Our seventh family are the dopamine agonist.
Now, note Nurse Natalie at the
bottom of the screen there.
See her expression?
That's to remind you.
We're not exactly sure how
these medications work.
We know they are helpful, but we're
not exactly sure how they work.
We've just got a couple of good guesses.
That's not uncommon in the CNS,
the central nervous system.
Even with our psych drugs
and other CNS medications,
it's so complex, we're not
exactly clear how they work.
But, we use this one anyway, it's
bromocriptine, is what the name is,
the generic name, when it's use to treat diabetes.
Now it has other names, or aliases,
when it's used to treat Parkinson's
which means that extra prolactin.
So, we use the same generic compound to
treat Parkinson's and hyperprolactinemia.
So, we think it might reverse the
hypothalamus' drive to raise blood glucose,
and the triglycerides and the free fatty acids,
but again, that's just a really good guess.
We're not exactly sure, at this point.
But since it messes with your CNS
system, drowsiness can be a problem.
Here's one that will get your attention.
Remember that it works in the CNS
system, it can exacerbate psychosis.
That's a significant side effect.
Not everyone experiences it, but if they
have a mental health history of psychosis,
this can definitely make it worse.
You can also have some issues
with orthostatic hypotension.
Remember, if you're going from lying
to sitting, or sitting to standing,
you want to do that slowly,
so your body can acclimate.
Now, the eighth family is the
sodium-glucose co-transporters 2s.
Remember, we're kind of excited about these
because research is starting to support
that these don't only help type 2 diabetics,
they might be very helpful
with the type 1 diabetics.
We'll not replace insulin, but it might really
help them have more effective treatment plans.
This may be something that
you weren't really aware of,
because a lot of people are surprised
to learn that the kidneys are --
really play an important role in helping to
maintain the glucose balance in the body.
See, they decide what to filter and
reabsorb, especially with glucose.
So the SGLTs --
remember, that's what it's in our name --
they're the transporters.
They have the majority of the
responsibility of reabsorbing the glucose.
So if we block their action, what
do you think's going to happen?
SGLT-2 inhibitors block the
reabsorption of glucose.
So, if it blocks the reabsorption
of glucose back into the body,
it's going to leave the body in the urine.
So you're going to have a lot more glucose
leaving in the urine, and a lot more calories.
That's a cool side effect.
Now, we use it with type 2 patients and there's
ongoing issues of research with type 1 patients.
So remember, I keep bringing that up
because it's such a cool development.
So, these medications help --
they block the action so
glucose is not reabsorbed.
You pee it out in your urine.
Remember that we've got a lot more glucose
leaving the body through the urine,
so you'll end up with a risk
for orthostatic hypotension.
Now because of that extra sugar
or glucose in your urine,
that environment becomes
really friendly to fungus,
so you're at a risk for fungal infections,
for females, in particular.
Also at risk for UTIs --
urinary tract infections --
and polyuria; having to go to the bathroom a lot.
So this one has some very unusual side effects.
Just try to remember that more glucose
leaves the body through the urine,
and that's why we end up with
a risk for a fungal infections, UTIs, and polyuria.