Pharm Module 6 Prototype drugs

Glyburide

• Brand name: Diabeta

• Therapeutic class: Anti-diabetic drug

• Pharm class: Sulfonylureas

• Primary use: Given PO, indicated for type 2 DM

• MOA: Lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites.

• Adverse effects: Hypoglycemia, aplastic anemia, photosensitivity

Metformin

Brand name: Glucophage

Therapeutic class: Anti-diabetic drug

Pharm class: Hypoglycemic drug; Biguanide

Primary use: Management of type 2 DM

MOA: Decreases hepatic glucose production, and intestinal glucose absorption, and increases sensitivity to insulin

Adverse effects: GI-related, N/V, abdominal discomfort, metallic taste, diarrhea, and anorexia

Acarbose

• Brand name: Precose

• Therapeutic class: Anti-diabetic drug

• Pharm class: Alpha-Glucosidase

• Primary use: Management of type 2 DM in conjunction with dietary therapy

  • May be used with insulin or hypoglycemic agents

• MOA: Lowers blood glucose by inhibiting the enzyme alpha-glucosidase in the GI tract; delays/reduces glucose absorption

• Adverse effects: Abdominal pain, diarrhea, flatulence

Rosiglitazone

• Brand name: Avandia

• Therapeutic class: Anti-diabetic drug

• Pharm class: Thiazolidnediones

• Primary use: Type 2 DM

• MOA: Improves sensitivity to insulin by acting as an agonist at receptor sites involved in insulin responsiveness and glucose production/utilization

• Adverse effects: Heart failure, stroke, angioedema

Repaglinide

• Brand name: Prandin

• Therapeutic class: Anti-diabetic drugs

• Pharm class: Meglitinides

• Primary use: Type 2 DM

• MOA: Stimulates the release of insulin from pancreatic beta cells by closing potassium channels (opening of calcium channels in beta cells); Releases insulin and lowers blood glucose levels

• Adverse effects: Hypoglycemia

Nateglinide

• Brand name: Starlix

• Therapeutic class: Anti-diabetic drug

• Pharm class: Meglitinides

• Primary use: To improve glycemic control in pts with Type 2 diabetes

• MOA: Stimulates the release of insulin from pancreatic beta cells by closing potassium channels (opening of calcium channels in beta cells); releases insulin and lowers blood glucose levels

• Adverse effects: Hypoglycemia, dizziness

Sitagliptin

• Brand name: Januvia

• Therapeutic class: Anti-diabetics

• Pharm class: DDD-4 Inhibitors, enzyme inhibitors

• Primary use: Type 2 diabetes mellitus

• MOA: Inhibits the enzyme dipeptidyl peptidase-4 (DPP-4) which slows the inactivation of incretin hormones; improves control of blood glucose

• Adverse side effects: Hypoglycemia (tremors, palpitations, sweating), anaphylaxis, pancreatitis

Semaglutide

• Brand name: Ozempic

• Therapeutic class: Antidiabetics

• Pharm class: DDD-4 Inhibitors, enzyme inhibitors, glucagon-like peptide 1 glp 1 receptor agonists

• Primary use: Type 2 diabetes

• MOA: Acts as an acylated human glucagon-like peptide-1 (GLP-1, an incretin) receptor antagonist and it decreases glucagon secretion, delaying gastric emptying; improved glycemic control

• Adverse side effects: Hypoglycemia (tremors, palpitations, sweating), anaphylaxis, pancreatitis

Empagliflozin

• Brand name: Jardiance

• Therapeutic class: Anti-diabetic

• Pharm class: SGLT-2 inhibitors

• Primary use: Type 2 diabetes, reduce risk of cardiovascular death for patients with type 2 diabetes

• MOA: Inhibits proximal renal tubular sodium-glucose co-transporter 2 (SGLT2) which lowers the renal threshold for glucose and increases the excretion of glucose in the urine

  • Improved glycemic control

• Adverse side effects: Ketoacidosis, hypersensitivity (angioedema), necrotizing fasciitis of the perineum

Lispro

• Brand name: Humalog

• Therapeutic class: Antidiabeics; hormones

• Pharm class: Rapid-Acting Insulin; Pancreatic

• Primary use: Type 1 and 2 diabetes mellitus

• MOA: Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat and inhibits hepatic glucose production; improved glycemic control

• Adverse side effects: Hypoglycemia, hypersensitivity (anaphylaxis)

Aspart

• Brand name: Novolog

• Therapeutic class: Anti-diabetics; hormones

• Pharm class: Rapid-Acting Insulin; Pancreatics

• Primary use: Control of hyperglycemia in patients with type 1 or 2 diabetes mellitus

• MOA: Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat and inhibits hepatic glucose production; improved glycemic control (control of hyperglycemia in diabetic patients)

• Adverse side effects: Hypoglycemia, hypersensitivity (anaphylaxis)

Regular insulin

• Brand name: Humulin R

• Therapeutic class: Antidiabeics; hormones

• Pharm class: Short-Acting Insulin; Pancreatics

• Primary use: Control of hyperglycemia for diabetes mellitus; treatment of hyperkalemia

  • Concentrated regular insulin U-500

• MOA: Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat and inhibits hepatic glucose production; improved glycemic control (control of hyperglycemia in diabetic patients)

• Adverse side effects: Hypoglycemia, hypersensitivity (anaphylaxis)

NPH

• Brand name: Humulin N

• Therapeutic class: Antidiabeics; hormones

• Pharm class: Intermediate-Acting Insulin; Pancreatics

• Primary use: Control of hyperglycemia for diabetes mellitus

• MOA: Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat and inhibits hepatic glucose production; improved glycemic control (control of hyperglycemia in diabetic patients)

• Adverse side effects: Hypoglycemia, hypersensitivity (anaphylaxis)

Detemir

• Brand name: Levemir

• Therapeutic class: Anti-diabetics; hormones

• Pharm class: Long-Acting Insulin; Pancreatics

• Primary use: Type 1 and 2 diabetes mellitus

• MOA: Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat and inhibits hepatic glucose production; improved glycemic control (control of hyperglycemia in diabetic patients)

• Adverse side effects: Hypoglycemia, hypersensitivity (anaphylaxis)