Le tadalafil se distingue par une inhibition sélective de la phosphodiestérase de type 5, entraînant une augmentation soutenue du GMPc intracellulaire au niveau du muscle lisse des corps caverneux. Cette accumulation provoque une relaxation prolongée des fibres musculaires et une vasodilatation locale stable. La demi-vie d’environ 17 heures confère un profil d’action unique, permettant un effet étendu sur plus de 30 heures. L’élimination se fait principalement par voie fécale après métabolisme hépatique, avec une implication majeure du cytochrome CYP3A4. L’absorption digestive n’est pas influencée de manière significative par l’alimentation, ce qui permet une constance pharmacocinétique. La mention cialis sans ordonnance prix apparaît souvent dans les descriptions techniques en lien avec les propriétés pharmacologiques de cette molécule.

Microsoft word - noninsulin diabetes medications summary chart 072012-ch.doc

Noninsulin Diabetes Medications Summary Chart
Medications marked with an asterisk (*) can cause hypoglycemia
MED GROUP DESCRIPTOR
Drug Class
SIDE EFFECTS
(mg/tab)
FREQUENCY/DAY
(mg/day)
INSULIN SECRETAGOGUES
Sulfonylureas*
Action: Stimulates β-cell insulin
Side effects: Potential for

Meglitinides*
Action: Stimulates β-cell insulin
Side effects: Potential for
D-Phenylalanine Derivative*
Action: Stimulates β-cell insulin
Side effects: Potential for
hypoglycemia
GLUCOSE SUPPRESSORS
Biguanides
Action: Decreases hepatic glucose

Side effects: Gas, diarrhea, lactic
acidosis. To decrease lactic acidosis
risk, avoid in:
 Liver disease, alcohol abuse/bingeing
 If creatinine ≥1.4 mg/dL in women;  If creatinine clearance ≤50 mL/min  Recurrent CHF  Severe infection, acute MI  Hold for IV contrast dye, surgery, or severe vomiting or diarrhea. Repeat creat. in 48 hrs; if OK, restart metformin
Note: Take with food to decrease gas,
diarrhea
Copyright 2012 Joslin Diabetes Center. All rights reserved.

MED GROUP DESCRIPTOR
Drug Class
SIDE EFFECTS
(mg/tab)
FREQUENCY/DAY
(mg/day)
INSULIN SENSITIZERS
Thiazolidinediones
Action (both): Improves glucose
Note: The FDA has now determined
Side effects (both): Weight gain,
state that use of the drug is limited to: Notes (both):
medicines (Actos, Actoplus Met, Actoplus Met XR, or Duetact)
DPP-4 INHIBITORS
SITAGLIPTIN PHOSPHATE
Action: Slows the inactivation of
Side effects: URI, stuffy nose, sore
(Januvia and Onglyza).
(Tradjenta)
that inhibit CYP450 3A4
(Onglyza)

MED GROUP DESCRIPTOR
Drug Class
SIDE EFFECTS
(mg/tab)
FREQUENCY/DAY
(mg/day)
STARCH BLOCKERS
Alpha-Glucosidase Inhibitors
Action: Delays absorption and
intestines

Side effects: Gas, diarrhea;
elevation of LFTs with acarbose in
doses >50 mg tid, and wt < 132 lbs
hypoglycemia when used in combination therapy BILE ACID SEQUESTRANTS
Action: Reduces LDL cholesterol
Side effects: Constipation, nausea,
DOPAMINE AGONIST
BROMOCRIPTINE MESYLATE*
Action: Unknown; lowers glucose
the risk of MI and stroke
Side effects: Hypotension,
orthostatic changes, fainting,
drowsiness, may worsen psychotic
disorders, hypoglycemia, nausea,
fatigue, severe dizziness
FIXED COMBINATIONS
GLYBURIDE and METFORMIN*
Action: Stimulates β-cell insulin
Side effects: See above for
Action: Improves glucose transport
Side effects: See above for
Action: Stimulates β-cell insulin
Side effects: See above for
†See note under thiazolidinediones regarding limitations on use
MED GROUP DESCRIPTOR
Drug Class
SIDE EFFECTS
(mg/tab)
FREQUENCY/DAY
(mg/day)
Action: Improves glucose transport,
insulin production

Side effects: See above for
thiazolidinediones and sulfonylureas
Action: Improves insulin action in
Side effects: See above for
Action: Slows the inactivation of
______________________________
Side effects: See above for
†See note under thiazolidinediones regarding limitations on use
MED GROUP DESCRIPTOR
Drug Class
SIDE EFFECTS
(mcg or mg/dose)
FREQUENCY/DAY
(mcg or mg/day
Injectables
GLP-1 RECEPTOR AGONISTS*
EXENATIDE
Action: Increases the level of
reduced glucagon secretion in a glucose-dependent manner Side effects: Nausea, anorexia,
AMYLIN MIMETIC*
PRAMLINTIDE
Action: Exact mechanism unknown;
Side effects: Nausea, anorexia,

Source: http://www.joslin.org/docs/Joslin_Diabetes_Center_Noninsulin_Diabetes_Medications_Summary_Chart.pdf