Pharmacology · MU Sofia

64. Oral antidiabetic drugs

Introduces oral antidiabetic drugs for type 2 diabetes and sets out seven classes with their example agents, from biguanides to alpha-glucosidase inhibitors. Goes on to explain how each class lowers blood glucose, then gives a table comparing absorption, metabolism, excretion and half-life for four drugs. Also covers common and rare side effects, interactions with other drugs and alcohol, therapeutic use, and advice on breastfeeding and pregnancy.

Inside: 8 sections · 3 labelled pictures · 1 table · 10 flashcards · 3 min

Topic 63 of 93 in the MU Sofia syllabus for Pharmacology (Medicine, Year 3). The free AceMed note covers it in 8 sections, about 413 words (3 min of reading), with 10 flashcards.

In this note

  1. Oral antidiabetic drugs
  2. Classification/Examples
  3. Pharmacodynamics
  4. Pharmacokinetics
  5. Side effects
  6. Drug interactions
  7. Therapeutic use
  8. Pregnancy and milk

Oral antidiabetic drugs

Oral antidiabetic drugs are medications used to manage blood glucose levels in individuals with type 2 diabetes.

Classification/Examples

  1. 1. Biguanides – Metformin
  2. 2. Sulfonylureas – Glipizide, Glyburide, Glimepiride
  3. 3. Meglitinides – Repaglinide, Nateglinide
  4. 4. Thiazolidinediones (TZDs) – Pioglitazone, Rosiglitazone
  5. 5. Dipeptidyl Peptidase-4 (DPP-4) Inhibitors – Sitagliptin, Saxagliptin, Linagliptin, Alogliptin
  6. 6. Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors – Canagliflozin, Dapagliflozin, Empagliflozin, Ertugliflozin
  7. 7. Alpha-Glucosidase Inhibitors – Acarbose, Miglitol

Pharmacodynamics

  • Biguanides reduce hepatic glucose production and improve insulin sensitivity in peripheral tissues.
  • Sulfonylureas stimulate insulin secretion from pancreatic beta cells, increasing insulin levels.
  • Meglitinides promote rapid, short-term insulin secretion from pancreatic beta cells, helping to control postprandial blood glucose spikes.
  • Thiazolidinediones (TZDs) enhance insulin sensitivity in muscle and adipose tissue by activating PPAR-gamma receptors, improving glucose uptake.
  • Dipeptidyl Peptidase-4 (DPP-4) Inhibitors increase incretin levels, which inhibit glucagon release and enhance insulin secretion, thereby lowering blood glucose levels.
  • SGLT2 Inhibitors reduce glucose reabsorption in the kidneys, leading to increased glucose excretion in urine and lowering blood glucose levels.
  • Alpha-Glucosidase Inhibitors slow down the breakdown of carbohydrates in the intestines, reducing postprandial glucose spikes and helping to manage blood glucose levels after meals.

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