Diabetes Drugs Flashcards
How does metformin work? (4)
1) INCREASES SENSITIVITY TO INSULIN
2) Decreases gycogenolysis
3) Decreases gluconeogenesis
4) Increase uptake and utilisation of glucose
What type of drug is metformin?
Biguanide
What are the main benefits of Metformin as a drug? (2)
1) Helps with weight loss
2) No risk of hypos
What is the most common side effect of Metformin?
GI disturbance
What are the contraindications of Metformin?
Renal failure (stop if GFR <30 and review if GFR <45)
Caution in hepatic failure
What are the interactions of Metformin?
Any other nephrotixic drugs
Drugs which increase glucose levels - e.g. corticosteroids
Give an example of a Sulphonylurea
Gliclazide
How do sulphonylreas work? (1)
Increase pancreatic insulin production
What are the side effects of sulphonylureas? (3)
1) Weight gain
2) HYPOS
3) GI upset
What are the contraidications of using sulphonylureas?
Hepatic/renal faikure
Give an example of a Thiazalidinone?
Pioglitazone
How do Thiazalidinones (Pioglitazone) work?
Increase fatty acids in adipocytes, thus less circulating fatty acids thus more cells dependent on glucose
What are the side effects of Thiazalidinones? (2)
1) Weight gain
2) Oedema/water retention
What are the contraindications to using Thiazalidinones? (3)
1) Heart failure
2) Bladder cancer
3) Uninvestigated macroscopic haematuria
Give an example of a DPP4 inhibitor?
Sitagliptin
How do DPP4 inhibitors work?
Increase incretin
Decrease glucagon and blood glucose level
What are the side effects (2) and advantages (2) of DPP4 inhibitors?
1) Allergy
2) GI disturbance
1) Weight neutral
2) Low risk of hypos
Give an example of an SGLT2 inhibitor?
Dapigliflozin (FLOZINS)
How do SGLT2 inhibitors work?
Prevent reuptake of glucose in the proximal tubule leading to glucose being excreted in the urine
What are the advatanges of SGLT2 inhibitors?
1) Weight loss
What are the disavanatages of SGLT2 inhibitors? (4)
1) UTIs
2) Need close drug monitoring
3) Expensive
4) Efficacy depends on renal function
How do GLP-1 mimics work?
1) increase insulin
2) decrease glucagon
3) delays gastric empyting - thus leads to decrease in food intake and body weight
4) increases B cell mass
What are the adverse effects of GLP-1 mimics? (2 + 2 bonus)
1) nausea
2) pancreatitis
To NHS - v expensive
SC injection
What effect does illness have on insulin requirement?
Illness makes resistance to insulin worse so may need more insulin
Also illness increases metabolic requirements of the body so need more energy and thus more glucose
What are the symptoms of hypo-ing?
1) Dizziness
2) Nausea
3) Sweating
4) Confusion
What is the management of hypos?
At home - something sugary and then something starchy
In hospital - there is a hypo box
