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Misc. Notes Year 2 > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

1
Q

Name a biguanide

A

Metformin

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2
Q

How do biguanides work

A

Reduces hepatic gluconeogenesis by stimulating AMP-activated protein kinase (AMPK)

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3
Q

What is the first line drug in T2DM normally

A

Metformin

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4
Q

What is the first line drug in T2DM if there are osmotic symptoms present

A

Sulphonylurea (Gliclazide)

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5
Q

Does Metformin prevent Micro or Macro -vascular complications

A

Macro and Micro

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6
Q

What effect does Metformin have on weight

A

Metformin causes weight loss

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7
Q

Is there a risk of hypoglycaemia with Metformin

A

No

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8
Q

What GI symptoms can Metformin cause

A

Diarrhoea, nausea, anorexia

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9
Q

Which T2DM drug can rarely cause lactic acidosis

A

Metformin

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10
Q

Is Metformin insulin dependent or independent

A

Insulin-independent

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11
Q

Which drug Increases glucose uptake and utilization by skeletal muscle

A

Metformin

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12
Q

Is Metformin safe during pregnancy

A

Yes

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13
Q

What are the contraindications to prescribing Metformin

A

If eGFR < 30 or serum creatinine > 150

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14
Q

What is a first generation sulphonylurea

A

Tolbutamide

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15
Q

What are some 2nd generation sulphonylurea’s

A

Glicazide
Glibenclamide
Glimepiride

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16
Q

How do Sulphonylureas work

A

Bind to SUR1 subunits (displacing ADP-MG) to close the KATP channel causing depolarisation -> insulin release

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17
Q

Do Sulphonylureas prevent Micro or Macro -vascular complications

A

Micro only

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18
Q

What effect doe Sulphonylureas have on weight

A

Weight Gain

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19
Q

Is there a risk of hypoglycaemia with Sulphonylureas

A

Yes

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20
Q

What are some side effects of Sulphonylureas

A 
GI symptoms
A headache
Hypersensitivity
Blood dyscrasias
Liver dysfunction
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21
Q

Are Sulphonylureas insulin dependent or independent

A

Insulin Dependent

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22
Q

What are the contraindications to prescribing Sulphonylureas

A

Avoid in severe renal or hepatic failure

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23
Q

What type of drug is Pioglitazone

A

TZD (Thiazolidinedione)

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24
Q

How do TZD’s work

A

Exogenous agonists of nuclear receptor PPARY (largely confined to adipocytes)
Decrease insulin resistance and reduce hepatic glucose output

25
Q

Do TZD’s prevent Micro or Macro -vascular complications

A

Neither

26
Q

Do TZD’s cause weight gain or loss

A

Weight Gain

27
Q

What are some side effects of TZD’s

A

Fluid Retention

Hepatotoxicity

28
Q

Is there a risk of Hypoglycaemia with TZD’s

A

No

29
Q

Are TZD’s insulin dependent or independent

A

Insulin-dependent

30
Q

What are the contraindications to prescribing TZD’s

A

Avoid in over 65’s due to bone risk

Avoid in heart failure patients due to fluid retention

31
Q

Give an example of an SGLT2 Inhibitor

A

Dapagliflozin

32
Q

How do SLGT2i’s work

A

Selectively block reabsorption of glucose by SGLT2 in proximal tubule of kidney _> deliberately causes glucosuria

33
Q

Is there a risk of hypoglycaemia with SGLT2i’s

A

Yes, very low risk

34
Q

Do SGLT2i’s cause weight gain or loss

A

Weight loss (calorific and osmotic diuresis effect)

35
Q

What are some side effects of SGLT2i’s

A

Thrush

Urine Infections

36
Q

Are SGLT2i’s insulin dependent or independent

A

Insulin-Independent

37
Q

Are there any contra-indications to prescribing SGLT2i’s

A

No

38
Q

Give examples of GLP-1 receptor agonist

A

Exenatide

Liraglutide

39
Q

How do GLP-1 receptor agonists work

A

Binds to GPCR GLP-1 receptors that increase intracellular cAMP of the pancreatic B cell

40
Q

Do GLP1 receptor antagonists cause weight loss or gain

A

Weight loss and reduces hepatic fat accumulation

41
Q

Is there a risk of hypoglycaemia with GLP-1 agonists

A

Yes

42
Q

Are GLP-1 antagonists insulin dependent or independent

A

Insulin-dependent

43
Q

Give some examples of DPP-IV inhibitors

A

“-Gliptins”
Sitagliptin
Saxigliptin
Vildagliptin

44
Q

How do DPP-IV inhibitors work

A

Competitively inhibit DPP-4 to prolong the action of GLP-1 and GIP

45
Q

What effect do DPP-IV inhibitors have on weight

A

Weight Neutral

46
Q

Is there a risk of hypoglycaemia with DPP-IV inhibitors

A

Yes

47
Q

Give some side effects of DPP-IV inhibitors

A

Nausea
Pancreatitis
Pancreatic Cancer

48
Q

Are DPP-IV inhibitors insulin dependent

A

Yes

49
Q

Give an example of an a-glucosidase inhibitor

A

Acarbose

50
Q

How do a-glucosidase inhibitors work

A

Inhibit a-glucosidase (a brush border enzyme that breaks down starch and disaccharides to absorbable glucose)

51
Q

Is there a risk of hypoglycaemia with a-glucosidase inhibitors

A

No

52
Q

What are some side effects of a-glucosidase inhibitors

A

flatulence, loose stool, diarrhoea, abdo pain, bloating

53
Q

Are a-glucosidase inhibitors insulin dependent

A

No, they are insulin independent

54
Q

If a patient is suffering from hypo’s when on a sulphonylurea, what type of drug can they be switched to

A

Glinides (meglitinides)

55
Q

Give some examples of Glinides (meglitinides)

A

Repaglinide

Nateglinide

56
Q

How do Glinides work

A

Bind to SUR1 (at a distinct benzamido site) to close the KATP channel causing depolarisation –> insulin release

57
Q

Is there a risk of Hypoglycaemia with Glinides

A

Yes but less likely to cause hypoglycaemia than SU’s as have rapid onset/offset kinetics

58
Q

Are Glinides insulin dependent

A

Yes

59
Q

What are the side effects of GLP-1 receptor agonists

A

Nausea
Pancreatitis
Pancreatic cancer

Misc. Notes Year 2 (30 decks)

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