Drugs play a role in the body by altering how the body works. Medication drugs prevent or cure diseases through the different mode of actions (Mozayoni & Raymon, 2012). In this study, Biguanides and Dipeptidyl peptidase-4 inhibitors will be discussed regarding their pharmacokinetics, pharmacodynamics and pharmacotherapeutic properties. The route, effects monitoring and patient teaching on the information of these medications will also be discussed.
Biguanides which is a class of oral type 2 diabetes medications help the body to improve sensitivity to insulin and alters the release of glucose in the liver (Elizabeth & American Diabetes Association, 2018).
Metformin, a biguanide agent, exhibit its pharmacodynamics properties by reducing hepatic glucose production. The glucose absorption is slowed in intestines while the glucose absorption by the muscle cells is increased.
Absorption takes about 6 hours after ingestion due to the high bioavailability. Distribution occurs efficiently as binding to plasma proteins is negligible. In most cases, biguanides are not metabolized since liver metabolism does not occur. The drug is excreted within six hours after the intake through the urine though elimination half-life increases in patients with renal impairment.
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Drug-to- drug interactions occur when biguanides are taken with other drugs like gatifloxacin or cephalexin and may result to serious side effects. Lactic acidosis characterized by nausea and diarrhea occurs due to drug- to-alcohol interactions. It is therefore important to limit the alcohol consumption rate while taking these medications. Similarly drug-to- herb interactions occur when herbs such as vanadium are consumed while on biguanides medications.
Routes and dosage ranges
The main route of administration is oral. However, parenteral can be used to patients with Gastro intestinal problems. The dosage for adults is normally 500 mg twice a day and 2 to 3 times a day for pediatrics depending on the body needs.
Lactic acidosis is common specifically to people who consume alcohol. Nausea, vomiting, diarrhea and skin allergy may occur due to the medication interaction with the body.
Patients are always advised to follow the doctor’s prescription and consultation before taking any medication. The doctor should schedule a follow-up schedule for the patients to see if the progress of the condition.
Dipeptidyl peptidase-4 inhibitors
This class is also used to treat diabetes type 2 and are administered orally but not taken as initial therapy.
The drugs’ pharmacodynamics property increases active levels of the incretin hormones glucagon-like peptide-1 and gastric inhibitory peptide by inhibiting the enzyme responsible for their breakdown (Barnett & Grice, 2011).
Absorption mostly occurs in the small intestines and has a high bioavailability of about three hours. Lipophilicity and protein binding favor distribution of the drugs. The metabolism of these drugs varies in various forms and may take up to twenty hours. The residue is excreted in urine and feces.
Drug-drug interactions do not alter the pharmacodynamics properties of the drugs in this class except that of saxagliptin. Drug-food interaction s may result when alcohol and some vitamins are taken while still on medication. However, the effects on blood glucose are unknown with most herbs and dietary supplements (Brophy, 2011).
Route and dosage
Oral ingestion is the main route of drug administration except for cases where the patient’s Gastro intestinal tract has complications. The dosage varies for adults in specific drugs in this class. The recommended dose for Linagliptin is 5 mg. Sitagliptin recommended from 25 to 100 mg depending on the patients need. Saxagliptin is recommended a dose of 5 mg. Alogliptin works at a dose of 25 mg daily. All these drugs are taken once a day. From the guidelines of the US Food and Drug administration, metformin and degludec are the only drugs used in pediatrics with type 2 diabetes mellitus.
Nausea, skin reactions, urinary tract infections and headache are the common side effects.
This plays a vital role to ensure the effectiveness of the medication. Patients are also taught and guided on drug use and on the most likely side effects likely to occur under specific drugs prescription.
American Diabetes Association, & In Kuball, E. (2018). Managing type 2 diabetes for dummies. Hoboken, New Jersey: John Wiley & Sons Inc.
Barnett, A. H., & Grice, J. (2011). New Mechanisms in Glucose Control: Barnett/New Mechanisms in Glucose Control. Hoboken, NJ USA: John Wiley & Sons, Inc.
Brophy, K. (2011). Clinical drug therapy for Canadian practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Mozayani, A., & Raymon, L. P. (2012). Handbook of drug interactions: A clinical and forensic guide. New York: Humana Press.
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