Drugs used in diabetes treat diabetes mellitus by altering the glucose level in blood. With the exceptions of insulin ,exenatide and pramlintide, all are administered orally and are thus also called oral hypoglycemic agents.
Types of Anti-diabetic drugs:
Combination of sulfonylureas plus metformin- known by generic names of two drugs.
Classification of Anti-diabetic drugs:
1st generation ; Tolbutamide
2nd generation; Glibenclamide , Glipizide
Glucagon-like peptide – [GLP-1] receptor agonists:
Dipeptidyl peptidase-4 [DPP-4] inhibitors:
Mechanism of Action:
Inhibits potassium efflux [blocks ATP- regulated K channels] causing depolarization and insulin release from pancreatic Beta-cell.
Metformin, It works by lowering glucose production in the liver and improving your body’s sensitivity to insulin so that your body uses insulin more effectively. If not at target, stage 1: Start with lifestyle and metformin. If A1C ≥7.5% (10) or ≥9% (9,10), consider short-term combination therapy or insulin, respectively.
The drugs which are used to treat bronchial asthma are called anti-asthmatic drugs.
Types of Asthma:
Characterized by episodes of dyspnea along with expiratory wheezing.
There is continous wheezing & breathlessness on exertion and recurrent respiratory infection.
Classification of anti asthmatic drugs:
Leukotriene Receptor Antagonist:
Mast cell Stabilizer:
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Mechanism of Action:
- Sympathomimetics act by stimulating beta2-receptors in bronchial smooth muscle and mast cells and the level of cyclic adenosine monophosphate increases and as a result bronchodilatation occurs which inhibits the release of histamine, SRS-A from mast cells and promote muco-ciliary clearance there is inhibition of phospholipase A2.
- Prostaglandins & Leukotrienes level decreases.
- Number of inflammatory cells in airways decreases.
- Histamine release decreases.
- Capillary permeability & mucosal edema decreases.
- Inhibition of antigen antibody.
- Up-regulate beta-2 receptors.
Pharmacokinetics of anti asthmatic drugs:
Methylxanthines: These are well absorbed after oral & parental administration, food delays rate of absorption of theophyline, distributed throughout the body can cross blood brain barrier metabolized through liver and excreted through urine.
Theophyline: It is poorly soluble in water not suitable for injection and available for oral administration.
Aminophyline: It is water soluble but so irritant can be given orally or slowly intravenously.
Etophyline: It is water soluble can be administered orally via intramuscular or intravenous pathway.
- Bronchial asthma
- reduce Apnea episodes
- cause Broncho-dilation
- cause Cardiac stimulation
- Episodic Asthmatic attacks
- Nocturnal awakenings
These drugs have narrow margin of safety because it may cause tachycardia, palpitation, hypotension and sometimes sudden death due to cardiac arrhythmia,
- Peptic ulcer
Anti asthmatic Drugs interaction:
The drug is more likely to interact with anti-anginals, anti-diabetics, anti-hypertensives, anti-epileptics anticoagulants and oral contraceptives.