Antidiabetic Drugs

Question 1

Diabetes mellitus is

Answer 1

Condition characterised by hyperglycemia due to absolute or relative lack of insulin

Question 2

Type of DM

Answer 2

Type 1 IDDM or juvenile
Type 2 NIDDM
GDM

Question 3

Anti diabetic drugs

Answer 3

Oral anti diabetic drugs
Injectable diabetic drugs

Question 4

Oral anti diabetic drugs are

Answer 4

Oral hypoglycaemic drugs
Oral euglycemic drugs

Question 5

Injectables

Answer 5

Insulin
Other agents

Question 6

Oral hypoglycaemic agents sulfonylurea group 1st gen

Answer 6

Tolbutamide
Chlorpropamide
Tolazamide

Question 7

2nd generation sulfonylurea group

Answer 7

Gliclazide
Glipizide
Glimepride
Glibenclamide

Question 8

Disadvantage of 2nd gen

Answer 8

Minimum 30% B cell needed for their action

Question 9

Disadvantage of 2nd gen

Answer 9

Minimum 30% B cell needed for their action

Question 10

A/E of sulphonylureas

Answer 10

Weight gain
Hypoglycemia
Chance of hyponatraemia
Renal impairment

Question 11

Euglycemic agents are

Answer 11

Insulin sensitizers
Glucosidase inhibitors
Incretin mimetic

Question 12

Insulin sensitizers

Answer 12

Biguanides : metformin , phenformin
Thia-zoli-dine-Diones = Pioglitazone , Rosiglitazone

Question 13

Incretin mimetics dipeptidyl peptidase -4 enzyme inhibitor

Answer 13

Sitagliptin
Vildagliptin
Lindagliptin
Saxagliptin

Question 14

Injectable Anti Dm drugs are

Answer 14

Insulin
Insulin analogues

Question 15

Insulin is

Answer 15

Secreted from B cell of islets of langerhans of pancreas
MW 5808
A chain has 21 @a
B chain has 30 @a

Question 16

Insulin conventional

Answer 16

Short acting : regular ( 6-8hrs )
Immediate acting = NPH lenter (12-18hrs )
Long acting = ultralente (24-36 hrs )

Question 17

Insulin analogues

Answer 17

Rapid acting = insulin Lispro , aspart , glulisine
Long acting = insulin glargine, detemir
Ultra long acting = degludec

Question 18

Indications of insulin

Answer 18

IDDM
NIDDM when OAD failure
GDM
DM with complications # diabetic keto acidosis # Hyperosmolar non ketotic state / COMA
# diabetic retinopathy # diabetic nephropathy
DM with severe infections
Pre operative and post operative management of DM patients
Management of hyperkelemia ( glucose potassium co transport )

Question 19

A/E of insulin

Answer 19

Hypoglycaemia
Insulin resistance
Insulin allergy
Lipodystrophy
Weight gain
Hypokalemia

Question 20

A/E of insulin

Answer 20

Hypoglycaemia
Insulin resistance
Insulin allergy
Lipodystrophy
Weight gain
Hypokalemia

Question 21

M/A of insulin

Answer 21

LIVER
(+) of hepatic glucose uptake
(-) of glycogenolysis
(-) of gluconeogenolysis

MUSCLE
(+) of glucose uptake and utilisation
(-) proteolysis
Gluconeogenesis

ADIPOSE TISSUE
increase glucose uptake
(-) lipolysis
(-) gluconeogenesis

Question 22

M/ A of glimepride

Answer 22

(+) b cell of pancreas —-release of insulin ——- decrease blood glucose by increase glucose uptake by cell

Question 23

M/A of sitagliptin

Answer 23

(-) dpp-4
No activation of glucagon like peptide 1 and gastric inhibitory peptide
Increase insulin level and glucagon level
Decrease blood glucose level
Anti DM action

Question 24

Management of hypoglycaemia

Answer 24

If patient can swallow = sugar sugar containing foods and glucose
If patient is unconscious = I/ v glucose or dextrose running 25% glucose in 100mil water

Question 25

Indications of metformin

Answer 25

NIDDM

Non diabetic patients = POLYCYSTIC OVARIAN DISEASE
OBESITY

Question 26

A/E of metformin

Answer 26

Anorexia
Epigastric discomfort
Diarrhoea
Lactic acidosis

Question 27

Metformin M/A

Answer 27

Increase glucose uptake in muscle and adipose tissue
Increase conversion of lactate from glucose
Decrease Glucose absorption from GIT
(+) glycolysis
Decrease plasma glucagon level
Reduced hypergylcemia
Anti diabetic action

Question 28

Metformin M/A

Answer 28

Increase glucose uptake in muscle and adipose tissue
Increase conversion of lactate from glucose
Decrease Glucose absorption from GIT
(+) glycolysis
Decrease plasma glucagon level
Reduced hypergylcemia
Anti diabetic action