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Diabetes Mellitus (Anti-diabetic Drug (Oral Antidiabetic Drug (Dipeptidyl…

- - - - Most rapid onset of action (5 to 15 minutes)
      - Peak: 1 to 2 hours
      - Duration: 3 to 5 hours
      - Patient must eat a meal after injection
      - Insulin lispro (Humalog)
      - Similar action to endogenous insulin
      - Insulin aspart (NovoLog)
      - Insulin glulisine (Apidra)
      - May be given subcutaneously (SQ) or via continuous SQ infusion pump (but not intravenously [IV])
    - - Regular insulin (Humulin R)
      - Routes of administration: IV bolus, IV infusion, intramuscular (IM), SQ
      - Onset (SQ route): 30 to 60 minutes
      - Peak (SQ route): 2.5 hours
      - Duration (SQ route): 6 to 10 hours
      - The only type is given by IV
    - - Insulin glargine (lantus)
        
        Clear, colorless solution
        
        Constant level of insulin in the body
        
        Usually dosed once daily
        
        Can be dosed every 12 hours
        
        Referred to as basal insulin
        
        Onset: 1 to 2 hours
        
        Peak: none
        
        Duration: 24 hours
      - Insulin detemir
        
        Duration of action is dose dependent
        
        Lower doses require twice-daily dosing
        
        Higher doses may be given once daily
    - - Insulin isophane suspension (also called NPH)
        
        Cloudy appearance
        
        Often combined with regular insulin
        
        Onset-1-2 hours
        
        Peak- 4-8 hours
        
        Duration- 10-18 hours
  - - - Pramlintide (symlin)
      - Averse effects
        
        Nausea, vomiting, anorexia, headache
    - - Exenatide (byetta)
      - Liraglutide (Victoza)
      - inject pen device
      - Adverse effect
        
        Nausea, vomiting, diarrhea, weight loss.
  - - - Metformin (glucophage
      - First line drug and is the most commonly used oral drug for the treatment of type 2 DM
      - Adverse effect
        
        Abdominal bnloating
        
        nausea
        
        Cramping
        
        Feeling of fullness
        
        Diarrhea
    - - Second generation
        
        glimepiride (amaryl)
        
        Glipizide (glucotrol)
        
        Glyburide(diabeta)
      - Adverse effect
        
        Hypoglycemia
        
        weight gain
        
        skin rash
        
        nausea
        
        epigastric fullness
        
        heartburn
    - - Repaglinide (prandin)
      - Nateglinide
      - Adverse effects
        
        headache, hypoglycemia, dizziness, weight gain, joint pain, upper respiratory infection or flulike symptoms.
    - - Pioglitazone(actos)
      - Rosiglitazone (avandia)
      - Insulin-sensitizing drugs
      - Adverse effects
        
        moderate weight gain, edema, mild anemia,, hepatic toxicity.
    - - Acarbose (precose)
      - miglitol (glyset)
      - adverse effects
        
        Flatulence, diarrhea,abdomnial pain.
    - - Sitagliptin (januvia)
      - Saxagliptin (onglyza)
      - LINgliptin (tradjenta)
      - alogliptin (nesina)
      - adverse effect
        
        upper respiratory tract infection, headache and diarrhea, hypoglycemia
  - - - hypoglycemia, hematologic effect, nausea, epigastric fullness, heartburn,
- - - - Reduced number of insulin receptors
      - insulin receptors less responsive
    - - Obesity
      - Coronary heart disease
      - Dyslipidimia
      - Hypertension
      - Microalbuminemia (protein in the urine)
      - Increased risk for thrombotic (blood clotting) events
    - - Lifestyle changes
      - Oral drugs
      - Insulin when above no longer provide glycemic control
  - - - Diabetic ketoacids (DKA)
      - Hyperosmolar nonketotic syndrome (hhns)
- - - - Confusion, irritability, tremor,sweating
    - - Hypothermia, seizures, coma and death will occur if not treated