| ORAL
AND INJECTABLE AGENTS FOR DIABETES
Updated
11/2007
CLASS:
Sulfonylureas
MODE
OF ACTION ACTION:
Stimulate
pancreas to make more insulin.
Must be making insulin to start.
Has potential to cause hypoglycemia.
GENERIC
NAME - BRAND NAME
acetohexamide - generic only
chloropropamide - Diabinase
glimepiride - Amaryl peak 2-3 hours
glipizide - Glucotrol peak 1-3 hours
glipizide-long acting - Glucotrol XL peak 6-12 hours
glyburide - DiaBeta, Micronase peak 4 hours best on empty stomach
glyburide- micronized micronized - Glynase PresTab peak 2 hours
best on empty stomach
tolazamide - Tolinase
tolbutamide - Orinase
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CLASS: Meglitinides
MODE
OF ACTION:
Stimulate
pancreas to make more insulin. kicks in faster than sulfonylureas
Must be making insulin to start. take 15 minutes before meals
Has potential to cause hypoglycemia.
GENERIC
NAME BRAND NAME
repaglinide - Prandin
nateglinide - Starlix
__________________________________________________________________________________
CLASS: Biguanides
MODE OF ACTION:
Inhibit glucose output
by liver. Rarely causes
hypoglycemia unless used in combination with
sulfonylureas, meglitinides or insulin.
GENERIC NAME - BRAND
NAME
metformin - Glucophage
metformin -long acting - Glucophage XR
__________________________________________________________________________________
CLASS: Thiazolidinediones (TZD's)
MODE OF ACTION:
Promote glucose uptake
by muscle and fat. Rarely
causes hypoglycemia unless used in combination with
sulfonylureas, meglitinides or insulin.
GENERIC NAME - BRAND
NAME
rosiglitazone - Avandia
pioglitazone - Actos
__________________________________________________________________________________
CLASS Alpha-Glucosidase Inhibitors
MODE OF ACTION:
Inhibit glucose uptake
from gut. Rarely causes take with first bite of food
hypoglycemia unless used in combination with
sulfonylureas, meglitinides, or insulin. Can be gassy.
GENERIC NAME - BRAND NAME
acarbose - Precose
miglitol - Gylset
__________________________________________________________________________________
CLASS: Combination Pills
MODE OF ACTION:
See above for each drug
in the combination above
GENERIC NAME - BRAND NAME
metformin + glyburide - Glucovance
metformin + rosaglitazone - Avandamet
metformin + glipizide - Metaglip
___________________________________________________________________________________
CLASS: Incretin Mimetics -INJECTED
MODE OF ACTION:
combination of all the
above
GENERIC NAME - BRAND
NAME
exenatide - Byetta used with type 2
pramlintide - Symlin used with type 1 and 2 who use insulin,
can cause severe hypoglycemia
__________________________________________________________________________________
INSULIN - ONSET - PEAK
EFFECTIVE - DURATION
RAPID ACTING - 15-30 minutes - 1/2-1 hour - 3-4 hours
lispro-humalog
aspart -novolog
glulisine apidra
INSULIN POWDER -10-20
minutes - 2 hours - 6 hours
exhubera
SHORT ACTING - 1/2-1
hour - 2-3 hours - 3-6 hours
regular
INTERMEDIATE - 2-4 hours
- 6-10 hours - 10-16 hours
NPH
LONG ACTING - 1-2 hours
- peakless - 24 hours
glargine-lantus
detemir-levemir
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