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    Table For DM Oral Medications

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    Chantal Carnes
    Useful table on oral diabetes medications

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    Table For DM Oral Medications

    Uploaded by

    Chantal Carnes
    14 views1 page
    Useful table on oral diabetes medications

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    Table for DM Oral Medications

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    Useful table on oral diabetes medications

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    14 views1 page

    Table For DM Oral Medications

    Uploaded by

    Chantal Carnes
    Useful table on oral diabetes medications

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Goodman &Gilman's: The Pharmacological Basis of Therapeutics, 13e >Endocrine Pancreas and

    Pharmacotherapy of Diabetes Mellitus and Hypoglycemia


    Laurence L. Brunton, Randa Hilal-Dandan, Björn C. Knollmann+
    Table 47–7Comparison of Agents Used for Treatment of Diabetes

    AGENT-SPECIFIC AGENT-SPECIFIC CONTRAINDICATIONS AND


    TYPE Agent MECHANISM OF ACTION HbA1C REDUCTION (%)a
    ADVANTAGES DISADVANTAGES PRECAUTIONS

    Oral

    GFR <50 mL/min, CHF,


    Weight neutral, do not cause Diarrhea, nausea, lactic
    Biguanidesc ↓ Hepatic glucose production 1–2 radiographic contrast studies,
    hypoglycemia, inexpensive acidosis
    seriously ill patients, acidosis

    Dipeptidyl peptidase 4 Prolong endogenous GLP-1


    0.5–0.8 Do not cause hypoglycemia Expensive ↓ Dose with renal disease
    inhibitorsc action

    GI flatulence, liver function


    α-Glucosidase inhibitorsc ↓ GI glucose absorption 0.5–0.8 ↓ Postprandial glycemia Renal/liver disease
    tests

    Insulin
    ↑ Insulin secretion 1–2 Inexpensive Hypoglycemia, weight gain Renal/liver disease
    secretagogues—sulfonylureasc

    Insulin
    Rapid onset of action, lower Hypoglycemia, precautions for
    secretagogues—nonsulfonylur ↑ Insulin secretion 1–2 Renal/liver disease
    easc postprandial glucose elderly and renal impairment

    Mild weight loss and BP ↑ Rate of lower urinary tract


    SGLT2 inhibitorsc (the reduction; do not cause and genital mycotic infections;
    ↑ Renal glucose excretion 0.9–1.2 Renal disease
    gliflozins) hypoglycemia; CV benefit hypotension; rarely DKA; see
    (empagliflozin, canagliflozin) text for canagliflozin

    Peripheral edema, CHF, weight


    Thiazolidinedionesc (the ↓ Insulin resistance, ↑ glucose
    0.5–1.4 Lower insulin requirements gain, fractures in females, CHF, liver disease
    glitazones) utilization
    macular edema

    Parenteral

    ↑ Glucose utilization, ↓ hepatic Well-known safety/adverse


    Injection, weight gain,
    Insulin glucose production, and other Not limited effect profile from much clinical Hypoglycemia
    hypoglycemia
    anabolic actions experience

    Injection, nausea, ↑ risk of Renal disease, agents that also


    ↑ Insulin, ↓ glucagon, slow Weight loss, CV benefit
    GLP-1R agonistsc 0.5–1.5 hypoglycemia with insulin slow GI motility, pancreatitis,
    gastric emptying, satiety (liraglutide)
    secretagogues medullary carcinoma of thyroid

    Slow gastric emptying, ↓ Reduce postprandial glycemia; Injection, nausea, ↑ risk of Agents that also slow GI
    Amylin agonistsb,c 0.25–0.5
    glucagon weight loss hypoglycemia with insulin motility

    Other

    Medical nutrition therapy and ↓ Insulin resistance, ↑ insulin Weight loss, improved CV Compliance difficult, long-term
    1–3
    physical activityc secretion health success low

    ↑ Glucose utilization, ↓ hepatic


    Inhaled insulinc,d glucose production, other 0.25–0.5 Rapid onset of action Limited clinical experience Pulmonary disease, smoking
    anabolic actions

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