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Unformatted text preview: dent: Type II
• Have some capacity for insulin production
80% obese, adult onset
10% stable adult onset (normal weight)
5% brittle, ketosis prone adult onset
– similar to juvenile onset individuals--likely to
become insulin dependent • Evaluate overall effectiveness of control by
checking glycosylated hemoglobin (HbA1c)
– under 8.0 = good diabetic control. Treatment of NIDDM
• Sometimes insulin injections
Sometimes oral hypoglycemic agents
• may do no real good in preventing complications
and cardiovascular deaths
• Use diet and exercise whenever possible. Oral Hypoglycemic Agents
Biguanides including Meglitinides
Thiazolidinediones Oral Hypoglycemic Agents:
• Up to 10 different drugs and 30 brand names
• tolbutamide (Orinase®) - short duration (6-12 hrs)
chlorpropamide (Diabinese®) - long duration (60 hrs)
glyburide (DiaBeta®, Micronase®) • Mechanism:
– stimulate insulin release
– alter receptor sensitivity to insulin
– change liver's response to insulin. • Side Effects:
– GI, dermatologic, hepatic, and hematologic
– Severe hypoglycemia (Keep patient well nourished )
– weight gain. Oral Hypoglycemic Agents:
• acarbose (Precose®), miglitol (Glyset®) • Additive with sulfonylureas
– work by different mechanism. Oral Hypoglycemic Agents:
• metformin (Glucophage®) • Monotherapy or in combination
• Does not seem to cause hypoglycemic
episodes seen with sulfonylureas.
• No tendency for weight gain.
– Meglitinides, a different type of biguanides
• include repaglinide (Prandin®), nateglinide (Starlix®) Oral Hypoglycemic Agents:
• rosiglitazone (Avandia®), pioglitazone (Actos®) • Another Alternative Objective 7:
• Identify major therapeutic uses and side or
toxic effects of estrogen, bone density
modifiers, progesterone, and androgens. Estrogens - (estradiol)
• Therapeutic Uses
– Suppress ovulation
• used with progesterone for birth control – Lessen undesirable effects of transition in menopause
– Sexual infantilism
• estrogen develops uterus and secondary sex characteristics – Inhibition of lactation • Osteoporosis in postmenopausal women
– does not reverse loss, merely prevents worsening of condition.
• Dietary calcium (1500 mg) and vitamin D (400-800 I.U.) can help.
No totally satisfactory treatment available.
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This document was uploaded on 02/07/2014.
- Spring '14