betahistine

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basics of vertigo

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betahistine

  1. 1. Gliptins background
  2. 2. New drugs for DM <ul><li>In DM, several pharmacologic interventions have undesirable side effects, including hypoglycemia and weight gain. </li></ul><ul><li>Drugs targeting the incretin pathway are the latest addition to the available antidiabetes agents. </li></ul><ul><li>Incretin-based therapy is either delivered: </li></ul><ul><ul><li>orally (dipeptidyl peptidase-4 [DPP-4]) inhibitors or </li></ul></ul><ul><ul><li>injected subcutaneously (glucagon-like peptide-1 [GLP-1] mimetics and analogues). </li></ul></ul>
  3. 3. India <ul><li>Eli Lilly has Byetta (exenatide injection)– [GLP-1 agonist] </li></ul><ul><li>There are 3 DPP-4 inhibitors currently available </li></ul><ul><ul><li>Sitagliptin [JANUVIA – MERCK] </li></ul></ul><ul><ul><li>saxagliptin, [ONGLYZA - BMS] and </li></ul></ul><ul><ul><li>Vildagliptin [VILDAGLIPTIN – NOVARTIS] </li></ul></ul>
  4. 4. DPP-4 <ul><li>Dipeptidyl peptidase-4 inhibitors are effective with a low incidence of hypoglycemia and no weight gain either as a single or combination therapy in lowering </li></ul><ul><ul><li>glycated hemoglobin, </li></ul></ul><ul><ul><li>fasting and </li></ul></ul><ul><ul><li>postprandial glucose levels. </li></ul></ul>
  5. 5. How DPP-4 works? <ul><li>The digestive system breaks down food into sugar (glucose). </li></ul><ul><li>This increases signals, called incretins. </li></ul><ul><li>Incretins tell the pancreas to release insulin in response to food. </li></ul><ul><li>In type 2 DM, the pancreas doesn't release enough insulin or the body's cells may not use insulin properly. </li></ul><ul><li>This leads to rise in blood sugar level. </li></ul>
  6. 6. How DPP-4 works? <ul><li>In response to a meal, active glucagon-like peptide-1 (GLP-1) is secreted by the L cells of the intestines. </li></ul><ul><li>Without the presence of a gliptin, GLP-1 is rapidly inactivated and degraded by the enzyme dipeptidyl peptidase IV (DPP4); </li></ul><ul><li>when a gliptin is present, it binds to DPP4, allowing GLP-1 to remain active. </li></ul><ul><li>Active GLP-1 causes the pancreas to increase insulin release and decrease glucagon release. </li></ul>

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