Diabetes drugs

Question 1

mechanism of action of metformin

Answer 1

reduces hepatic glucose output by activating adenosine monophosphate kinase. rate of gluconeogenesis reduced

Question 2

pros of metformin

Answer 2

no hypos, does not affect insulin secretion, no weight gain

Question 3

cons of metformin

Answer 3

anorexia, diarrhea, epigastric discomfort

Question 4

contraindications for metformin

Answer 4

kidney disease: eGFR below 30

liver disease

Question 5

sulphanylurea mechanism of action

Answer 5

binds to sulphanylurea receptor in beta cell, promotes depolarisation & insulin secretion.

Question 6

pros of sulphanylurea meds

Answer 6

cheap, good for short term control

Question 7

cons of sulphanyl urea meds

Answer 7

as beta cell mass declines, less useful. promotes weight gain, can cause mild hypos and severe in elderly

Question 8

contraindications for sulphanylurea

Answer 8

overweight people, cautious in renal problems. pregnancy, and if don’t have any beta cells left

Question 9

meglitinide mechanism of action

Answer 9

also closes K+ channels via aTPase, promoting insulin secretion

Question 10

pros of meglitinide

Answer 10

same as sulphonylurea

Question 11

cons of meglitinide

Answer 11

more costly than sulphonylurea

Question 12

mechanism of action of thiazolidinediones.glitazones:

Answer 12

reduce insulin resistance by acting on nuclear receptor that controls gene expression of insulin action/lipid metabolism

Question 13

pros of thiazolidinediones

Answer 13

increase glucose uptake by periphery and insulin sensitivity

Question 14

cons of thiazolidinediones

Answer 14

weight gain, fluid retention, heart failure, risk of bladder cancer, mild anaemia, osteoporosis

Question 15

dpp4 inhibitors mechanism of action

Answer 15

potentiates insulin secretion, reduces glucagon secretion

Question 16

dpp4 pros

Answer 16

weight neutral, best for early stages of type 2 diabetes. increases incretin effect

Question 17

dpp4 cons

Answer 17

nausea, acute pancreatitis

Question 18

sodium/glucose transporter 2 inhibitors mechanism of action

Answer 18

excretion of glucose - via transporter in proximal renal tubule

Question 19

pros of sodium/glucose transporter 2

Answer 19

lowers plasma glucose, facilitates weight loss

Question 20

cons of sodium/glucose transporter 2

Answer 20

general candidiasis, uti

Question 21

mechanism of action of glp-1 agonist

Answer 21

injection therapy, analog of intestinal gut hormone with incretin effect - promotes insulin secretion, inhibits glucagon secretion, makes food stay for longer and dampens appetite.

Question 22

pros of glp-1 agonist

Answer 22

promotes weight loss, improves glucose control

Question 23

cons of glp-1 agonist

Answer 23

need to inject, acute pancreatitis, acute kidney injury