DIABETIC DRUGS:
METFORMIN:
MECHANISM OF ACTION: metformin inhibits mitochondrial complex I activity. This causes decrease in blood
glucose levels by decreasing hepatic glucose production (gluconeogenesis), decreasing the intestinal
absorption of glucose, and increasing insulin sensitivity by increasing peripheral glucose uptake and utilization
INDICATION: type 2 Diabetes, gestational diabetes, polycystic ovary syndrome
CONTRAINDICATION: severe renal dysfunction (eGFR <30 mL/minute/1.73 m2); acute or chronic metabolic
acidosis with or without coma (including diabetic ketoacidosis)
SIDE-EFFECTS: diarrhoea, nausea and vomiting
INTERACTION:
What to do? Enhance side enhance the Diminish the Increase
effects of hypoglycemic effect therapeutic effect concentration of
metformin drug in serum
Avoid Alcohol (Ethyl)
Monitor NSAIDs Quinolones Quinolones Trimethoprim
Salicylates Thiazide and
Thiazide-Like
SSRIs Diuretics
Verapamil
* Vitamin K Antagonists (eg, warfarin): MetFORMIN may diminish the anticoagulant effect of Vitamin K
Antagonists. Vitamin K Antagonists may enhance the hypoglycemic effect of MetFORMIN. Monitor therapy
SULFONYLUREAS:
MECHANISM OF ACTION: Sulfonylureas stimulate insulin release by blocking ATP sensitive potassium
channels in the Beta cells, reducing potassium permeability. This causes depolarization of the cell and
increases calcium entry, increasing insulin secretion.
INDICATION:TYPE 1 DIABTES (THEY DO NOT WORK ON TYPE 1 AS THEY WORK OF FUNCTIONAL B CELLS
ONLY)
CONTRAINDICATION:
SIDE-EFFECTS:
INTERACTION:
GLITAZONES:
MECHANISM OF ACTION:
, INDICATION:
CONTRAINDICATION:
SIDE-EFFECTS:
INTERACTION:
GLIPTINS:
MECHANISM OF ACTION:
INDICATION:
CONTRAINDICATION:
SIDE-EFFECTS:
INTERACTION:
The table below summarises characteristic (if not necessarily the most
common) side-effects of drugs used to treat diabetes mellitus
Drug Side-effect
Metformin Gastrointestinal side-effects
Lactic acidosis (if someone has diarrhoea and is losing a lot of electrolyte,
we stop metformin for a bit.)
Sulfonylureas Hypoglycaemic episodes
Increased appetite and weight gain
Syndrome of inappropriate ADH secretion
Liver dysfunction (cholestatic)
Glitazones Weight gain
Fluid retention
Liver dysfunction
Fractures
Gliptins such as Pancreatitis
Sitagliptin.
RECREATIONAL DRUGS
LYSERGIC ACID DIETHYLAMIDE
Its psychedelic effects usually involve heightening or distortion of sensory stimuli and enhancement of feelings
and introspection. It is one of the most potent psychoactive compounds known.
Patients with LSD toxicity typically present following acute panic reactions (known as bad trips), massive
ingestions or unintentional ingestions.
PSYCHOACTIVE SYMPTOMS
Variable subjective experiences
Impaired judgements which can lead to injury
Amplification of current mood which leads to euphoria or dysphoria
Agitation, appearing withdrawn - especially in inexperienced users
METFORMIN:
MECHANISM OF ACTION: metformin inhibits mitochondrial complex I activity. This causes decrease in blood
glucose levels by decreasing hepatic glucose production (gluconeogenesis), decreasing the intestinal
absorption of glucose, and increasing insulin sensitivity by increasing peripheral glucose uptake and utilization
INDICATION: type 2 Diabetes, gestational diabetes, polycystic ovary syndrome
CONTRAINDICATION: severe renal dysfunction (eGFR <30 mL/minute/1.73 m2); acute or chronic metabolic
acidosis with or without coma (including diabetic ketoacidosis)
SIDE-EFFECTS: diarrhoea, nausea and vomiting
INTERACTION:
What to do? Enhance side enhance the Diminish the Increase
effects of hypoglycemic effect therapeutic effect concentration of
metformin drug in serum
Avoid Alcohol (Ethyl)
Monitor NSAIDs Quinolones Quinolones Trimethoprim
Salicylates Thiazide and
Thiazide-Like
SSRIs Diuretics
Verapamil
* Vitamin K Antagonists (eg, warfarin): MetFORMIN may diminish the anticoagulant effect of Vitamin K
Antagonists. Vitamin K Antagonists may enhance the hypoglycemic effect of MetFORMIN. Monitor therapy
SULFONYLUREAS:
MECHANISM OF ACTION: Sulfonylureas stimulate insulin release by blocking ATP sensitive potassium
channels in the Beta cells, reducing potassium permeability. This causes depolarization of the cell and
increases calcium entry, increasing insulin secretion.
INDICATION:TYPE 1 DIABTES (THEY DO NOT WORK ON TYPE 1 AS THEY WORK OF FUNCTIONAL B CELLS
ONLY)
CONTRAINDICATION:
SIDE-EFFECTS:
INTERACTION:
GLITAZONES:
MECHANISM OF ACTION:
, INDICATION:
CONTRAINDICATION:
SIDE-EFFECTS:
INTERACTION:
GLIPTINS:
MECHANISM OF ACTION:
INDICATION:
CONTRAINDICATION:
SIDE-EFFECTS:
INTERACTION:
The table below summarises characteristic (if not necessarily the most
common) side-effects of drugs used to treat diabetes mellitus
Drug Side-effect
Metformin Gastrointestinal side-effects
Lactic acidosis (if someone has diarrhoea and is losing a lot of electrolyte,
we stop metformin for a bit.)
Sulfonylureas Hypoglycaemic episodes
Increased appetite and weight gain
Syndrome of inappropriate ADH secretion
Liver dysfunction (cholestatic)
Glitazones Weight gain
Fluid retention
Liver dysfunction
Fractures
Gliptins such as Pancreatitis
Sitagliptin.
RECREATIONAL DRUGS
LYSERGIC ACID DIETHYLAMIDE
Its psychedelic effects usually involve heightening or distortion of sensory stimuli and enhancement of feelings
and introspection. It is one of the most potent psychoactive compounds known.
Patients with LSD toxicity typically present following acute panic reactions (known as bad trips), massive
ingestions or unintentional ingestions.
PSYCHOACTIVE SYMPTOMS
Variable subjective experiences
Impaired judgements which can lead to injury
Amplification of current mood which leads to euphoria or dysphoria
Agitation, appearing withdrawn - especially in inexperienced users
