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Pharmacology - Diabetes (dropped image link (Liver Fat and Muscles…
Pharmacology - Diabetes
Pancreas
*SulfonuriasMOA
- release insulin from Beta Islet cells
--> only if they are still working
- inhibit the Na+/K+ ATPas
--> stops K+ entering cell
--> positive charge depolarizes the cell
--> increase in Intracellular Ca++
--> Beta cells release insulin
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Liver and Pancreas
*Incretins = GLP-1
- GLP-1 = glucagon like peptide
- GLP-1 are broken down by dipeptidyl peptidase-4 DPP-4
MOA
- after eating incretins are released to increase the effects of insulin
*GlitpinsDrugs
- Sitagliptin
- Alogliptin
- Saxagliptin
MOA
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*Exanatide = GLP1 analogDrugs
MOA
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GI glucose uptake
*Arcabose = Glucose analog = Alpha-glucosidase blockersMOA
- acarbose = Glucose analog
- Alpha-glucosidase blockers
--> Alpha- G binds acarbose thinking it is glucose
--> gets inactivated
--> lowers glucose uptake from the gut
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Kidneys
*SGLT-2 inhibitors = GLY FLOZINsMOA
*SGLT-2 inhibitors = GLY FLOZINs
- think the GLY FLOZ IN to the tubule since the SGLT2s can't absorb the glucose at the PCT like normal
MOA
- release
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Liver Fat and Muscles
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*Lactic acidosis and renal insufficiency
- build up of the lactic acid in the liver from metformin stopping the glucose pathway
--> build up behind pyruvate moving up the path
--> get build up of side path lactic acid
--> this leask into the blood and can damage the kidney
- biggest risk starting metformin in kidney injury
--> so check creatinine levels before starrting
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*Clinical DM meds
- obese people
--> metformin best
--> GLP-1 analogs + DPP4 = neutral also good
- Increase Weight
--> TZDs
--> Pancreas specific drugs = Glinides + Sulfonurias = glybride
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