Class Examples MOA Best in patients with Dose/Administration Contraindications Sulfonylurea Glimepiride, Glipizide, Glyburide Type II Diabetes Mellitus Orally, before or with breakfast Repaglinide and Nateglinide Type II Diabetes Mellitus Orally after/with a meal Biguanides Metformin GI disturbance - diarrhea Thiazolidinediones Type II Diabetes Mellitus DPP-4 Inhibitors Type II Diabetes Mellitus Given orally N/A Incretin Mimetics Exenatide (Byetta) Amylin Analogs Pramlintide acetate Subcutaneously at mealtimes Acarbose and Miglitol Type II Diabetes Mellitus N/A Insulin Insulin replacement Adverse effects (common) "Hypoglycemic agent": acts to increase insulin secretion; Block K+ channels on the Beta cell; also work to lower glucagon levels Hypoglycemia, weight gain, skin rashes, N/V, and cholestasis Drug interactions - specifically alcohol, however they also interact with ACE-I, NSAIDs, salicylates, sulfonamides, etc. Meglitinides aka Non-Sulfonylurea "Hypoglycemic agent": acts to increase insulin secretion; Also block K+ channels in Beta cells Hypoglycemia, weight gain; Can only be used with metformin, no other oral antidiabetic drug or insulin "Antihyperglycemic drug": prevent or
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