DI SGLT2 Inhibitors

Question 1

What is the starting and target dose of SGLT2 Inhibitors when used for chronic heart failure? (Without concomitant diabetes).

Answer 1

10 mg daily

Question 2

True or False: SGLT2 Inhibitors help reduce mortality in heart failure patients

Answer 2

True

Question 3

What is the eGFR requirement for initiating Dapagliflozin?

Answer 3

Greater than or equal to 30 mL/min/1.73m2

Question 4

What is the eGFR requirement for initiating Empagliflozin?

Answer 4

Greater than or equal to 20 mL/min/1.73m2

Question 5

What are 3 adverse effects of SGLT2 Inhibitors?

Answer 5

Dehydration, UTI, Hypoglycemia

Question 6

What other disease state are SGLT2 Inhibitors beneficial for?

Answer 6

Diabetes

Question 7

True or False: Loop diuretic dose may need to be adjusted if patient is initiated on a SGLT2 Inhibitor

Answer 7

True

Question 8

What is the MOA for SGLT2 inhibitors?

Answer 8

Increase urine output by osmotic diuresis (glucose excretion)

Question 9

True or false: SGLT2 Inhibitors cause a decrease in the amount of glucose excreted in the urine

Answer 9

False

Question 10

What is a good monitoring parameter for patients on a SGLT2 Inhibitor? (Without concomitant diabetes).

Answer 10

Volume Status

Question 11

Generic and brand names of the SGLT2 inhibitors

Answer 11

Dapagliflozin [Farxiga]

Empagliflozin [Jardiance]

Question 12

What NYHA Classification class warrants the use of a SGLT2 Inhibitor?

Answer 12

Class II-IV

Question 13

How do the SGLT2 inhibitors differ from loop diuretics in terms of mechanism and mortality?

Answer 13

Loop diuretics pull from intravascular volume space, whereas SGLT2 inhibitors pull more from interstitial space and deplete intravascular volume to less of a degree compared to loop diuretics.

In loop diuretics, depleting too much volume in these congested patients may trigger body to hold on to more fluid - no mortality benefit, may worsen mortality!