Diabetes

Question 1

pramlintide

Answer 1

amylin analog(s.c.inj)

fxn:
delays gastric emptying

decrease post prandial glucagon secretion

improves satiety

Question 2

name incretins

Answer 2

GLP:glucagon like peptide

GIP:glucose dependant insulotropic peptide

Question 3

moa of GLP1 agonists

Answer 3

1. inc glucose dep insulin secretion

2. rest same as amylin analog

Question 4

exanetide and liraglutide

Answer 4

GLP 1 receptor agonists

Question 5

SE of incretin mimetics

Answer 5

n/v
diarrhoea
constipation
pancreatitis

Question 6

moa of sulfonaylurea

Answer 6

insulin secretagogues
(block the ATP sensitive K channels-depolarisation-Ca influx-exocytosis )

also
inc insulin sensitivity
dec hepatic glucose production

Question 7

glyburide

Answer 7

should not be given in renal impairment (glimperide, glipizide give)

can be used as an alt to insulin pregnancy

Question 8

major SE of sulfonylureas

Answer 8

1. weight gain

2. hyperinsulinemia/hypoglycemia

Question 9

moa of glinides

Answer 9

similar to sulfonylureas

but rapid and short duration of action

post prandial glucose regulatot

Question 10

SE of glinides

Answer 10

similar to sulfonylureas

interactions becoz metabolized by CYP

Question 11

moa of biguanides

Answer 11

MAIN: dec hepatic gluconeogenesis

Question 12

SE of metformin

Answer 12

git

Contraindicated in renal dysfxn due to risk of LACTIC ACIDOSIS

phkinetics: not protein bound , not metabolised , exn via kidneys

any process that dec renal fxn has the risk of LACTIC ACIDOSIS

• MI
• Heart failure
• sepsis
• i.v. radiocontrast

long term use- dec VIT B12 absorption

Question 13

any other use of metformin

Answer 13

PCOD
dec insulin resistance
ovulation occurs

also thiozolidenediones

Question 14

insulin sensitisers

Answer 14

biguanides

thiozolidenediones

Question 15

thiozolidenediones moa

Answer 15

acting as agoinst of PPAR- gamma(peroxisome proliferator activated receptor)

regulates the transcription of insulin responsive genes in liver , adipose and skeletal m

Question 16

effect thiozolidenediones on blood lipid levels

Answer 16

rosi- inc LDL and TGs

pio- dec TGs

BOTH INC HDL

pio is preffered due to better CVS effects

Question 17

SE of thiozolidenediones

Answer 17

CVS- rosi

fluid retention so should not be used in HF

wt gain- inc s.c. fat and fluid retention

pio- bladder cancer

Question 18

alpha glucosidase inh

Answer 18

acarbose

miglitol

Question 19

moa of glucosidase inh

Answer 19

reversibly inhibits this enz in intestinal brush border

dec in carb digestion and post prandial glucose levels.

taken before meals

Question 20

SE OF GLUCOSIDASE INH

Answer 20

flatulence
abdominal pain
diarrhoea

CI
colonic ulceration
IBD
intestinal obs

Question 21

why glucose given in glucosidase inh toxicity

Answer 21

sucrose not given as sucrase is also inhibited

Question 22

DDP4 inh moa

Answer 22

inh DDP4 which is responsible for incretin inactivation

inc insulin release

no feelimg of SATIETY/FULLNESS and WT GAIN as in incretin analogues

Question 23

se of DDP4 inh(gliptans)

Answer 23

nasopharyngitis
headache
pancreatitis

Question 24

SGLT 2 inh (gliflozin) moa

Answer 24

inhibits glucose and Na reqbsortion from filterate

Question 25

SE of SGLT2 inh

Answer 25

hypotension- osmotic diuresis (na and glucose)

vulvovaginal inf
uti
urinary frequecy