Diabetes drugs Flashcards
What is the action of insulin
Acts via protein kinases
Upregulates synthesis of glycogen, lipids and proteins
Increases cell uptake of glucose
Downregulates lipolysis and gluconeogenesis
What are the side effects of insulin
Hypoglycemia (increased glucose uptake in cells)
Weight gain (increases synthesis + decreases lysis of lipids)
Lipodystrophy (injecting at same site causes lumps to form)
which drug is part of the guanide class?
Metformin
What are the effects of metformin (4)
Essentially complements insulin: Inhibits gluconeogenesis (AMP-PKase activation) Increases glucose uptake Reduces carb absorption Increases fatty acid absorption
What is the clinical use of metformin
First line treatment of T2DM
GI upset and lactic acidosis are side effects of which drug
Metformin
Give 2 examples of Sulphonylureas
Tolbutamide
Glibenclamide
Glicazide
Glipizide
What is the mechanism of action and effect of sulphonylureas
Prevents ADP-Mg2+ binding on SUR-1 to keep Katp closed
No K+ efflux
Increased insulin release
SUs are used as…
Add on therapy in T2DM
hypoglycemia, weight gain and hyponatraemia are side effects of?
SUs
SUs are not given to
CKD patients
Pregnant patients
How do glinides work?
Closes Katp channel in B cell to increase insulin release
repaglinide and nateglinide are used as
Add on therapy in T2DM
When are glinides contraindicated?
liver damage
pregnancy
Give 2 examples of DPP-4 inhibitors
GLIPTIN sitagliptin saxagliptin vildagliptin linagliptin alogliptin
What is the mechanism of action in DPP-4i?
Inhibits DPP4 enzyme to prolong GLP-1 and GIP effects:
Enhance glucose uptake (↑insulin ↓gastric emptying)
Decrease glucose production (↓glucagon production)
When are DPP-4i used?
Add on in T2DM
Pancreatitis is a risk of which drug?
DPP-4is
Give an example of an incretin analogue (GLP-1 agonists)
Extenatide
Liraglutide
What is the action of incretin analogues?
acts as a DDP-4 resistant GLP-1 so : ↑ Insulin ↓glucagon secretion ↓gastric emptying ↓decrease apetite
nausea/vomiting, weight loss and pancreatitis are side effects of
Incretin analogues
Give an example of an α-glucosidase inhibitor
AcarBOSE
VogliBOSE
Miglitiol
How do a glucosidase inhibitors work?
enzyme inhibition prevents starch breaking down into glucose
This prevents glucose rising after a meal
What are the side effects of a glucosidase inhibitors
GI issues
Thiazolinedione examples
GLITIAZONES
pioglitiazone
What is the action pioglitiazone?
PPARY-RXR agonist
Increased coding of pro-insulin signalling and lipid metabolism components
weight gain, fluid retention and hepatotoxicity are side effects of which drug?
Thiazolinediones (APART FROM PIOGLITIAZONE)
SGLT-2 inhibitor action
Blocks glucose absorption SGLT-2 of nephron
‘piss out glucose’
Weight loss and UTIs are side effects of which drugs?
SGLT-2is
Name an example of an SGLT-2i ?
FLOZIN
dapagliflozin
canagliflozin
empagliflozin
Which drugs cause hyopglycemia (2)
Insulin
Sulphonylureas
Which drugs incur weight gain? (3)
Thiazolinediaones
Insuln
Sulphonylureas
Which drugs incur weight loss? (3)
Metformin
Incretin analogues
SGLT-2 inhibitors
