https://wikem.org/w/api.php?action=feedcontributions&feedformat=atom&user=Markmonterroso 2026-05-13T23:03:10Z User contributions MediaWiki 1.38.2 https://wikem.org/w/index.php?title=Diabetes_medications&diff=98728 2016-09-05T22:07:08Z

<p>Markmonterroso: I had planned to add a small section to this page when I added a page for GLP-1 agonists. Thank you</p> <hr /> <div>==Background==<br /> *Hypoglycemics<br /> **Sulfonylureas<br /> **Benzoic acid derivatives<br /> *Antihyperglycemics<br /> **Biguanides<br /> **Alpha glucosidase inhibitors<br /> **Thiazolidinediones<br /> <br /> {{Common Anti-hyperglycemic Drugs and Pharmacology}}<br /> <br /> ==[[Insulin]]==<br /> <br /> ==Biguanides (Metformin)==<br /> Suppresses liver glucose production<br /> ===Dose===<br /> Metformin 500mg PO BID is first-line agent for type II diabetics<br /> *Do not prescribe if creatinine &gt; 1.4 (GFR &lt;40), CHF, hepatic insufficiency, ETOH abuse<br /> *Should be withheld for 48hr after IV contrast<br /> ===Side Effects===<br /> *Lactic acidosis (due to increased lactate production)<br /> **Seen almost exclusively in patients with renal failure<br /> *Nausea, diarrhea, crampy abdominal pain<br /> ===Toxicity===<br /> *Almost never causes hypoglycemia when taken alone, but can exacerbate hypoglycemia when taken in combination with hypoglycemic agents<br /> *Toxic dose unknown<br /> *Management: Supportive care<br /> <br /> ==Sulfonylureas==<br /> *Increases insulin secretion (glipizide, glyburide)<br /> *Hypoglycemia is the major adverse effect (esp with glyburide)<br /> <br /> ==Alpha Glucosidase Inhibitors==<br /> *acarbose, miglitol, voglibose<br /> *competitively and reversibly inhibit alpha glucosidase brush border hydrolase enzyme- makes postprandial decrease in carbohydrate absorption since complex polysaccharides not broken down into absorbable monosaccharides<br /> *does not affect lactose absorption<br /> *if hypoG- sucrose/ table sugar will not work- use glucose- PO or IV<br /> *taken with first bite of each meal <br /> *since limited absorption, stays in gut and side effects mostly GI- bloating, gas, diarrhea<br /> *contraindications- cirrhosis, IBD, malabsorption synd<br /> *alpha glucs do not cause hypoG when used as monotreatment<br /> *acarbose- can cause transaminitis/ liver inj<br /> *since minimal absorption- systemic toxicity from OD unlikely<br /> <br /> ==Thiazolidinediones==<br /> *rosiglitazone and poiglitazone<br /> *enhance insulin effect on muscle, fat, liver without increasing panc insulin secretion<br /> *protein bound and hep metab- not good if liver disease<br /> *side effects- induce ovulation, decrease effectiveness of OCP's, increase plasma volume (bad if CHF)<br /> <br /> ==Benzoic Acid Derivatives==<br /> *repaglinide- mono or combined with metformin<br /> *binds to ATP dependent potassium channel like sulfonyls but at different site.<br /> *Unlike sulfonyls, it decreases insulin lvls<br /> *Dose 30 min before meal to decrease post prandial hyperglycemia<br /> <br /> ==[[GLP-1 agonists]]==<br /> *Exanatide (Byetta and Bydureon), Liraglutide (Victoza)<br /> *Synthetic glucagon-like peptide-1 (GLP-1) receptor agonists<br /> *Stimulates insulin release from pancreatic islet cells<br /> *May promote weight loss by slowing gastric emptying and increasing satiety<br /> <br /> ==See Also==<br /> *[[Diabetes Mellitus (Main)]]<br /> <br /> ==References==<br /> <br /> <br /> [[Category:Endocrinology]]<br /> [[Category:Pharmacology]]</div>

