antidiabetic agents II Flashcards
1
Q
List the Meglitinides
A
- Repaglinide
- Nateglinide
2
Q
MOA of Meglitinides
A
- bind and block ATP-sensitive K+ channel to cause membrane depolarization and increase Ca2+ influx on B cells
3
Q
which Antidiabetic Agents can be used in sulfa allergy
A
Meglitinides
4
Q
therapeutic effects of Meglitinides
A
- decrease postprandial serum glucose
- decrease HbA1c
5
Q
route of administration and onset of action of meglitinides
A
- oral, preprandially
- rapid action; peak effect at 1 hour
6
Q
MOA of Metformin (Glucophage)
A
- increase glucost uptake (muscle and adipose tissue)
- decrease glucose absorption from GI
- decrease glucagon
- decrease gluconeogenesis
7
Q
drug of choice for Type 2 diabetics
A
-
Metformin
- does not increase body weight
- Reduces CV problems
8
Q
theraputic effects of Metformin (Glucophage)? is glucose lowered in normal subjects
A
- overall effect: decrease glucose levels
- glucose is not lowered in normal subjects
- decreases postprandial hyperglycemia
9
Q
can metformin be used in children
A
safe for use in children > 10 years old
10
Q
adverse effects of metformin
A
- lactic acidosis
- diarrhea
11
Q
contraindications to taking metformin
A
- lactic acidosis conditions
- renal disease
- hepatic disease
- alcoholism
- disease predisposing to tissue hypoxia (CHF, COPD)
12
Q
List the Thiazolidinediones
A
- Pioglitazone
- Rosiglitazone
13
Q
MOA of Thiazolidinediones
A
- “insulin sensitizers”-> increase insulin sensitivity
- ligands of the nuclear PPARy receptor -> post receptor insulin-mimetic action
14
Q
theraputic effects of Thiazolidinediones
A
- lowers insulin resistance
- reduces the development of type 2 DM -> prophylatic use
15
Q
adverse effects of Thiazolidinediones
A
- weight gain
- edema: increase in risk of heart failure in CHF patients
- rosiglitazone black lavel warning for increased incidence of MI and angina
16
Q
contraindications to taking Thiazolidinediones
A
- hepatic disease
- CHF
17
Q
List the alpha-glucosidase inhibitors
A
- Acarbose
- Miglitol
18
Q
MOA of alpha-glucosidase inhibitors
A
delayed carbohydrate digestion and absorption
19
Q
theraputic effects of alpha-glucosidase inhibitors
A
- Effectively lower postprandial serum glucose
- Has minimal effects on fasting glucose
- Modest decreases in HbA1c glycosylation
- No significant effects on weight
20
Q
adverse effects of alpha-glucosidase inhibitors
A
- flatulence
21
Q
oral glucose stimulates release of the incretins:
A
- glucagon-like peptide (GLP-1)
- glucose dependent insulinotropic peptide (GIP)
22
Q
function of GLP-1 and GIP
A
- increase release of insulin
- GLP-1 inhibits glucagon release -> decreased hepatic gluconeogenesis
23
Q
List the GLP-1 Incretin Mimetics
A
- Exenatide
- Liraglutide
- Dulaglutide
- Albiglutide
24
Q
incretin mimetics are resistant to enzymatic degradation by
A
DPP-IV
25
route of administration of GLP-1 mimetics
S.C.
26
theraputic effects of incretic mimetics
* lowers postprandial and fasting serum glucose
* potential increased B cell number and function
* weight loss
27
adverse effects of Incretin mimetics
* acute pancreatitis
28
contraindications to taking Incretin mimetics: Liraglutide
* thyroid CA -\> black box warning
29
list the Dipeptidyl-peptidase-IV (DPP-IV) inhibitors
* Sitagliptin
* Saxagliptin
* Linagliptin
* Alogliptin
30
MOA of Dipeptidyl-peptidase-IV (DPP-IV) inhibitors
* potentiates the effects of incretin hormones, by inhibiting thier breakdown by DPP-IV
31
theraputic effects of Dipeptidyl-peptidase-IV (DPP-IV) inhibitors
* lowers postprandial and fasting serum glucose
* has no significant effects on weight
32
how are Dipeptidyl-peptidase-IV (DPP-IV) inhibitors administered
orally, once a day
33
adverse effects of Dipeptidyl-peptidase-IV (DPP-IV) inhibitors
* acute pancreatitis
* pancreatic CA
34
MOA and use of Pramlintide
* **synthetic analog of amylin**, a hormone co-secreted with insulin
* used as an **adjuct** to insulin therapy in **type 1 and type 2 DM**
* **regulates postprandial glucose** by
* decrease gastric empyting
* centrally mediated modulation of appetite
35
theraputic effects of Pramlintide
weight loss
36
MOA of Bromocriptine
* Dopamine agonist
* reduction in postmeal plasma glucose levels due to **enhanced suppression of hepatic glucose production**
37
therapeutic effects of Bromocriptine
* **no AM glucose surge**
* decrease fasting and postprandial free fatty acid and triglyceride levels
* reduces the cardiovascular end point problems in diabetics
38
MOA of Colesevelam
* bile acid binding resin
* MOA unknown
39
adverse effects of Colesevelam
* constipation and bloating
40
List the SGLT2 inhibitors
* Canagliflozin
* Dapagliflozin
* Empagliflozin
41
MOA of SGLT2 inhibitors
* Inhibits the sodium-glucose co-transporter 2 (SGLT2) in the kidney
* Blocks the reabsorption of glucose by the kidney, which results in increased glucose excretion and lower blood glucose concentrations in patients with type 2 diabetes mellitus
42
adverse effects of SGLT2 inhibitors
* female genital mycotic infections, UTIs and increased urinary frequency
43
which antidiabetic drugs cause episodes of hypoglycemia
* sulfonylureas
* meglitinides
44
which antidiabetic drugs cause episodes of hyperinsulinemia
* sulfonylureas
* meglitinides
45
Which of the Antidiabetic drugs cause weight gain
* sulfonylureas
* thiazolidinediones
46
Which of the Antidiabetic drugs causes weight loss
* incretin mimetics
* pramlintide
