Diabetes Drugs Flashcards
what class of drug is metformin?
biguanide
what is the first line drug treatment for T2DM?
metformin
what is the mechanism of metformin
decrease in hepatic gluconeogenisis
increase in peripheral glucose uptake into muscle
side effects of metformin
lactic acidosis
GI upset
what is the mechanism of action of SUs?
stimulate insulin release by blocking KATP channel
what is the main risk side effect of SUs?
HYPOglycaemia
SUs tend to cause wgt gain/loss?
wgt gain
this makes them suitable as first line treatment in underweight patients
who is at risk when using SUs?
elderly people
those with CKD
which drug is simialr to SUs but with less risk of hypos?
glinides
when is GLP-1 released in the body and from where?
released in response to ingestion of food
enteroendocrine cells in small intestine- L cells in ileum an dcolon, K cells in jejunum/duodenum
how does GLP-1 affect insulin an dblood glucose levels?
enhances insulin release from pancreatic B cells and delays gastric emptying therfore lowering blood glucose
what effect does GLP-1 have on pancreatic a cells?
decreases glucagon secretion lowering blood glucose
what is the DPP4 enzyme?
Dipeptidyl Peptidase 4 enzyme
how do DPP4 inhibtors work?
inhibit DPP4 which in turn prolongs action of GLP-1 and GIP lowering blood glucose
alpha glucosidase inhibitors are also knwon as?
acarbose
what is alpha - glucosidase?
brush border enzyme responsilbe for the breakdown of starch into glucose
a- glucosidase inhibitors are useful in diabetes how?
delay the absorption of glucose by preventing breakdown of starch to glucose
a- glucosidases brign the risk og hypos true/false?
false- no risk of hypos
adverse effects of a- glucosidases?
GI upset- abdo pain, loose stools, bloating etc
what do TZDs do?
enhance action of insulin at target tissues
NOTE: they do not inc the production of insulin, only enhance its action
which receptor do TZDs act on?
nuclear receptor PPARy
TZDs can cause wgt gain/loss?
wgt gain and possibly fluid retention
what is the mechanism of action of SGLT-2 inhibitors?
block the reabsorption of glucose by SGLT in the proxiaml tubes of the kidney
what is a side effect of SGLT-2 inhibitors?
Thrush and UTIs- due to glycosuria
can SGLT-2 inhibitors cause wgt loss?
YES- makes them suitable for use overweight patients
what drugs are insulin independant?
a-glucosidase inhibtors
SGLT-2 inhibitors
the KATP channel is a pentameric/octomeric complex?
octomeric complex
what is the KATP channel made up of?
4 Kir subunits
4 SUR1 subunits
ATP binds to what in the KATP channel causing what?
Kir subunit closing the channel and causing depolarisation
KATP channel closure and depolarisation of the B cells results in what?
insulin release
