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Pancreatic Hormones & Antidiabetic Drugs. By S. Bohlooli, PhD Pharmacology Department School of Medicine, Ardabil University of Medical Sciences. Pancreatic islet cells and their secretory products. Diabeted mellitus. Two major type of diabetes mellitus Type I Type II
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Pancreatic Hormones & Antidiabetic Drugs By S. Bohlooli, PhD Pharmacology Department School of Medicine, Ardabil University of Medical Sciences
Diabeted mellitus • Two major type of diabetes mellitus • Type I • Type II • Both require careful monitoring of: • Diet, fasting, postprandial blood glucose • Hemoglobin A1c,
Insulin • Physiology • Proinsulin: 86 amino acid • C-peptide: 31 amino acid • Effects • Liver • Skeletal muscle • Adipose tissue
One model of control of insulin release from the pancreatic B cell
Insulin preparation • Rapid-acting • Short-acting • Intermediate-acting • Long-acting • Insulin delivery systems
Hazards of insulin use • Hypoglycemia • Insulin induced immunologic complication
Non Insulin antidiabetic drugs • Insulin secretagogues • Biguanide metformin • Thiazolidinediones • Alpha-glucosidase inhibitors
Insulin secretagogues • Group drugs: • Sulfunylureas: tolbutamide, chlorpropamide, glyburide, glipizide, glimepride • Mechanism of action • Closure of potassium channel • Toxicity • Hypoglycemia, allergic reactions • Weight gain
Insulin secretagogues: Sulfonylureas • First-Generation Sulfonylureas • Tolbutamide, Chlorpropamide, Tolazamide • Second-Generation Sulfonylureas • Glyburide, Glipizide, Glimepiride
Biguanides: metformin • Mechanism of action • Inhibit gluconeogenesis • Induction of glucose uptake in periphery • Slowing the absorption of glucose • Reduction of glucagon level • Toxicity • Gastrointestinal distress • Lactic acid in some patiets
Thiazolidinediones • Group drugs: • rosiglitazone, pioglitazone • Mechanism of action • Increase target tissue sensivity • Activating: peroxisome proliferator-activated receptor-gamma nuclear receptor (PPAR- receptor) • Toxicity • Fluid retention, MI, bone fracture • Liver enzyme inducers
Alpha glucosidase inhibitors:acarbose, miglitol • Mechanism of action • Inhibit -glucosidase • Toxicity • Flatulence, diarrhea, abdominal pain
Miscellaneous • Paramlitide • Exenatide • Sitagliptin