Diabetes

PHARMACOTHERAPY OF DIABETES MELLITUS Aaditya Udupa

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BLOOD GLUCOSE Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],LIVER TG synthesis Acetyl Co A Fatty liver Ketone bodies Gluconeogenesis Cholesterol synthesis Metabolised Dr. Aaditya Hypertriglyceridemia

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

[object Object],Dr. Aaditya PREP. pH Protein Onset [hrs] Peak [hrs] Dura [hrs] Remarks Regular 3.2 - 0.5 -1 2-4 6-8 ,[object Object],[object Object],Semilente 7.2 - 1 8 12-14 I.M or S.C

[object Object],Dr. Aaditya PREP. pH Protein Onset [hrs] Peak [hrs] Dura [hrs] Remarks Regular 3.2 - 0.5 -1 2-4 6-8 ,[object Object],[object Object],Semilente 7.2 - 1 8 12-14 I.M or S.C Isophane [NPH] 7.2 Protamine 1-2 6-12 18-24 I.M or S.C Lente 7.2 - 1-2 6-12 18-24 I.M or S.C

[object Object],Dr. Aaditya PREP. pH Protein Onset [hrs] Peak [hrs] Dura [hrs] Remarks Regular 3.2 - 0.5 -1 2-4 6-8 ,[object Object],[object Object],Semilente 7.2 - 1 8 12-14 I.M or S.C Isophane [NPH] 7.2 Protamine 1-2 6-12 18-24 I.M or S.C Lente 7.2 - 1-2 6-12 18-24 I.M or S.C PZI 7.2 Protamine 4-6 14-18 24-36 Not used now-a-days Ultralente 7.2 4-6 14-18 24-36 I.M or S.C

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

Dr. Aaditya LIMITATION PRECAUTION/ TREATMENT HYPOGLYCEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],INSULIN RESISTANCE ,[object Object],[object Object],[object Object],[object Object],INSULIN ALLERGY ,[object Object]

Dr. Aaditya LIMITATION PRECAUTION/ TREATMENT INSULIN LIPODYSTROPHY ,[object Object],[object Object],INSULIN EDEMA/ PRESBYOPIA/ NEUROPATHY Requires frequent injections Jet injections, Inhaled insulin, Insulin pumps Does not mimic physiologic pattern [high hepatic] Investigational- Rectal route, Intraperitoneal injection, liposomal preparations for oral use Plasma insulin level does not exactly match the BSL Microprocessor containing devices- artificial pancreas--- Used mainly for research purpose 30 min lag period  rigid planning of meal timings Use insulin lispro/ aspart/ glulysine

Dr. Aaditya ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dr. Aaditya 1 . The rapid acting insulin analogue formed by replacing proline of B28 with aspartic acid. 2. The rapid acting insulin analogue formed by replacing lysine at B29 with glutamine and lysine replaces aspargine at B23. 3. The rapid acting insulin analogue that is formed by exchanging the positions of amino acids at B28 and B29. 4 The insulin analogue whose pharmacokinetic pecularity depends on the acidic pH of the preparation and gives a prolonged action on s/c injection . ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dr. Aaditya SULFONYLUREAS BIGUANIDES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dr. Aaditya SULFONYLUREAS BIGUANIDES HYPOGLYCEMIC ANTIHYPERGLYCEMIC Weight gain Anorexia and Weight loss Requires atleast 30% functioning pancreas Requires presence of insulin for its action Hypoglycemia; Skin rash; Antabuse reaction & cholestatic jaundice [Chlorpropamide] Lactic acidosis GI upset B 12 and folate defeciency

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Aaditya

Diabetes

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