> anti-platlet