Endocrinology Book

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Non-Sulfonylurea Insulin SecretagoguesAka: Meglitinide, Repaglinide, Prandin, Nateglinide, Starlix

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  1. See Also
    1. Second Generation Sulfonylurea
  2. Mechanism
    1. Insulin secretogogue
  3. Indication
    1. Early Type II Diabetes Mellitus Oral Agent
    2. Elevated postprandial glucose
    3. Consider if only used intermittently pre-meal
  4. Contraindications
    1. Hypersensitivity Reaction to sulfa
  5. Category
    1. Insulin Secretagogue
  6. Mechanism
    1. Benzoic acid derivative
    2. Similar to Sulfonylurea
      1. Binds different sites from Sulfonylureas
      2. Closes ATP sensitive K+ channels
      3. Results in Insulin secretion
      4. Shorter duration of binding and shorter effect
    3. Predominately effects postprandial glucose
  7. Advantages
    1. Low risk of Hypoglycemia (2.4%)
    2. Effect depends on Ambient Blood Glucose levels
    3. No significant gastrointestinal side effects
    4. Minimal weight gain
    5. No lab monitoring required
    6. No significant drug interactions
    7. No Lactic Acidosis
    8. No adjustments needed (other than per meal)
      1. No adjustment in Congestive Heart Failure
      2. No adjustment for age
      3. No adjustment in renal insufficiency
  8. Adverse Effects
    1. Hypoglycemia (lower risk of Sulfonylureas)
  9. Disadvantages
    1. Two to three times as expensive as Sulfonylureas
  10. Agents
    1. Repaglinide (Prandin)
    2. Nateglinide (Starlix)
      1. Significantly weaker activity compared with Prandin
  11. References
    1. Luna (2001) Am Fam Physician 63(9):1747
    2. Luna (1999) Prim Care 26:895

meglitinide (C0065880)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC030516
Englishmeglitinide
Spanishmeglitinida
Parent ConceptsAntidiabetics (C0935929), Antidiabetic preparation (C1273672)
SourcesMSH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


repaglinide (C0246689)

Definition (NCI)A benzoic acid derivative belonging to the meglitinide class of antidiabetic agents. Repaglinide blocks ATP-dependent potassium channels in pancreatic beta cells, thereby causing depolarization of the cell membrane and subsequent opening of calcium channels. The increased calcium influx into the pancreatic beta cells induces insulin secretion, thereby lowering blood glucose levels.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC072379
Englishrepa-glinide, repaglinide, REPAGLINIDE PREPARATION
Spanishrepaglinida
Parent ConceptsAntidiabetics (C0935929), Carbamates (C0006948), Piperidines (C0031960), Oral hypoglycemic (C0359086), meglitinide (C0065880), Drug allergen (C1320237), Meglitinides (C1579432)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Prandin (C0722725)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC072379
EnglishNovo Nordisk brand 2 of repaglinide, Prandin
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


nateglinide (C0903898)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC060142
EnglishIPCCPA, nate-glinide, nateglinide, NATEGLINIDE PREPARATION, senaglinide
Spanishnateglinida
Parent ConceptsAntidiabetics (C0935929), A 4166 (C0067413), Oral hypoglycemic (C0359086), meglitinide (C0065880), Duplicate concept (C1274013), Meglitinides (C1579432)
SourcesLNC, MSH, MTHSPL, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Starlix (C1323198)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC060142
EnglishNovartis brand of nateglinide, Starlix
SourcesMSH, MTH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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