Diabetes Flashcards
Name 4 sulphonylureas
Tolbutamide, Chlorpropamide, Glibencamide and Glipizide
How do sulphonylureas work?
Act at Beta-cells in the pancreas, to antagonise K+-ATP channels, causing depolarisation and calcium influx, causing more insulin vesicle fusion and insulin release.
What ADRs do sulphonylureas cause?
Weight gain and hypoglycaemia
What class of drug is metformin?
A biguanide
What do biguanides do?
Increase insulin receptor sensitivity, increasing glucose uptake by muscle and adipose tissue, and decreasing gluconeogenesis.
What main advantage do biguanides have over sulphonylureas?
Don’t risk occurrence of hypoglycaemia.
What main ADR do biguanides have?
Lactic acidosis
Name two thiazolidinediones
Pioglitazone and Rosiglitazone
How to thiazolidinediones work?
increase insulin receptor sensitivity, increasing adipose and muscle glucose uptake and decrease gluconeogenesis. They are PPAR-gamma agonists (nuclear hormone receptor).
What ADR do thiazolidinediones cause?
Weight gain
Name two Meglitidines
Repaglinide and Nateglinide
How do meglitidines work?
Antagonise K+ATP channels to cause depolarisation and subsequently cause calcium influx, increasing insulin vesicle fusion and release.
Compare meglitidine ADRs to sulphonylurea ADRs
They carry a lower but still present risk of hypoglycaemia and do not cause weight gain.
What is the route of delivery for insulin analogues?
Sub-cutaneous
What are 2 ADRs for insulin analogues?
Reactions at delivery site, and hypoglycaemia.
