CPTP 4.6-8 Flashcards
What is tolbutamide
A sulphonylurea
how do sulphonylureas work
close K channels, depolarise beta bell, calcium channels then open, insulin vesicle can fuse with csm and insulin released
TZDs aka
PPARy agonists
Endogenous ligands for PPARy receptors
free fatty acids
TZDs mechanisms of action
increase lipogenesis and decrease lipolysis and free fatty acids
adverse effects of TZDs
bladder cancer, fractures, fluid retention, weight gain
Two drugs that act affect incretins to promote glucose dependent insulin secretion
DPP-IV inhibitors (e.g. sitagliptin) GLP-1 mimetics (exenatide)
A diabetes treatment that doesn’t directly affect insulin levels
SGT2 inhibitors - prevent glucose reabsorption in proximal tubule
advantages of insulin analogues e.g. novorapid, Humalog, glargine, detemir
less nocturnal hypos, reduced fasting glucose. smoother metabolic profile - less overlapping
statins mechanism of action
decrease cholesterol biosynthesis, increase cholesterol uptake into liver, reduce inflammation and thrombus formation
How do you calculate anion gap
Na + K - (HCO3 + Cl)
what is a normal anion gap
16 +/- 4
causes of a high anion gap metabolic acidosis
methanol, metformin uremia dka paracetamol iron, isoniazid lactic acidosis ethanol salicylate
why are serum K levels high in DKA
body trying to get rid of H+ ions in urine therefore retaining potassium instead
is the administration of sodium bicarbonate needed in DKA
no. adequate fluid and insulin tx will resolve the acidosis, administering HCO3 may increase risk of cerebral oedema as rise in CSF CO2 and acidosis
