Insulins 8 drugs Replace the key that moves sugar from blood into cells — dosed by speed: rapid, short, intermediate, long.
Treats: Type 1 diabetes · Type 2 diabetes · DKA/HHS · Hyperkalemia (with dextrose)
High-alert medication — hypoglycemia kills; double-check doses, never abbreviate 'U'. insulin lispro, insulin aspart, insulin glulisine, regular insulin, NPH insulin…
Biguanides (Metformin) 1 drugs First-line type 2 diabetes drug — tells the liver to stop over-producing sugar and helps cells listen to insulin.
Treats: Type 2 diabetes · Prediabetes · PCOS (off-label)
Lactic acidosis in severe renal impairment; hold before iodinated contrast; GI upset is the everyday complaint. metformin
Sulfonylureas 3 drugs Squeeze the pancreas to release more insulin — cheap and effective, but hypoglycemia is the price.
Treats: Type 2 diabetes
Hypoglycemia — especially glyburide in older adults and kidney disease; weight gain. glipizide, glimepiride, glyburide
GLP-1 Receptor Agonists 5 drugs Mimic the gut hormone that boosts insulin only when sugar is high, slows the stomach, and quiets appetite.
Treats: Type 2 diabetes · Obesity/weight management · Cardiovascular risk reduction
Boxed warning: thyroid C-cell tumors in rodents — avoid with personal/family history of medullary thyroid cancer or MEN2; pancreatitis risk; hold before anesthesia per current guidance. semaglutide, liraglutide, dulaglutide, exenatide, tirzepatide
SGLT2 Inhibitors 4 drugs Make the kidneys spill sugar into the urine — and protect the heart and kidneys while doing it.
Treats: Type 2 diabetes · Heart failure · Chronic kidney disease
Euglycemic DKA (normal sugar, acidotic patient), genital fungal infections, volume depletion — hold when NPO or acutely ill. empagliflozin, dapagliflozin, canagliflozin, ertugliflozin
DPP-4 Inhibitors 4 drugs Stop the enzyme that destroys the body's own GLP-1 — a gentle, weight-neutral sugar lowerer.
Treats: Type 2 diabetes
Pancreatitis and severe joint pain reported; saxagliptin linked to heart-failure hospitalization. sitagliptin, linagliptin, saxagliptin, alogliptin
Thiazolidinediones (TZDs) 2 drugs Make muscle and fat more sensitive to insulin — but hold fluid, which failing hearts cannot afford.
Treats: Type 2 diabetes
Boxed warning: causes or worsens heart failure — contraindicated in NYHA III-IV; fracture risk; weight gain. pioglitazone, rosiglitazone
Thyroid Hormone Replacement 3 drugs Replace the body's metabolism thermostat when the thyroid quits.
Treats: Hypothyroidism · Post-thyroidectomy · Myxedema coma (IV)
Take on an empty stomach, apart from calcium/iron; overdose mimics hyperthyroidism — palpitations, tremor, weight loss; boxed warning against use for weight loss. levothyroxine, liothyronine, desiccated thyroid
Antithyroid Agents 3 drugs Slow an overactive thyroid by blocking hormone production.
Treats: Graves disease · Hyperthyroidism · Thyroid storm
Agranulocytosis — report fever/sore throat immediately; methimazole teratogenic in first trimester (PTU preferred then); PTU boxed warning for liver failure. methimazole, propylthiouracil, potassium iodide
Adrenal & Pituitary Agents 5 drugs Replace or block hormones from the body's master glands.
Treats: Adrenal insufficiency · Diabetes insipidus · Cushing syndrome · Acromegaly
Missing stress-dose steroids in adrenal insufficiency during illness/surgery can cause fatal adrenal crisis; desmopressin causes dangerous hyponatremia. hydrocortisone, fludrocortisone, desmopressin, octreotide, ketoconazole
