diabetes Flashcards
1
Q
pharmacology for diabetes
A
- metformin
- glibenclamide/glipizide
- repaglinide
- exenatide
- sitagliptin
- dapagliflozin
- pioglitazone
- acarbose
my glucose rly exists so dicks preferentially atrophy
2
Q
metformin
A
- activates AMPK, decrease genes in hepatic gluconeogenesis
- less gluconeogenesis, more glucose uptake, less carb absorption, less VLDL and LDL, less appetite
3
Q
glibenclamide and glipizide are
A
sulphonylurea compounds
4
Q
how do sulphonylurea compounds work
A
- e.g. glibenclamide, glipizide
- bind to SUR1 subunit of KATP > insulin release
- glipizide mainly metabolised to inactive products but glibenclamide > active, so potentiated effect if renal insufficiency
- worry about cardiac but SUR2A
5
Q
what is repaglinide
A
a meglitinide
6
Q
how do meglitinides work
A
- inhibits KATP by binding to SUR1 (like sulphonylurea drugs)
- but faster onset and offset
7
Q
incretins
A
- decrease blood glucose - GIP (K cells) and GLP-1 (L cells)
- stimulate insulin and inhibit glucagon secretion, reduce gastric emptying, GLP-1 also reduces appetite and so body weight
- broken down by DPP-4
8
Q
exenatide mechanism
A
like GLP-1 (decrease blood glucose) but longer acting
9
Q
what is sitagliptin
A
a gliptin
10
Q
what do gliptins do
A
inhibit DPP-4 (so inhibit incretin breakdown > decrease blood glucose)
11
Q
what is dapagliflozin
A
a gliflozin
12
Q
what do gliflozins do
A
- increase urinary glucose loss and reduce GI glucose absorption because inhibit SGLT2 (dapagliflozin) or SGLT1/2
13
Q
what is pioglitazone
A
a thiazolidinedione
14
Q
what do thiazolidinediones do
A
- activate PPAR gamma, highly expressed in adipose tissue but also present in liver and muscle
- increase lipogenesis, glucose/fatty acid uptake, and increased transcription of numerous genes e.g. GLUT4
15
Q
what is acarbose
A
an alpha-glucosidase inhibitor
