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Core Formulary > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

1
Q

What is the MOA of metformin?

A

Activates AMP dependent protein kinase (hepatically)
Reduces glucogenic processes
Increases insulin action

Increases glucose uptake, inhibits hepatic GNG and carb absorption

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2
Q

What are ADRs of Metformin?

A

Abdominal pain and bloating
Diarrhoea
Anorexia

B12 deficiency

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3
Q

When is Metformin contraindicated?

A

Renal impairment - CKD3

Can provoke lactic acidosis

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4
Q

What are important things that Metformin does NOT do?

A

Does not induce hypoglycaemia

Does not promote weight gain

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5
Q

What are examples of Sulphonylureas?

A

Gliclazide

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6
Q

What is the MOA of Gliclazide?

A

Enhances secretion of insulin in the pancreas
Blocks B cell K+ effluxer channels
Depolarisation
Ca2+ influx and IP3 mediated insulin secretion

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7
Q

What are ADRs of Gliclazide?

A

Hypoglycaemia
Rarely can cause haematological disorders
Weight gain

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8
Q

When is Gliclazide contraindicated?

A

Severe hepatic impairment
Renal impairment
Be careful when pregnant

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9
Q

What is the problem with Sulphonylureas?

A

Need good B cell mass

Goof for few years then after 3years, begins to wear off

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10
Q

How do DDP4 inhibitors work?

A

Increase the incretin effect by blocking DDP4 receptors

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11
Q

What is an example of a DDP4 inhibitor?

A

Saxagliptin?

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12
Q

What is the MOA of Saxagliptin?

A

Inhibits DDP4

Increases half life of incretin and this increases insulin secretion

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13
Q

What are points to note about DDP4 inhibitors?

A

2nd line
Moderate effect of decreasing blood sugars and keep weight neutral
Only good if insulin secretion is preserved

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14
Q

What are ADRs of Saxagliptin?

A 
Dizziness
Dyspepsia
Headache 
Fatigue 
Gastritis and gastroenteritis 
Hypoglycaemia
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15
Q

When is Saxagliptin contraindicated?

A

Severe hepatic impairment

Sensitivity

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16
Q

What is Exenatide?

A

Injectable
Analogue of GLP-1 s increases incretin effect
Long acting
Promotes insulin release (decreasing glucagon), reduces appetite and delays gastric emptying
Weight loss and decrease in blood sugars

17
Q

What are ADRs of Exenatide?

A

Hypoglycaemia
Injection site reactions
Weight loss
Abdominal pain

18
Q

When is Exenatide contraindicated?

A

Ketoacidosis

Severe GI pathologies

19
Q

What are Thiazolidinediones?

A

Reduce insulin resistance by interaction with PPAR-y
Regulates many genes

Decreases hepatic GNG, increases glucose uptake and increases insulin effect

20
Q

What is an example of a Thiazolidinedione?

A

Pioglitazone

21
Q

What are ADRs of Pioglitazone?

A

Weight gain
Fluid retention
Heart failure

Core Formulary (11 decks)

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