Antidiabetic drugs - ANTIDIABETIC DRUGS Pharmacology of drugs for the treatment of diabetes mellitus Oliver Grundmann [email protected] Keywords key

Antidiabetic drugs - ANTIDIABETIC DRUGS Pharmacology of...

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ANTIDIABETIC DRUGS Pharmacology of drugs for the treatment of diabetes mellitus
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Keywords & key drugs Diabetes mellitus Hyperglycemia Microangiopathies Three p’s: polydipsia, polyuria, polyphagia Ketoacidosis Hypoglycemia Insulin shock 50% Dextrose (D50) Glucagon Type 1 diabetes mellitus Insulin-dependent diabetes mellitus Autoimmune reaction Type 2 diabetes mellitus Insulin-independent diabetes mellitus Oliver Grundmann, [email protected] 2
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Keywords & key drugs Insulin Lipodystrophy Regular insulin (Humulin R®, Novolin R®) Humulin (50/50, 70/30, N, L, Mix 75/25) Novolin 70/30 Human insulin aspart (Novolog®) Insulin Glargine (Lantus®) Insulin Lispro (Humalog®) Insulin Glulisine (Apidra®) Neutral-protamine Hagedorn Lente Oliver Grundmann, [email protected] 3
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Keywords & key drugs Oral antidiabetic drugs First generation Tolbutamide (Orinase®) Tolazamide (Tolinase®) Chlorpropamide (Diabinese®) Second generation Glipizide (Glucotrol®) Glyburide (Glynase®, Micronase®) Glimepiride (Amaryl®) Non-sulfonylureas Metformin (Glucophage®) Alpha-Glucosidase inhibitors Acarbose (Precose®) Miglitol (Glyset®) Insulin-enhancing agents Pioglitazone (Actos®) Oliver Grundmann, [email protected] 4
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Diabetes mellitus Oliver Grundmann, [email protected] 5 Diabetes means “to pass through” (polyuria) and mellitus means “from honey” (sweet smell and taste of urine) Approximate number in US: 18.5 million Complications – third leading cause of death Two predominant types: Type 1, insulin dependent diabetes mellitus (IDDM), 10-12% Type 2, Non-insulin dependent diabetes mellitus (NIDDM) 85-90% Two main drug classes: Insulin Oral antidiabetics To be discussed: Differences between drugs When each is used
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Type 1 diabetes mellitus Insulin-dependent → requires insulin therapy from an early age Pathogenesis involves several factors: Genetic pre- disposition Environmental factors Autoimmune destruction of pancreatic beta-cells Absolute insulin deficiency Oliver Grundmann, [email protected] 6
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Insulin Hormone secreted from pancreatic beta-cells Mainly regarded as an anabolic hormone counteracting the effects of glucagon Many types - to be covered Action: controls hyperglycemia by stimulating glucose uptake in muscle and fat inhibiting hepatic glucose production Indications: Type 1 and 2 diabetes mellitus Contraindications/Cautions: Hypoglycemia Allergy to insulin, preservatives, or additives Adverse Reactions/Side Effects Hypoglycemia, erythema, lipodystrophy ( fat accumulation at injection site, make sure to altenate sites, pruritis, swelling Oliver Grundmann, [email protected] 7
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Insulin
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