Markmonterroso https://wikem.org/w/index.php?title=GLP-1_agonists&diff=96215 2016-08-23T02:40:15Z

<p>Markmonterroso: internal link added</p> <hr /> <div>==Background==<br /> * Synthetic glucagon-like peptide-1 (GLP-1) receptor agonists<br /> * Stimulate insulin release from pancreatic islet cells<br /> ==Types==<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! Short Acting !! Dose<br /> |-<br /> | Exenatide(Byetta) || 5-10 mcg SC bid<br /> |-<br /> | Liraglutide(Victoza) || 0.6-1.8 mg SC daily<br /> |-<br /> ! Long Acting !! <br /> |-<br /> | Exenatide(Bydureon) || 2 mg SC qwk<br /> |-<br /> | Albiglutide(Tanzeum) || 30-50 mg SC qwk<br /> |-<br /> | Dulaglutide(Trulicity) || 0.75-1.5 mg qwk<br /> |}<br /> <br /> ==Indication==<br /> * Diabetes Mellitus, Type 2<br /> <br /> ==Adverse Reactions==<br /> * Nausea, vomiting, diarrhea<br /> * Acute pancreatitis<br /> * Exenatide should not be used in patients with creatinine clearance below 30mL/min<br /> * Should not be used if personal of family history of medullary thyroid cancer or MEN 2A/2B<br /> <br /> ==See Also==<br /> [[Diabetes medications]]<br /> <br /> ==References==<br /> 1.Epocrates<br /> <br /> 2.http://www.uptodate.com/contents/glucagon-like-peptide-1-receptor-agonists-for-the-treatment-of-type-2-diabetes-mellitus?source=see_link&amp;sectionName=GLUCAGON-LIKE+PEPTIDE-1&amp;anchor=H2#H619400</div>

Markmonterroso https://wikem.org/w/index.php?title=GLP-1_agonists&diff=96214 2016-08-23T02:37:02Z

<p>Markmonterroso: Created page with &quot;==Background== * Synthetic glucagon-like peptide-1 (GLP-1) receptor agonists * Stimulate insulin release from pancreatic islet cells ==Types== {| class=&quot;wikitable&quot; |- ! Short...&quot;</p> <hr /> <div>==Background==<br /> * Synthetic glucagon-like peptide-1 (GLP-1) receptor agonists<br /> * Stimulate insulin release from pancreatic islet cells<br /> ==Types==<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! Short Acting !! Dose<br /> |-<br /> | Exenatide(Byetta) || 5-10 mcg SC bid<br /> |-<br /> | Liraglutide(Victoza) || 0.6-1.8 mg SC daily<br /> |-<br /> ! Long Acting !! <br /> |-<br /> | Exenatide(Bydureon) || 2 mg SC qwk<br /> |-<br /> | Albiglutide(Tanzeum) || 30-50 mg SC qwk<br /> |-<br /> | Dulaglutide(Trulicity) || 0.75-1.5 mg qwk<br /> |}<br /> <br /> ==Indication==<br /> * Diabetes Mellitus, Type 2<br /> <br /> ==Adverse Reactions==<br /> * Nausea, vomiting, diarrhea<br /> * Acute pancreatitis<br /> * Exenatide should not be used in patients with creatinine clearance below 30mL/min<br /> * Should not be used if personal of family history of medullary thyroid cancer or MEN 2A/2B<br /> <br /> ==See Also==<br /> [[Diabetic medications]]<br /> <br /> ==References==<br /> 1.Epocrates<br /> <br /> 2.http://www.uptodate.com/contents/glucagon-like-peptide-1-receptor-agonists-for-the-treatment-of-type-2-diabetes-mellitus?source=see_link&amp;sectionName=GLUCAGON-LIKE+PEPTIDE-1&amp;anchor=H2#H619400</div>

Markmonterroso