KINE 2475 Lecture Notes - Lecture 52: Glibenclamide, Team Ldlc.Com, Hypotension

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Sulfonylureas: are ir or er formulations, dosed od-bid, enhance insulin secretion by binding to sur1 receptors on b-cells. Glyburide has higher risk of hypoglycemia compared to other sulfonylureas. Lower dose should be used in high-risk patients. Hypoglycemia on low-dose sulfonylureas means switch therapy: weight gain is common 1-2kg. Thiazolidinedione: pioglitazone & rosiglitazone for treatment of dm2, oral agents dosed od, work by binding to nuclear receptors on fat cell & vascular cells . Activation of receptors alters transcription of genes involved in glucose & lipid metabolism: tzds enhance insulin sensitivity at muscle, liver & fat tissues. Ldl-c increase with ros 5-15%, but not with pioglita. Differ in clinical efficacy, rate of ae, dosing schedules: short acting agents (exenatide & lixisenatide)- lower ppg levels. Long-acting agents (dulaglutide, liraglutidem exenatide xr, semaglutide)- lower both fpg, ppg. Liraglutide & semaglutide have high a1c & weight-lowering efficacy. Exenatide & lixisenatide-lowest: cv safe (myocardial infarction, stroke, cv death)

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