{"id":6640,"date":"2024-11-18T20:40:07","date_gmt":"2024-11-18T20:40:07","guid":{"rendered":"https:\/\/workhouse.sweetdishy.com\/?p=6640"},"modified":"2024-11-18T20:40:09","modified_gmt":"2024-11-18T20:40:09","slug":"antidiabetogenic-drugs","status":"publish","type":"post","link":"https:\/\/workhouse.sweetdishy.com\/index.php\/2024\/11\/18\/antidiabetogenic-drugs\/","title":{"rendered":"Antidiabetogenic drugs"},"content":{"rendered":"\n<p><strong>I. INSULIN<\/strong><br>Sources include pork or beef, combination of pork and beef and also human insulin<br>(Recombinant DNA technique)<br><strong>Actions:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Insulin lower blood glucose level through increasing utilization of glucose by peripheral<br>tissue and promoting synthesis and storage of glycogen<\/li>\n\n\n\n<li>The main actions of the hormone are exerted on metabolism of carbohydrate (CHO), fat and<br>protein in liver, muscle &amp; adipose tissue.<br><strong>Effects of insulin<\/strong><br>Carbohydrate metabolism<br>Liver: it increases glycogen synthesis from glucose and glucose utilization while<br>decreases gluconeogenesis and glycogenolysis<br>Muscle: it increases glucose uptake, glucose utilization and glycogen synthesis.<br>Adipose tissue: it increases glucose uptake and glycerol synthesis (esterifies fatty acid)<br>Fat metabolism<br>Liver: it increases lipogenesis<br>Adipose tissue: it increases synthesis of triglycerides and synthesis of fatty acid<br><br>Protein metabolism<br>Liver: it increases protein catabolism<br>Muscle: it increases aminoacid uptake and protein synthesis<br>Other metabolic effect:<br>It increases uptake of K+<br>and Ca++ into cells and synthesis of nucleic acids<br>There are some factors that increase insulin demand: like Infection, surgery, pregnancy and<br>drugs (those that antagonize actions of insulin glucocorticoids, thyroid hormone, adrenaline)<br><strong>Type of insulin preparation:<\/strong><br>A. Short acting (rapid onset): Eg Regular Insuline<br>B. Intermediate acting Eg Lente insuline,NPH insuline<br>C. Long acting E.g Protamine Zn insuline<br><strong>Types Route Onset (hrs) Duration (hrs)<br>Regular insulin IV, SC, IM \u00bc &#8211; 1 5 \u2013 7<br>Lente insulin SC, IM 1 \u2013 1\u00bd 18 \u2013 24<br>Protamine Zn insulin SC, IM 4 \u2013 8 36<\/strong><br>N.B. It is only regular insulin that can be given by intravenous route.<br><strong>Therapeutic use <\/strong>-IDDM, NIDDM (not controlled by diet and oral hypoglycemic agents), diabetic<br>ketoacidosis, Control of diabetes in pregnancy, during surgery and in infections.<br>They are also used in the treatment of hyper kalmia due to renal failure<br><strong>Adverse Reaction:<\/strong> can be categorized as<br>Local: Atrophy or hypertrophy at site of injection, local hypersensitivity and secondary<br>infections.<br>Systemic: Hypoglycemic coma and Immunologic reaction like hypersensitive and insulin<br>resistance<br><strong>II. ORAL HYPOGLYCEMICS<\/strong><br>These are drugs administered orally to lower blood glucose level used in mild diabetes.<br>They are grouped as Sulphonylureas and Biguinides.<br><br><strong>Sulphonyl ureas<br><\/strong>These compounds are chemically related to sulphonamides.<br>First generation: Tolbutamide, Chlorpropamide<br>Second generation: Glibenclamide, Glipizide<br>Mechanism: hypoglycemic action is due to Stimulation of insulin release from \u03b2 cell, Depression<br>of glucagon secretion, Increase number of insulin receptor, Reduce insulin output from liver<br>(Decrease hepatic gluconeogenesis and glycogenolysis)<br>Pharmacokinetics: They are rapidly absorbed from the gastrointestinal tract. They are also<br>extensively plasma protein bound and are mainly metabolized in the liver.<br>Use: Mild diabetes mellitus in old patients (type II)<br><strong>Adverse reaction:<\/strong> The toxicity of these compounds is remarkably low. The important toxic<br>effects include: hypoglycemia, allergic skin rash and bone marrow depression, cholestatic<br>jaundice (esp. chlorpropamide)<br><strong>Side effects<\/strong>: Gastric irritation, prolonged hypoglycemia (esp. chlorpropamide), large doses<br>confusion, vertigo, ataxia, leucopenia, aggranulocytosis, thrombocytopenia, and teratogenecity<br><strong>Drug interaction:<\/strong><\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Hypoglycemia is enhanced by sulphonamides, phenylbutazone<\/li>\n\n\n\n<li>Alcohol produces \u201cDisulfirum\u201d like action (flushing of the face, severe headache,<br>vomiting etc.)<\/li>\n\n\n\n<li>Sulphonyl ureas increase anticoagulant effect of oral anticoagulant<\/li>\n\n\n\n<li>Thiazides oppose the action of sulphonylureas.<br><strong>Biguinides<\/strong><br>They potentiate the hypoglycemic action of insulin and sulphonyl ureas but they don\u2019t produce<br>clinical hypoglycemia in diabetics.<br>Biguanides include drugs like metformin and phenformin<br>Mechanism: They do not stimulate the release of insulin. They increase glucose uptake in<br>skeletal muscle, and have effects on glucose absorption and hepatic glucose production.<br>They also enhance anaerobic glycolysis.<br><br><strong>Pharmacokinetics<\/strong>: Phenformin and metformin are rapidly absorbed from the gastrointestinal<br>tract. Metformin is largely excreted unchanged in the urine and has a longer duration of<br>action.<br>Side effects: Nausea, vomiting, anorexia, diarrhea, abdominal cramp, lactic acidosis (esp.<br>phenformin)<br>Use: Obese diabetics (uncontrolled by diet alone), Supplement to sulphonyl urea<br>Contraindication: Diabetes with hepatic, renal insufficiency, In IDDM, NIDDM (with<br>infection, fever, surgery) and during pregnancy<br>They have no value in diabetes complicated by acidosis or coma<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>I. INSULINSources include pork or beef, combination of pork and beef and also human insulin(Recombinant DNA technique)Actions:<\/p>\n","protected":false},"author":1,"featured_media":6510,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[683],"tags":[],"class_list":["post-6640","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocrine-drugs"],"jetpack_featured_media_url":"https:\/\/workhouse.sweetdishy.com\/wp-content\/uploads\/2024\/11\/18179857.png","_links":{"self":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6640","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/comments?post=6640"}],"version-history":[{"count":1,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6640\/revisions"}],"predecessor-version":[{"id":6641,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6640\/revisions\/6641"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media\/6510"}],"wp:attachment":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media?parent=6640"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/categories?post=6640"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/tags?post=6640"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}