03.1 Diabetes - Hypoglycaemic Agents

Question 1

What is an example of a buiguanide?

Answer 1

Metformin

Question 2

How does metformin work?

Answer 2

Unknown mechanism of action but increases insulin sensitivity
Inhibits gluconeogenesis

Question 3

Give an example of a sulphonylurea?

Answer 3

Gliclazide

Question 4

What is the mechanism of action of gliclazide?

Answer 4

Antagonise B cell K+ATP channel activity
Decrease in K+ causes depolarisation
Increased Ca2+ entry
Increased insulin release

Question 5

What are some ADRs of sulphonylureas?

Answer 5

Hypoglycaemia
Weight gain
GI disturbance

Question 6

What are some examples of Thiazolinedinediones?

Answer 6

Rosiglitazone

Pioglitazone

Question 7

What is the mechanism of action of Thiazolinedinediones?

Answer 7

Agonist to peroxisome proliferator activated receptor

Genes coding for insulin and glucose governing are upregulated

Question 8

What are some ADRs of Thiazolinedinediones?

Answer 8

Older ones caused liver failure, oedema and heart failure

Newest one, pioglitazone has association with bladder cancer

Question 9

What are some examples of meglitidines?

Answer 9

Repaglinide

Nateglinide

Question 10

What is the mechanism of action of Meglitidines?

Answer 10

(same as sulphonylureas)
Antagonise B cell K+ATP channel activity
Decrease in K+ causes depolarisation
Increased Ca2+ entry
Increased insulin release

Question 11

What is the mechanism of action of GLP-1?

Answer 11

Glucagon like peptide - increases insulin levels and decreases glucagon

Question 12

What are some examples of DDP4 inhibitors? (Don’t think we need to know these but unlike the majority of other diabetes drugs we’ve been told about, these ones are actually used)

Answer 12

Gliptins e.g. Sitagliptin, vilda gliptin