27.9: Pharm-Oral hypoglycaemic agents Flashcards
How do sulfonylureas work? (action and mechanism)
Increase insulin secretion (B cells) by inhibiting K ATP channels
What are some adverse effects of sulfonylureas?
Who is it contraindicated in?
Hypoglycaemia (duh), weight gain (? mechanism)
Pregnancy (cross placenta)
Impaired renal function (excreted via kidney)
How does insulin actually work? (molecular level)
It has a cell surface tyrosine kinase receptor (that dimerises and autophosphorylates)
Glut-4 transporter is recruited to the cell membrane
What is an example of a biguanides?
Metformin
What are the actions (4) metformin?
Action:
Increase glucose uptake, reduce hepatic production
Decrease CHO absorption
Reduce LDL/triglycerides
What is the mechanism of how metformin works?
Sensitise the body to insulin/control hepatic glucose production via activation of AMP kinase
What are some adverse effects of metformin? Who is it contraindicated in?
GI disturbances, ?weight loss
Contraindicated if impaired renal function
What drug slows the absorption of starches as its main mechanism?
Alpha-glucosidase inhibitor (blocks the enzymes digesting starches)
What are some adverse effects of alpha-glucosidase inhibitors?
Who is it contraindicated in?
GI effects: flatulence/discomfort, loose stools
IBS patients or cirrhosis-contraindications
How do DDP-4 inhibitors work? (gliptins)
Increase insulin and decrease glucagon (by increasing native GLP-1)
What are some adverse effects of DDP-4 inhibitors?
URTIs, headaches, hypoglycaemia, pancreatitis
How do GLP-1 R’ agonists (Exenatide) work? (still in clinical trials)
Incretins: supress glucagon, regulate insulin
What drugs slow renal glucose reabsorption? (currently in progress)
SGLT inhibitors
