Diabetes drugs

Question 1

What is the action of insulin

Answer 1

Acts via protein kinases
Upregulates synthesis of glycogen, lipids and proteins
Increases cell uptake of glucose
Downregulates lipolysis and gluconeogenesis

Question 2

What are the side effects of insulin

Answer 2

Hypoglycemia (increased glucose uptake in cells)
Weight gain (increases synthesis + decreases lysis of lipids)
Lipodystrophy (injecting at same site causes lumps to form)

Question 3

which drug is part of the guanide class?

Answer 3

Metformin

Question 4

What are the effects of metformin (4)

Answer 4

Essentially complements insulin: 
Inhibits gluconeogenesis (AMP-PKase activation)
Increases glucose uptake
Reduces carb absorption
Increases fatty acid absorption

Question 5

What is the clinical use of metformin

Answer 5

First line treatment of T2DM

Question 6

GI upset and lactic acidosis are side effects of which drug

Answer 6

Metformin

Question 7

Give 2 examples of Sulphonylureas

Answer 7

Tolbutamide
Glibenclamide
Glicazide
Glipizide

Question 8

What is the mechanism of action and effect of sulphonylureas

Answer 8

Prevents ADP-Mg2+ binding on SUR-1 to keep Katp closed
No K+ efflux
Increased insulin release

Question 9

SUs are used as…

Answer 9

Add on therapy in T2DM

Question 10

hypoglycemia, weight gain and hyponatraemia are side effects of?

Answer 10

SUs

Question 11

SUs are not given to

Answer 11

CKD patients

Pregnant patients

Question 12

How do glinides work?

Answer 12

Closes Katp channel in B cell to increase insulin release

Question 13

repaglinide and nateglinide are used as

Answer 13

Add on therapy in T2DM

Question 14

When are glinides contraindicated?

Answer 14

liver damage

pregnancy

Question 15

Give 2 examples of DPP-4 inhibitors

Answer 15

GLIPTIN
sitagliptin
saxagliptin
vildagliptin
linagliptin
alogliptin

Question 16

What is the mechanism of action in DPP-4i?

Answer 16

Inhibits DPP4 enzyme to prolong GLP-1 and GIP effects:
Enhance glucose uptake (↑insulin ↓gastric emptying)
Decrease glucose production (↓glucagon production)

Question 17

When are DPP-4i used?

Answer 17

Add on in T2DM

Question 18

Pancreatitis is a risk of which drug?

Answer 18

DPP-4is

Question 19

Give an example of an incretin analogue (GLP-1 agonists)

Answer 19

Extenatide

Liraglutide

Question 20

What is the action of incretin analogues?

Answer 20

acts as a DDP-4 resistant GLP-1 so : 
↑ Insulin 
↓glucagon secretion
↓gastric emptying 
↓decrease apetite

Question 21

nausea/vomiting, weight loss and pancreatitis are side effects of

Answer 21

Incretin analogues

Question 22

Give an example of an α-glucosidase inhibitor

Answer 22

AcarBOSE
VogliBOSE
Miglitiol

Question 23

How do a glucosidase inhibitors work?

Answer 23

enzyme inhibition prevents starch breaking down into glucose

This prevents glucose rising after a meal

Question 24

What are the side effects of a glucosidase inhibitors

Answer 24

GI issues

Question 25

Thiazolinedione examples

Answer 25

GLITIAZONES

pioglitiazone

Question 26

What is the action pioglitiazone?

Answer 26

PPARY-RXR agonist

Increased coding of pro-insulin signalling and lipid metabolism components

Question 27

weight gain, fluid retention and hepatotoxicity are side effects of which drug?

Answer 27

Thiazolinediones (APART FROM PIOGLITIAZONE)

Question 28

SGLT-2 inhibitor action

Answer 28

Blocks glucose absorption SGLT-2 of nephron

‘piss out glucose’

Question 29

Weight loss and UTIs are side effects of which drugs?

Answer 29

SGLT-2is

Question 30

Name an example of an SGLT-2i ?

Answer 30

FLOZIN
dapagliflozin
canagliflozin
empagliflozin

Question 31

Which drugs cause hyopglycemia (2)

Answer 31

Insulin

Sulphonylureas

Question 32

Which drugs incur weight gain? (3)

Answer 32

Thiazolinediaones
Insuln
Sulphonylureas

Question 33

Which drugs incur weight loss? (3)

Answer 33

Metformin
Incretin analogues
SGLT-2 inhibitors