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Clinical Pharmacology > 5) Oral Hypoglycaemic Drugs > Flashcards

5) Oral Hypoglycaemic Drugs Flashcards

1
Q

What lifestyle changes are recommended for those with type 2 diabetes?

A

Losing weight - limit fat intake
Reduction in alcohol
Cessation of smoking
Increase exercise

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2
Q

What is the mechanism of action of biguanides (e.g. Metformin)?

A

Decrease hepatic gluconeogenesis

Decrease insulin resistance

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3
Q

What are the side effects of biguanides (e.g. Metformin)?

A

Loose stools, vit B12 def., lactic acidosis (rare), stop if CKD <30ml/min

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4
Q

How often are biguanides taken?

A

2-3 times a day, before meals

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5
Q

What is the mechanism of action of sulphonylureas?

A

Stimulate beta cells by antagonizing K+/ATP channel

Causes K+ to accumulate in cell, depolarisation, Ca2+ entry and insulin release

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6
Q

Give examples of sulphonylureas:

A

Gliclazide, glimepride

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7
Q

What are the side effects of sulphonylureas?

A

Weight gain, hypoglycemia, GI disturbance

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8
Q

What is the mechanism of action of acarbose?

A

Inhibits breakdown of carbohydrates to glucose by blocking action of enzyme alpha-glucosidase

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9
Q

What are the side effects of acarbose?

A

Flatulence, loose stools, abdominal pain

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10
Q

What is the mechanism of action of glitazones?

A

Bind and activate peroxisome proliferator-activated receptors that upregulate genes for insulin signalling and glucose metabolism

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11
Q

Give some examples of glitazones:

A

Pioglitazone, rosiglitazone

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12
Q

What are some side effects of glitazones?

A

Weight gain, fluid retention, heart failure, effects on bone metabolism
CVS concerns with rosiglitazone

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13
Q

What are glucagon like peptides and what is their action?

A

Released from intestinal L cells and acts to increase insulin secretion and decrease glucagon secretion. Promotes fullness and decreases gastric emptying

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14
Q

How can knowledge of GLP-1 be applied to pharmacology?

A

GLP1 agonists

DPP4 inhibitors - prevents breakdown of GLP1

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15
Q

What are the side effects of DPP4 inhibitors?

A

GI symptoms, ?pancreatitis

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16
Q

What are the side effects of GLP1 agonists?

A

GI symptoms, nausea, loos stools, GORD, avoid if GFR<30ml/min

17
Q

How can sodium-glucose co-transporter 2 inhibitors be used in diabetes? Give examples of these drugs?

A

Inhibit the re-absorption of glucose in the proximal tubule by SGLT2
Dapaglifozin, canaglifozin

18
Q

What are some side effects of SGLT2 inhibitors?

A

Increased risk of LUTS, UTI, polyuria

Clinical Pharmacology (24 decks)

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