Diabetes medications

Drug / Examples / Mechanism / Uses / Side Effects
Insulin / Lispro
Aspart
Glulisine / Binds insulin receptor
Incr. liver/muscle glycogen
Incr. protein synthesis
Incr. K+ cell uptake
Incr. TG storage / Type 1 DM
Type 2 DM
Gestational DM
DKA
Stress hyperglycemia / Hypoglycemia
Lipodystrophy
Hypersensitivity
Regular
NPH
Detemir
Glargine
Biguanides / Metformin / Mechanism unknown
Decr. gluconeogenesis
Incr. glycolysis
Incr. peripheral glucose uptake / First line in T2DM
Cause modest weight loss
Oral agent / GI upset
Lactic acidosis
(Contraindicated w/
renal insufficiency)
Sulfonylureas / Chlorpropamide
Tolbutamide / Close K+ channel in B-cells
Depolarization
Endogenous insulin release / T2DM
Useless in T1DM
(requires working islets) / Hypoglycemia
(incr. in renal failure)
Weight gain
Disulfiram (1st gen.)
Glimepiride
Glipizide
Glyburide
Glitazones/
Thiazolidinediones / Pioglitazone
Rosiglitazone / Incr. peripheral insulin sensitivity
Binds PPAR-γ (nuclear receptor) / T2DM monotherapy
Combined w/ above drugs
Safe w/ renal impairment / Weight gain, edema
Hepatotoxicity
Heart failure
Incr. fracture risk
Meglitinides / Nateglinide
Repaglinide / Bind K+ channel in B-cells
(different site than sulfonylurea)
Stimulate postprandial release / T2DM monotherapy
Combined w/ metformin / Hypoglycemia
(incr. in renal failure)
Weight gain
GLP-1 analogs / Exenatide
Liraglutide / Incr. glucose-dependent release
Decr. glucagon release
Decr. gastric emptying
Incr. satiety / T2DM / Nausea/vomiting
Pancreatitis
Modest weight loss
DPP-4 inhibitors / Linagliptin
Saxagliptin
Sitagliptin / Inhibits DPP-4 (GLP-1 inhibitor)
Incr. GLP-1 levels
Same effects as GLP-1 analogs / T2DM / Mild urinary infections
Mild respiratory infections
Amylin analogs / Pramlintinde / Decr. gastric emptying
Decr. glucagon / T1DM
T2DM / Hypoglycemia
Nausea
SLGT-2 inhibitors / Canagliflozin
Dapagiflozin
Empagliflozin / Block glucose reuptake in PCT / T2DM / Glucosuria, UTIs
Vaginal infections
Hyperkalemia
Dehydration
a-glucosidase inhibitors / Acarbose
Miglitol / Inhibit intestinal a-glucosidases
Decr. glucose absorption
Decr. postprandial hyperglycemia / T2DM / GI disturbances
(massive flatulence)

Other Endocrine Drugs

Drug / Examples / Mechanism / Uses / Side Effects
Thionamides / Propylthiouracil (PTU)
Methimazole / Block thyroid peroxidase
Inhibit iodide oxidation
Inhibit iodide organification
PTU: blocks 5’-deiodinase / Hyperthyroidism
PTU: safe in pregnancy / Skin rash
Agranulocytosis
Aplastic anemia
Hepatotoxicity
Methimazole: aplasia cutis
Thyroid hormones / Levothyroxine (T4)
Triiodothyronine (T3) / Thyroid hormone replacement / Hypothyroidism
Myxedema
Weight loss (off label) / Tachycardia
Heat intolerance
Tremors
Arrhythmias
Hypothalamic/
Pituitary
Drugs / Conivaptan
Tolvaptan / Block ADH (V2 receptor)
(Demeclocycline is a
tetracycline antibiotic) / SIADH / Nephrogenic DI
Demeclocycline:
Photosensitivity
Bone/teeth abnormalities
Demeclocycline
Desmopressin / ADH analog / Central DI
(notnephrogenic)
Recombinant GH / GH analog / GH deficiency
Turner syndrome
Pitocin / Oxytocin analog / Stimulates labor
Uterine contractions
Incr. milk letdown
Control uterine hemorrhage
Octreotide / Somatostatin analog
Inhibits multiple hormones
(GH, serotonin, glucagon,
gastrin, CCK) / Acromegaly
Carcinoid syndrome
Gastrinoma
Glucagonoma
Esophageal varices / Gallstones
Glucocorticoids / Beclomethasone
Dexamethasone
Hydrocortisone
Methylprednisolone
Prednisone
Triamcinolone / Metabolic/catabolic effects
Anti-inflammatory effects
Immunosuppressive effects
Inhibit PLase-A2
Inhibit transcription factors / Adrenal insufficiency
Inflammation
Immunosuppression
Asthma / Iatrogenic Cushing syndrome
Adrenocortical atrophy
Steroid diabetes
Steroid psychosis
Cataracts
Insufficiency if not tapered
Fludrocortisone / Aldosterone analog
Little glucocorticoid effects / Mineralocorticoid replacement
(1O adrenal insufficiency) / Similar to glucocorticoids
Edema
HF exacerbation
Hyperpigmentation
Cincalcet / Sensitize CaSR in PT gland
(decr. PTH secretion) / 1O/2O hyperparathyroidism / Hypocalcemia