3.1 Oral Hypoglycaemic Agents Flashcards
What drug is first line for T2DM?
Metformin
How do metformin work?
Reduces insulin resistance by cells
Reduces hepatic gluconeogenesis
What is one common ADR and one rare but significant ADR of metformin?
Common ADR is GI upset
Rare ADR is lactic acidosis
What are some examples of sulphonylureas?
Gliclazide and glimepiride
How do sulphonylureas work?
Stimulate beta cells to release insulin
What are some side effects of sulphonylureas?
Weight gain
Hypoglycaemia
GI disturbance
What enzyme do gliptins inhibit and what is the function of this enzyme?
DPP4
This enzyme breaks down GLP1
How do gliptins exert their action?
Inhibits DPP4 so more levels of GLP1
So exerts its action through GLP1
- Stimulates beta cells to secrete insulin
- Reduces glucagon secretion from alpha cells
- Reduces gastric emptying
- Increase glucose uptake by tissues
- Acts on the brain to increase feeling of satiety
- Reduces hepatic gluconeogenesis
What is an example of a GLP 1 agonist?
Exenatide
What type of drug is exenatide?
GLP1 agonist
How does exenatide exert its action?
Agonises GLP1 which…
- reduces appetite
- increases glucose uptake by tissues
- increases insulin release from beta cells
- reduces glucagon release from alpha cells
- reduces hepatic gluconeogenesis
- reduces gastric emptying
How does piaglitazone act?
Reduces hepatic gluconeogenesis and reduces insulin resistance (Acts like metformin)
Which T2DM medication can cause weight loss as opposed to weight gain?
GLP1 agonists
So suitable for obese px
What type of drug is pioglitazone?
Glitazone
What are some ADRs of pioglitazone?
Weight gain
Bladder cancer
Fluid retention
Heart failure
