Pharmacology Lecture Notes PDF

‫د‪.‬ي‬ ‫مواف التالتة فارما ر‬  01229984633 ‫مهم وحفظ‬ Ty...

‫د‪.‬ي‬ ‫مواف التالتة فارما ر‬  01229984633 ‫مهم وحفظ‬ Type of insulin Onset Peak Duration Rapid-Acting Insulin Insulin aspart 10-20 min 40-50min 3-5hr Insulin lispro 15-30min 30-90min 3-5hr Insulin glulisine 20-30min 30-90min 1-2.5hr Short-Acting Insulin Regular insulin 30-60 min 2-5 hr 5-8 hr Intermediate-Acting Insulin Isophane (NPH) insulin 1-2 hr 4-12 hr 18-24 hr Long-Acting Insulin Insulin glargine 1-1.5 hr None 20-24 hr Insulin detemir 1-2 hr 6-8 hr Up to 24 hr Insulin degludec 1-2 hr None >24 hr Inhaled Insulin Human insulin lipid 5-10 min 1 hr 5-10 hr Routes  SC –inhalation- continuous SC infusion with an insulin pump S/E  reactions (lipodystrophy) that affect the rate of insulin absorption Oral hypoglycemic agents Insulin secretagogue A) Sulfonylurea Drugs B) Meglitinide Drugs The original sulfonylureas The second-generation  Ex: Repaglinide and nateglinide drugs  useful for patients whose meal schedules vary from day to day Chlorpropamide, Acetohexamide, Glicilized glipizide, glyburide. & And S/E tolbutamide Glimepiride "classify as 3”  increases their risk of hypoglycemic reactions to sulfonylureas  Hypoglycemic reactions are not often serious as in sulfonylureas 1 ‫ بارا‬/ ‫ فارما‬/ ‫ باثو‬/‫فسيولوجي‬ By/ Ali Elmewafy  01229984633 "Insulin sensitizer" A) Biguanides: o Another biguanide, phenformin, was removed from the market in the 1970s because of an unacceptable risk of fatal lactic acidosis. Metformin o used alone or in combination with a sulfonylurea, meglitinide, a-glucosidase inhibitor, or incretin mimetic for patients whose diabetes is (Antihyperglycemic) ‫ممكن‬ not controlled with a single drug. ‫اخده مع نوع اول‬ B) Thiazolidinediones  Ex: Pioglitazone and rosiglitazone  used as an adjunct to diet and exercise for the management of type 2 diabetes  Rosiglitazone and pioglitazone have somewhat different effects on serum lipids a) edema, increase plasma volume, Adverse Effects b) increase the risk of developing heart failure in individuals with diabetes. c) not be used in persons with heart failure or a high risk of developing heart failure. d) risk of myocardial infarction (MI) (Rosiglitazone Pioglitazone) -Glucosidase Inhibitors Acarbose and miglitol  Adverse Effects increased flatulence and abdominal bloating. GLP-1-Based "Incretin mimetics" Therapies  GLP-1 Receptor Agonists (GLP-1Ra's) and DPP-4 Inhibitors  GLP-1 itself is not suited for therapeutic use because it is rapidly degraded by dipeptidyl peptidase- 4 (DPP-4) and has a half-life of only 2 minutes. Exenatide  A sustained-release preparation is now available for once-weekly injection Liraglutide Sitagliptin, linagliptin, and saxagliptin Pramlintide acetate Amylin Analogue  reduces caloric intake and may lead to weight loss  subcutaneously. Inhibitors of Glucose Reabsorption in the  SGLT-2 Inhibitors Kidney  canagliflozin, empagliflozin, and dapagliflozin are now approved or treating patients with type 2 diabetes.  The main adverse effects include urinary tract infection due to the excretion of glucose in the urine. 2 ‫ بارا‬/ ‫ فارما‬/ ‫ باثو‬/‫فسيولوجي‬ By/ Ali Elmewafy