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Endocrinology > Cuddy - DM drugs > Flashcards

Cuddy - DM drugs Flashcards

1
Q

Which drug classes increase endogenous insulin secretion?

A

Sulfonylureas, meglinitides, GLP-1 agonists, and DPP-4 inhibitors

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2
Q

Which drugs drug classes act at peripheral tissues to decrease insulin resistance?

A

Metformin, TZDs

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3
Q

Which drugs decrease glucose release and absorption?

A

Metformin

SGLT-2 inhibitors (make your pee sweet)

a-glucosidase inhibitors
-Decrease post-prandial glucose spike

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4
Q

What are the long-acting insulins?

A

Degludec; Glargine (Lantus)

These control basal insulin levels

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5
Q

What are the long-acting insulins?

A

Degludec, Glargine (Lantus)

These control basal insulin levels - no peak

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6
Q

What is the MOA of sulfonylurea drugs?

A

Bind ATP-dependent K+ channels on B-cells

  • -> Ca+ influx
  • -> release of insulin-containing vesicles
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7
Q

What is the MOA of sulfonylurea drugs?

A

Bind ATP-dependent K+ channels on B-cells, causing them to close

  • -> Ca+ influx
  • -> release of insulin-containing vesicles
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8
Q

What class of drugs has the suffix “-ride”?

Glyburide, glimepiride

A

Sulfonylureas (also included: glipizide)

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9
Q

What class of drugs has the suffix “-glinide”?

Repaglinide, nateglinide

A

Meglitinides

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10
Q

What are the secretogouges that increase endogenous insulin release WITHOUT sensitivity to [glucose]?

A

Sulfonylureas and meglitinides

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11
Q

What are the secretogogues that increase endogenous insulin release WITHOUT sensitivity to [glucose]?

A

Sulfonylureas and meglitinides

*Increased risk of hypoglycemia

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12
Q

What class of drugs has the suffix “-tide”?

Exenatide, liraglutide, dulaglutide, lixisenatide, semaglutide

A

GLP-1 agonists

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13
Q

Which classes of drugs increase endogenous insulin release dependent on [glucose]?

A

GLP-1 agonists

dPP-4 inhibitors

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14
Q

What is the MOA of meglinitide drugs?

A

Bind ATP-dependent K+ channels on B-cells, causing them to close

  • -> Ca+ influx
  • -> release of insulin-containing vesicles
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15
Q

What is the MOA of GLP-1 agonists?

A

Bind and activate GLP-1 receptors, which do the following:

  • Increases insulin release (dependent on increased glucose levels)
  • Decreases inappropriate glucagon release
  • Suppresses appetite
  • Delays gastric emptying
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16
Q

What is the MOA of DPP-4 inhibitors?

A

Inhibit the peptide responsible for breaking down endogenous GLP-1.

(Increased activity of GLP-1 = glucose-sensitive insulin secretion, decreased glucagon release, suppressed appetite, and delayed gastric emptying)

17
Q

What class of drugs has the suffix “-gliptin”?

Sitagliptin, saxagliptin, linagliptin

A

DPP-4 inhibitors

18
Q

What are the actions of Metformin?

A

Via phosphorylation/activation of AMPK:

Decreases hepatic gluconeogenesis

Decreases intestinal glucose absorption

Sensitizes liver and skeletal muscles to insulin (increases glucose uptake in periphery)

Reduces FFA turnover

19
Q

What are some important adverse effects associated with metformin?

A
  • GI intolerance (N/V/D; metallic taste, anorexia - dose dependent and transient)
  • Possibility of lactic acidosis (don’t use in situations that predispose to hypoxia or renal insufficiency)
    CONTRAINDICATED in patients with GFR <30 (caution in patients with GFR <45)
20
Q

What is the class of drugs that has the suffix “-glitazone”?

rosiglitazone, pioglitazone

A

TZD/thiazolidinediones/PPAR-y agonists

21
Q

What is the MOA/action of TZD drugs?

A

Binds to nuclear receptors (PPAR-y) to influence gene transcription.

Increases insulin sensitivity (via increased translocation of GLUT-4 receptors).

Increases glucose utilization and decreases glucose production in adipose tissue, muscle tissue, and liver.

22
Q

TZDs are contraindicated in patients with ____?

A

Heart failure

TZDs can cause fluid retention and peripheral edema that can exacerbate HF

23
Q

Which drug class has the suffix “-flozin”?

Canaglifozin, dapagliflozin, empagliflozin, ertugliflozin

A

SGLT-2 inhibitors

24
Q

What is a signature AE associated with SGLT-2 inhibitors?

A

UTIs

25
Q

Which drugs are associated with risk for hypoglycemia?

A

Insulin
Sulfonylureas
Meglinitides
Amylin

26
Q

Which drugs are associated with benefits for PCOS patients?

A

TZDs

Metformin

27
Q

GFR must be monitored with which drugs?

A

SGLT-2 inhibitor: Dapagliflozin

Metformin

28
Q

Which drugs are associated with weight gain?

A

Insulin
Sulfonylureas
Meglinitides
TZD

29
Q

Which drugs are associated with possible weight loss?

A

Metformin
SGLT-2 inhibitors
GLP-1 agonists, esp Liraglutide
DPP-4 inhibitors

30
Q

Which drugs have cardioprotective qualities?

A

Metformin
Empagliflozin
Liraglutide

Endocrinology (6 decks)

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