MOA: Blocks K+ channels in

INSULIN SECRETAGOGUES Beta cells

WOF:
SULFONYUREAS 1. Hypoglycemia
2. Disulfiram-like
FIRST GEN SECOND GEN
rxns
CHLORPROPRAMIDE GLIMEPIRIDE CHLORPROPRAMIDE
- Very long T ½
TOLBUTAMIDE GLIPIZIDE - C/I: Elderly
TOLBUTAMIDE
ACETOHEXAMIDE GLIBENCLAMIDE - Cardiotoxic
- Rapid onset
TOLAZAMIDE GLYBURIDE - Given to
elderly
WOF:
MEGLITINIDE 1. Hypoglycemia
2. Disulfiram-like rxns
REPAGLINIDE
Use: Post-prandial hyperglycemia
NETAGLINIDE NOTE: Take 30 min before breakfast

MOA: Activates AMP-

1. Insulin sensitizer activated protein
BIGUANIDES 2. Inc. Fatty Acid Oxidation kinase

METFORMIN WOF:
1ST LINE AGENT OF T2DM 1. Diarrhea
USED IN PCOS 2. Lactic acidosis ( inc. risk if dehydrated
PHENFORMIN or with congested liver/kidney)
Notes:
“Euglycemic” = NO HYPOGLYCEMIA
 MOA: acts on PPAR-GAMMA peroxisomal
THIALOZIDINEDIONES proliferator acting receptor (insulin sens.)

ROSIGLITAZONE WOF:
1. Hepatotoxicity
(Avandia) 2. Cardiotoxicity
PIOGLITAZONE
(Prialta, PPAR)

Incretin- produced in
ACTING ON INCRETIN SYSTEM response to oral glucose
DPP-IV load
GLP-1 Inactive For T1DM and T2DM

GLP-1 AGONIST + Metformin in atherosclerotic

CVD px
EXENATIDE (Byetta) - UNIQUE: WEIGHT LOSS
LIRAGLUTIDE - Dec. risk of Hypoglycemia
- Not assoc. with weight gain
LIXISENATIDE

DPP-IV ANTAGONIST WOF:

Pancreatitis
SAXAGLIPTIN (Onglyza)
SITAGLIPTIN (Januvia) - Dec. risk of
Hypoglycemia
VILDAGLIPTIN (Galus, Proglin) - Not assoc. with
LINAGLIPTIN (Trajenta) weight gain
TENEGLIPTINE (Glipten)
 Inbhits SGLT-2 transporter in the PCT
SGLT-2 INHIBITORS responsible for glucose reabsorption

CANAGLIFLOZIN WOF:
1. Euglycemic Diabetic Ketoacidosis
DAPAGLIFLOZIN 2. UTI and AKI
(Forsiga)
XIGDUO: Dapagliflozin + Metformin
EMPAGLIFLOZIN GLYAXMBI: Empagliflozin + Linagliptin

AMYLIN ANALOG
WOF:
PRAMLINTIDE 1. Hypoglycemia
2. Nausea and vomiting
3. Weight loss