Diabetes

Question 1

Glibenclamide

Answer 1

Sulfonylurea

Inhibit SUR-1 subunit of the K+/ATP channel
- Close channel → membrane depolarization
- Increase pancreatic insulin secretion; may decrease insulin resistance.

Question 2

Gliclazide

Answer 2

Sulfonylurea

Inhibit SUR-1 subunit of the K+/ATP channel
- Close channel → membrane depolarization
- Increase pancreatic insulin secretion; may decrease insulin resistance.

Question 3

Glimepride

Answer 3

Sulfonylurea

Inhibit SUR-1 subunit of the K+/ATP channel
- Close channel → membrane depolarization
- Increase pancreatic insulin secretion; may decrease insulin resistance.

Question 4

Glipizide

Answer 4

Sulfonylurea

Inhibit SUR-1 subunit of the K+/ATP channel
- Close channel → membrane depolarization
- Increase pancreatic insulin secretion; may decrease insulin resistance.

Question 5

Alogliptin

Answer 5

Inhibit dipeptidyl peptidase‑4 (DPP‑4) thereby increasing the concentration of the incretin hormones glucagon-like peptide‑1 and glucose-dependent insulinotropic polypeptide; glucose-dependent insulin secretion is increased and glucagon production reduced.

Question 6

Linagliptin

Answer 6

Inhibit dipeptidyl peptidase‑4 (DPP‑4) thereby increasing the concentration of the incretin hormones glucagon-like peptide‑1 and glucose-dependent insulinotropic polypeptide; glucose-dependent insulin secretion is increased and glucagon production reduced.

Question 7

Saxagliptin

Answer 7

Inhibit dipeptidyl peptidase‑4 (DPP‑4) thereby increasing the concentration of the incretin hormones glucagon-like peptide‑1 and glucose-dependent insulinotropic polypeptide; glucose-dependent insulin secretion is increased and glucagon production reduced.

Question 8

Sitagliptin

Answer 8

Inhibit dipeptidyl peptidase‑4 (DPP‑4) thereby increasing the concentration of the incretin hormones glucagon-like peptide‑1 and glucose-dependent insulinotropic polypeptide; glucose-dependent insulin secretion is increased and glucagon production reduced.

Question 9

Vildagliptin

Answer 9

Inhibit dipeptidyl peptidase‑4 (DPP‑4) thereby increasing the concentration of the incretin hormones glucagon-like peptide‑1 and glucose-dependent insulinotropic polypeptide; glucose-dependent insulin secretion is increased and glucagon production reduced.

Question 10

Dulaglutide

Answer 10

Analogues of glucagon-like peptide‑1 (an incretin); increase glucose-dependent insulin secretion and suppress inappropriate glucagon secretion. They also delay gastric emptying, which slows glucose absorption, and decrease appetite.

Question 11

Liraglutide

Answer 11

Analogues of glucagon-like peptide‑1 (an incretin); increase glucose-dependent insulin secretion and suppress inappropriate glucagon secretion. They also delay gastric emptying, which slows glucose absorption, and decrease appetite.

Question 12

Semaglutide

Answer 12

Analogues of glucagon-like peptide‑1 (an incretin); increase glucose-dependent insulin secretion and suppress inappropriate glucagon secretion. They also delay gastric emptying, which slows glucose absorption, and decrease appetite.

Question 13

Acarbose

Answer 13

Alpha-glucosidase inhibitors

Delays intestinal absorption of carbohydrates by inhibiting alpha-glucosidase enzymes in the small intestine; reduces postprandial hyperglycaemia.

Question 14

Metformin

Answer 14

Biguanide

Reduces hepatic glucose production; increases peripheral utilisation of glucose.

Question 15

Pioglitazone

Answer 15

Thiazolidinedione

Agonist of peroxisome proliferator-activated receptor gamma, which regulates genes involved in lipid and glucose metabolism.

Increases the sensitivity of peripheral tissues to insulin; decreases hepatic glucose output.

Question 16

Tirzeparide

Answer 16

Agonist at glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors. Increases insulin sensitivity and glucose-dependent insulin secretion, reduces glucagon secretion, delays gastric emptying (which slows glucose absorption) and decreases appetite.

Question 17

Insulin asparat

Answer 17

Ultra-short acting analogue

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 18

Insulin lispro

Answer 18

Ultra-short acting analogue

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 19

Insulin glulisine

Answer 19

Ultra-short acting analogue

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 20

Neutral insulin

Answer 20

Short acting

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 21

Isophane insulin

Answer 21

long acting

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 22

Insulin detemir

Answer 22

Long acting analogue

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 23

Insulin glargine

Answer 23

Long acting analogue

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 24

Degludec

Answer 24

long acting

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 25

Aspart protamine

Answer 25

long-acting

Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.

Question 26

Dapagliflozin

Answer 26

Inhibit sodium-glucose co-transporter 2, reducing glucose reabsorption in the kidney (and increasing its excretion in the urine).

How SGLT2 inhibitors exert their effects in heart failure and chronic kidney disease is not established but the mechanisms appear to be independent of glucose lowering.

Question 27

Empagliflozin

Answer 27

Inhibit sodium-glucose co-transporter 2, reducing glucose reabsorption in the kidney (and increasing its excretion in the urine).

How SGLT2 inhibitors exert their effects in heart failure and chronic kidney disease is not established but the mechanisms appear to be independent of glucose lowering.

Question 28

Glucagon

Answer 28

Increases blood glucose concentration by activating hepatic glucose production; decreases GI motility.