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DM drugs - Coggle Diagram
DM drugs
Mechanism
Activate AMP kinase
Metformin (Biguanide)
Type 2 first line
BW loss effect
Adverse effect
Lactic acidosis
D / N
Not for low kidney function patients
Improve cardiovascular outcomes
Inhibit ATP-sensitive K+ channel @ beta cell
Sulfonylureas (SU)
Rapid onset
Long HL
Prefix
Gli-
Gly-
Not for low hepatic/renal fc. patients
non-SU insulin secretagogues (NSIS)
Meglitinides
Short-acting
E.g.
Repaglinide
Nateglinide
Okay for low hepatic/renal fc. patients
GLUT-1 & GLUT-4 expression increases
Thiazolidinediones (TZDs)
Target
Muscle
Liver
Adipocyte
Gene expression
Takes time to react
Activation of PPARγ
E.g.
Rosiglitazone (off)
Pioglitazone (off)
Adverse eff.
BW gain
Water retention
Decrease Glc reabsorption @ S1 seg. of proximal tubule
SGLT2 Inhibitors
Drugs
Dapagliflozin
Empagliflozin
Canagliflozin
P.O.
SID
Only for type 2 DM
Adverse eff.
UTI
Hyperkalemia
Renal
Improve cardiovascular outcomes
Sodium-glucose co-transporter 2
Incretin-based therapy
Incretin
GLP-1 (glucagon-like peptide 1)
Target
Pancreas
CNS
Short HF
Due to degradation of DPP4 (dipeptidyl peptidase 4)
FC
Insulin secretion when Glc exist
Drugs
GLP-1 mimetics
Exenatide (Byetta)
Liraglutide (Victoza)
Not affected by DPP4
I.M.
Inhibition of gastric emptying
DPP4 inhibitors
Vildagliptin(Galvus)
Saxagliptin(Onglyza)
Sitagliptin(Januvia)
Linagliptin(Trajenta)
P.O.
Adverse eff.
N / V
Pancreatitis