Medicine & USMLE

Meglitinides

703 views
Diabetes Drugs
  1. Insulin Overview
  2. Rapid Acting Insulin
  3. Short Acting Insulin
  4. Intermediate Acting Insulin
  5. Long Acting Insulin
  6. Metformin
  7. Sulfonylureas
  8. Meglitinides
  9. Thiazolidinediones (TZDs)
  10. DPP-4 Inhibitors
  11. Incretin Mimetics
  12. SGLT2 Inhibitors
  13. Alpha Glucosidase Inhibitors
  14. Pramlintide

Summary

Meglitinides are a drug class that end with “-glinides”, like nateglinide and repaglinide. They are used to treat type 2 diabetes mellitus. Meglitinides work by increasing insulin release and are short acting. One side effect is hypoglycemia, and the risk increases with use of gemfibrozil. Another side effect is weight gain. Meglitinides should be taken with every meal.

Key Points

  • Meglitinides
    • Drug Names
      • -glinide Ending
        • Nateglinide (Starlix)
        • Repaglinide (Prandin)
    • Mechanism
      • Increases insulin release
        • Meglitinides act on the beta cells in the pancreas to increase the amount of insulin released, thus lowering blood glucose levels
      • Short Acting
        • Rapid onset and short duration of action
          • Meglitinides peak in less than one hour and have a duration of up to 4 hours
    • Clinical Use
      • Treats Type 2 Diabetes Mellitus (DM)
    • Side Effects
      • Causes Hypoglycemia
        • Gemfibrozil increases risk of hypoglycemia
          • Gemfibrozil is a cholesterol lowering medication that inhibits the breakdown of repaglinide, causing the drug to accumulate in the bloodstream, leading to hypoglycemia
        • Closely monitor blood glucose levels and observe for symptoms of hypoglycemia
      • Causes Weight Gain
      • May cause chest pain (angina)
    • Administration
      • Take with meals
        • Patient should eat within 30 minutes of taking a meglitinide
        • If the patient skips a meal (i.e. doesn’t eat breakfast), the dose should be skipped