diabetes drugs

Question 1

metformin dose

Answer 1

500mg OD with meals
titrated after 7 days
max dose 2g daily

Question 2

metformin side effects

Answer 2

GI - diarrhoea, dyspepsia (transient)
risk of lactic acidosis
suppresses appetite - overweight

Question 3

when to avoid metformin

Answer 3

eGFR < 30 ml/min/1.73m

don’t Rx if eGFR < 45

Question 4

sulphonylurea dose (gliclazide)

Answer 4

40 - 80mg OD
increased to 160mg OD
max 320mg OD
> 160mg in divided doses

Question 5

side effects of SU

Answer 5

weight gain - not for overweight patients
hypoglycaemia (increased in renal/hepatic impariment)
GI - n&v, diarrhoea, constipation
hypersensitivity reactions - skin rashes, blood disorders (rare)

Question 6

pioglitazone dose (glitazones)

Answer 6

15 - 30mg OD

max 45mg daily

Question 7

side effects of pioglitazone

Answer 7

inceased incidence of HF
bladder cancer
increased fracture risk
weight gain
fluid retention

Question 8

when to avoid pioglitazone

Answer 8

HF

bladder cancer

Question 9

side effects of DPP4i/gliptins (sitagliptin)

Answer 9

weight loss
decreased appetite
increased risk of pancreatitis
n&v, dyspepsia
oedema

Question 10

side effects of SGLT2 inhibitors

Answer 10

rapid weight loss
UTI
DKA

Question 11

when can SGLT2 inhibitors not be used

Answer 11

eGFR < 30 ml/min/1.73m