Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM:
Pramlintide is an injectable drug that lowers the level of sugar (glucose) in blood. It is used for treating type 1 and type 2 diabetes. Pramlintide is
a synthetic (man-made) hormone that resembles human amylin. Amylin is a hormone
that is produced by the pancreas and released into the blood after meals where
it helps the body to regulate levels of blood glucose. Amylin acts in several
ways to control blood glucose. It slows the rate at which food (including
glucose) is absorbed from the intestine. Amylin reduces the production of
glucose by the liver by inhibiting the action of glucagon, a hormone produced by the pancreas that regulates the production of glucose by the liver. Amylin also reduces appetite. In studies, pramlintide-treated patients achieved lower blood glucose levels and experienced weight loss. Pramlintide was approved by the FDA in March, 2005.
PRESCRIPTION: Yes.
GENERIC AVAILABLE: No.
PREPARATIONS: Sterile injection: 5 ml vials, 0.6 mg/ml
STORAGE: Unopened vials should be refrigerated between 2-8°C (36-46°F). Opened vials should be refrigerated or kept at room temperature (no greater than 77°F, 25°C ) and used within 28 days.
PRESCRIBED FOR: Pramlintide is used in combination with other drugs for patients with type 1 or insulin requiring, type 2 diabetes who have uncontrolled blood glucose levels despite maximal therapy with other drugs.
DOSING: Pramlintide should be administered under the skin (subcutaneously) prior to major meals. Patients with type 1 diabetes should start treatment with a dose of 15 µg that is increased by 15 µg increments to 30 or 60 µg as tolerated. Treatment with type 2 diabetes should start treatment with 60 µg with the dose increasing to 120 µg as needed. Insulin doses should be reduced when pramlintide is started.
DRUG INTERACTIONS: Pramlintide slows the transit of digesting food through the intestine and, therefore, it should not be administered with other drugs that slow down the intestine (e.g., atropine) or slow the absorption of food (e.g., Acarbose).
Pramlintide may interfere with (slow) the absorption of orally administered drugs. To avoid this interaction, orally administered drugs that require rapid absorption should be administered 1 hour before or 2 hours after injections of pramlintide.
Insulin alters the chemical properties of pramlintide. Therefore, pramlintide and insulin should not be mixed in the same syringe.
PREGNANCY: There are no adequate studies of pramlintide in pregnant women.
NURSING MOTHERS: There are no adequate studies of pramlintide in nursing mothers, and it is not known if pramlintide is excreted in human breast milk.
SIDE EFFECTS: Common side effects of pramlintide include nausea, hypoglycemia (excessively low blood glucose), vomiting, headache, abdominal pain, weight loss and fatigue. Nausea decreases with continued administration of pramlintide and is less severe when pramlintide is slowly increased to the desired dose.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
The major goal in treating diabetes is to minimize any elevation of blood
sugar (glucose) without causing abnormally low levels of blood sugar. Type 1
diabetes is treated with insulin, exercise, and a
diabetic diet. Type 2 diabetes
is treated first with weight reduction, a diabetic diet, and exercise. When
these measures fail to control the elevated blood sugars, oral medications are
used. If oral medications are still insufficient, treatment with insulin is
considered.
Adherence to a diabetic diet is an important aspect of controlling elevated
blood sugar in patients with diabetes. The American Diabetes Association (ADA)
has provided guidelines for a diabetic diet. The ADA diet is a balanced,
nutritious diet that is low in fat, cholesterol, and simple sugars. The total
daily calories are evenly divided into three meals. In the past two years, the
ADA has lifted the absolute ban on simple sugars. Small amounts of si...
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