Diabetes Drugs Flashcards
1
Q
Bigaunide
- Mechanism
- Example
- COUNCILLING
A
Mechanism
- Inc insulin sensitivity
Example
- Metformin
COUNCILLING
- Nausea (titrate dose up)
- Lactic acidosis (monitor renal function)
- Serm Cr >150
- eGFR
- NO angiography
- High risk of contract induced nephropathy
- Stop on the day + 48hrs
2
Q
Sulphonylureas
- Mechanism
- Example
- Indications
- COUNCILLING
A
Mechanism
- Inc insulin release
Example
- Gliclazide
- Glimepiride
Indications
- 2nd line after Metformin
COUNCILLING
- HYPOglycaemia (inform DVLA)
- CI Goods drivers
3
Q
Thiazolidinediones
- Mechanism
- Example
- Indication
- COUNCILLING
A
Mechanism
- Inc insulin sensitivity
Example
- Pioglitazone - bladder cancer
- Rosiglitazone (no longer used - CV affects)
Indication
- 3rd line: HbA1C >7.5% or >58mmol/L
COUNCILLING
- Weight gain + fracture
- Liver impairment (monitor LFTs)
- Fluid retention (CI in HF)
- Insulin = Peripheral oedema
4
Q
DPP-4 Inhibitors
- Mechanism
- Example
- Indications
- COUNCILLING
A
Mechanism
- Inhibits DPP-4 ⇒ Inc Incretins
- Inhibit Glucagon ⇒ Inc INSULIN
Example - GLIPTINS
- Sitagliptin
Indications
- Only used with other drugs (1,2,3)
- 4th line
- Only continue if HbA1C drops 0.5%/6m
COUNCILLING
- GI
- Flu-like symptoms
- Rare: Acute Pancreatitis
- Rare: Hypoglycaemia
5
Q
GLP-1 analogues
- Mechanism
- Example
- Indications
- COUNCILLING
A
Mechanism
- mimics Incretin
- Inhibit Glucagon ⇒ Inc INSULIN
Example
- Exenatide SUBCUTANEOUS
Indications
- Only used with other drugs (1,2,3)
- BMI >35kg/m2 or Can’t do insulin
- 5th line
COUNCILLING
- GI
- Dizziness, headache, jittery
- Rare: Acute pancreatitis
- Rare: Hypoglycaemia
6
Q
SGLT2 inhibitors
- Mechanism
- Example
- Indications
- COUNCILLING
A
Mechanism
- Increase renal excretion of GLUCOSE
Example - GLIFLOZIN
- Dopagliflozin
Indications
- Only used with something else (any drug or insulin) (NOT with 1+2 together!)
COUNCILLING
- UTIs
7
Q
Glinides
- Mechanism
- Example
- Indications
- COUNCILLING
A
Mechanism
- Inc Insulin SECRETION quickly (30mins before meal)
Example - GLINIDES
- Nateglinide/ mitiglinide
Indications
- Erratic lifestyle
COUNCILLING
- Hypoglycaemia
- Weight gain
