Diabetes Drugs

Question 1

what class of drug is metformin?

Answer 1

biguanide

Question 2

what is the first line drug treatment for T2DM?

Answer 2

metformin

Question 3

what is the mechanism of metformin

Answer 3

decrease in hepatic gluconeogenisis

increase in peripheral glucose uptake into muscle

Question 4

side effects of metformin

Answer 4

lactic acidosis

GI upset

Question 5

what is the mechanism of action of SUs?

Answer 5

stimulate insulin release by blocking KATP channel

Question 6

what is the main risk side effect of SUs?

Answer 6

HYPOglycaemia

Question 7

SUs tend to cause wgt gain/loss?

Answer 7

wgt gain

this makes them suitable as first line treatment in underweight patients

Question 8

who is at risk when using SUs?

Answer 8

elderly people

those with CKD

Question 9

which drug is simialr to SUs but with less risk of hypos?

Answer 9

glinides

Question 10

when is GLP-1 released in the body and from where?

Answer 10

released in response to ingestion of food

enteroendocrine cells in small intestine- L cells in ileum an dcolon, K cells in jejunum/duodenum

Question 11

how does GLP-1 affect insulin an dblood glucose levels?

Answer 11

enhances insulin release from pancreatic B cells and delays gastric emptying therfore lowering blood glucose

Question 12

what effect does GLP-1 have on pancreatic a cells?

Answer 12

decreases glucagon secretion lowering blood glucose

Question 13

what is the DPP4 enzyme?

Answer 13

Dipeptidyl Peptidase 4 enzyme

Question 14

how do DPP4 inhibtors work?

Answer 14

inhibit DPP4 which in turn prolongs action of GLP-1 and GIP lowering blood glucose

Question 15

alpha glucosidase inhibitors are also knwon as?

Answer 15

acarbose

Question 16

what is alpha - glucosidase?

Answer 16

brush border enzyme responsilbe for the breakdown of starch into glucose

Question 17

a- glucosidase inhibitors are useful in diabetes how?

Answer 17

delay the absorption of glucose by preventing breakdown of starch to glucose

Question 18

a- glucosidases brign the risk og hypos true/false?

Answer 18

false- no risk of hypos

Question 19

adverse effects of a- glucosidases?

Answer 19

GI upset- abdo pain, loose stools, bloating etc

Question 20

what do TZDs do?

Answer 20

enhance action of insulin at target tissues

NOTE: they do not inc the production of insulin, only enhance its action

Question 21

which receptor do TZDs act on?

Answer 21

nuclear receptor PPARy

Question 22

TZDs can cause wgt gain/loss?

Answer 22

wgt gain and possibly fluid retention

Question 23

what is the mechanism of action of SGLT-2 inhibitors?

Answer 23

block the reabsorption of glucose by SGLT in the proxiaml tubes of the kidney

Question 24

what is a side effect of SGLT-2 inhibitors?

Answer 24

Thrush and UTIs- due to glycosuria

Question 25

can SGLT-2 inhibitors cause wgt loss?

Answer 25

YES- makes them suitable for use overweight patients

Question 26

what drugs are insulin **independant**?

Answer 26

a-glucosidase inhibtors SGLT-2 inhibitors

Question 27

the KATP channel is a pentameric/octomeric complex?

Answer 27

octomeric complex

Question 28

what is the KATP channel made up of?

Answer 28

4 Kir subunits 4 SUR1 subunits

Question 29

ATP binds to what in the KATP channel causing what?

Answer 29

Kir subunit closing the channel and causing depolarisation

Question 30

KATP channel closure and depolarisation of the B cells results in what?

Answer 30

insulin release