Noninsulin antidiabetic agents for type 2 diabetes mellitus

Sulfonylureas, Meglitinides

Insulin secretagogues

Mechanism of Insulin Sulfonylureas

increase insulin secretion by inhibiting beta-cell K ATP channels

adverse effect of Sulfonylureas

Hypoglycemia, weight gain

Metformin

Biguanides

Mechanism of Biguanides

Stimulate AMPK & inhibit mitochondrial gluconeogenesis

lower hepatic glucose production, increase peripheral glucose uptake

Adverse effect of Metformin

Diarrhea, Lactic acidosis, Mild weight loss

Adverse effect of Pioglitazone

Fluid retention/heart failure, weight gain

Mechanism of Pioglitazone

Activate transcription regulator PPAR-gamma, lower insulin resistance

Exenatide, Liraglutide

GLP-1 agonist

Mechanism of GLP-1 agonists

increase glucose-dependent insulin secretion, lower glucagon secretion, delayed gastric emptying

Side effect of GLP-1 (Exenatide, Lraglutide)

Pancreatitis, Weight loss

Mechanism of DPP-4 inhibitors

increase endogenous GLP-1 & GIP levels

Side effect of DPP-4 inhibitors

Nasopharyngitis

atenolol

selective beta 1 adrenergic antagonist

beta 1 receptors found in

cardiac tissue and on renal juxtaglomerular cells

encapsulated bacteria

Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae

deep, purulent painful genital ulcers with suppurative lymphadenitis

Haemophilus ducreyi

what is a cause of multiple, painful, superficial vesicles or ulcerations with erythematous base,

bilateral painful lymphadenopathy

HSV

Tzanck smear

Syphilis diagnostic test

VDRL/RPR

Darkfield microscopy

Cause of painless, progressive, red, serpiginous, ulcerative genital lesions with no lymphadenopathy

Klebsiella granulomatis (granuloma inguinale)

causes of diabetes insipidus

Pituitary tumors or resection

head trauma

primary brain tumors or infiltrative lesions (sarcoidosis, lymphoma)

brain metastases

nephrogenic cause of diabetes insipidus

drugs (lithium, amphotericin B, gentamicin, cisplatin)

Hypercalcemia

Hypokalemia

Post obstructive diuresis