MedicalToday

Sildenafil (Viagra) was developed more than 10 years ago as an antihypertensive and antianginal drug. It proved ineffective in these applications but was shown to affect the smooth muscles of the penis.

Pharmacology.

Definition
Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or when cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, tiredness, excessive thirst, and hunger.

Description
Diabetes mellitus is a chronic disease that causes serious health complications including renal (kidney) failure, heart disease, stroke, and blindness. Approximately 14 million Americans (about 5% of the population) have diabetes. Unfortunately, as many as one-half of them, are unaware that they have it.

Pharmacology.
Enalapril is a prodrug that is rapidly converted to its active metabolite, enalaprilat, by ester hydrolysis in the liver. Enalaprilat is a competitive ACE inhibitor. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein-kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin-angiotensin system. The net effect is reduction in total peripheral resistance and blood pressure in hypertensive patients, especially those with high pretreatment plasma renin activity and increased renal plasma flow, and reduction of elevated afterload in patients with CHF.

Pharmacology.
Acarbose is an oral alpha-glucosidase inhibitor indicated for the management of hyperglycemia caused by type 2 diabetes mellitus. Inhibition of this gut enzyme system effectively reduces the rate of complex carbohydrate digestion and the subsequent absorption of glucose, thereby lowering postprandial glucose excursions in type 2 diabetes. In obese and non-obese patients with type 2 diabetes, acarbose monotherapy is associated with a 0.5-1% decrease in hemoglobin A1c.

Pharmacology.
Pioglitazone is a thiazolidinedione anti-hyperglycemic agent used to improve insulin sensitivity in patients with type 2 diabetes. Insulin-dependent glucose disposal in skeletal muscle is improved and hepatic glucose production is decreased; both actions contribute to pioglitazone’s glucose-lowering effects. Pioglitazone is only effective in the presence of insulin; by itself it does not lead to hypoglycemia and does not increase insulin secretion. Because insulin is required for its action, pioglitazone should not be used in patients with type 1 diabetes.