- 1. ANTIDIABETIC DRUGS
- 2. Diabetes Mellitus Metabolic disorder characterized by
hyperglycemia, glycosuria Types: type I (IDDM) type II (NIDDM)
- 3. Actions of insulin Inhibits glycogenolysis Inhibits
gluconeogenesis Promotes glycogen synthesis Fat + glucose uptake +
storage of TG Inhibits lipolysis Muscle + protein synthesis +
glycogen synthesis - Protein breakdown
- 4. 1. Rapid acting a. Lispro b. Aspart c. Glulisine 2. Short
acting a. Regular insulin Insulin preparations
- 5. 3. Intermediate acting a. Insulin zinc suspension (lente) b.
Neutral Protamine Hagedorn (NPH) 4. Long acting a. Glargine b.
Detemir
- 6. Insulin administration All insulin preparations are
administered subcutaneously Regular insulin can be administered i.v
& i.m also
- 7. 1. Hypoglycemia Treatment- oral glucose 50ml of 50% dextrose
i.v 2. Local reactions lipodystrophy, swelling, erythema 3. Allergy
and resistance Adverse effects of insulin
- 8. Oral Antidiabetic Drugs
- 9. Classification A. Stimulators of insulin release from
pancreas i) Sulfonylureas Tolbutamide, chlorpropamide,
glibenclamide, glipizide, gliclazide, glimepiride ii) Meglitinide
analogue Repaglinide iii) D-phenylalanine derivative
Nateglinide
- 10. B. Inhibitors of hepatic neoglucogenesis Biguanides -
Phenformin, metformin C. Drugs which reduces insulin resistance
Thiazolidinediones - Rosiglitazone Pioglitazone D. - Glucosidase
inhibitors Acarbose, Miglitol
- 11. Adverse effects of sulfonylureas Hypoglycemia Nausea,
vomiting, diarrhoea, headache, weight gain Hypersensitivity
reactions Chlorpropamide - Cholestatic jaundice
- 12. Repaglinide & Nateglinide Rapid and short acting Low
risk of severe hypoglycemia
- 13. Biguanides Adverse effects Nausea, metallic taste,
abdominal pain, diarrhea Lactic acidosis Vitamin B12
deficiency
- 14. Thiazolidinediones Adverse effects Nausea, vomiting,
anemia, weight gain, fluid retention, hepatotoxicity (rare)
- 15. Glucosidase inhibitors Adverse effects Flatulence, loose
stools, abdominal pain
- 16. Therapeutic uses Type II DM Alone or in combination with
insulin Cannot be used for Type I DM