Thiazolidinediones

Thiazolidinediones are used in type II diabetes and work by increasing peripheral tissues' sensitivity to insulin, which improves serum glucose levels.  These medications accomplish this by activating production of PPAR gamma, which increases transcription of insulin responsive genes in the peripheral tissues.  Use caution in heart failure as fluid retention is a known side effect.  Also, avoid use in patients with hepatic impairment.

Class Drugs

• Pioglitazone

• Rosiglitazone

Class Mechanism of Action

Improves insulin sensitivity

• Activates production of PPAR gamma (peroxisome proliferator-activated receptor-gamma), which increases transcription of insulin responsive genes in peripheral tissues

Class Applications

Type II Diabetes Mellitus

Class Adverse Effects

Liver toxicity

• Caution in hepatic impairment as metabolized in liver

Metabolized by CYP3A4, so take caution when administered with CYP3A4 inhibitors (itraconazole, fluconazole, etc) as hypoglycemia risk increases

Weight gain

Fluid retention

• Caution in heart failure

Osteopenia

Drug Table

Drug Name	Application	Comments	Image
Pioglitazone		Adverse Effects:; Possible increased risk of bladder cancer	"Pie" "Glitter"
Rosiglitazone		Adverse Effects:; Drug was restricted for possible increase in myocardial infarctions and death from cardiovascular causes for a period of time, the restriction has been lifted.	"Roses" "Glitter"