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Drugs Lists > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

1
Q

Name a rapid acting insulin

A

Insulin aspart (Novorapid)

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2
Q

Name a short acting insulin

A

Soluble insulin (Actrapid, Humulin S)

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3
Q

Name an intermediate acting insulin

A

Isophane insulin (NPH)

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4
Q

Name a long acting insulin

A

Insulin degludec

Insulin glargine

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5
Q

What are some side effects of insulin?

A

Hypoglycaemia - renal impairment increases risk
Lipohypertrophy
Lipoatrophy

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6
Q

When a patient is on steroids, what should you do with the insulin dose?

A

Increase it

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7
Q

Name a biguanide

A

Metformin

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8
Q

How does metformin work?

A

Decreases hepatic glucose output (gluconeogenesis, glycogenolysis)
Increases glucose utilization in skeletal muscle

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9
Q

Does metformin cause weight gain? Why?

A

No because it suppresses appetite

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10
Q

What are side effects of metformin?

A

GI upset

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11
Q

What are some contraindications/warnings with metformin?

A

If eGFR<30 as excreted unchanged by kidneys

ACEi, diuretics, NSAID’s can impair renal function

Thiazides can cause hyperglycaemia

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12
Q

Name a sulphonylurea

A

Gliclazide

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13
Q

How do sulfonylureas work?

A

Stimulate B cell pancreatic insulin secretion blocking ATP dependent K+ channels

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14
Q

Do sulfonylureas cause weight gain and hypoglycaemia?

A

Yes because of anabolic effects of insulin

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15
Q

What are side effects of gliclazide?

A

Mild GI upset

Hypersensitivity

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16
Q

What are some warnings with gliclazide?

A

Caution with other hypoglycaemic agents, hepatic or renal impairment

Thiazide like diuretics cause hyperglycaemia

17
Q

Name two thiazolidinediones/glitazones

A

Pioglitazone

Rosiglitazone

18
Q

How do thiazolidinediones/glitazones work?

A

Increase insulin sensitivity of muscle and adipose by activating PPAR-y

19
Q

Do glitazones cause weight gain and hypoglycaemia?

A

Yes because of fat cell differentiation

Yes they cause hypoglycaemia

20
Q

What are the side effects of glitazones?

A 
GI upset
Fluid retention
Fracture risk
CVD concerns
Bladder cancer
21
Q

Name two SGLT-2 inhibitors

A

Dapaglifozin

Canaglifozin

22
Q

How do SGLT-2 inhibitors work?

A

They decrease glucose absorption in the kidneys and excrete it out in the urine

23
Q

Do SGLT-2 inhibitors cause weight gain?

A

No, weight loss

24
Q

What are the side effects of SGLT-2 inhibitors?

A

UTI
Genital infections
Thirst
Polyuria

25
Q

What are some warnings with SGLT-2 inhibitors?

A

Antihypertensives

Other hypoglycaemic agents

26
Q

Name 2 DPP-4 inhibitors

A

Sitagliptin

Saxagliptin

27
Q

How do DPP-4 inhibitors work?

A

They prevent GLP-1 degradation

28
Q

Do DPP-4 inhibitors cause weight gain or hypoglycaemia?

A

No - GLP-1 is glucose dependent so postprandial action, insulin wont be stimulated at low blood sugar levels

No - Suppresses appetite

29
Q

What are the side effects of DPP-4 inhibitors?

A

GI upset
Pancreatitis risk
Avoid in pregnancy

30
Q

What are cautions with DPP-4 inhibitors?

A

Other hypoglycaemic agents

Drugs that oppose - thiazide, loop diuretics

31
Q

Name two GLP-1 receptor agonists

A

Exenatide

Liraglutide

32
Q

How do GLP-1 receptor agonists work?

A

Increase glucose dependent synthesis of insulin secretion from B-cells by activating the GLP-1 receptor

33
Q

How is exenatide/liraglutide given?

A

SC injection

34
Q

Do GLP-1 receptor agonists cause weight gain?

A

No as promote satiety

35
Q

What are side effects of GLP-1 receptor agonists?

A

GI upset

GORD

36
Q

What are contraindications to GLP-1 receptor agonists?

A

Stop if eGFR<30

37
Q

What is the guideline for treating type 2 diabetes?

A
  1. If HbA1c rises to 6.5% on lifestyle measures, offer standard release metformin to a target of 6.5%
  2. If HbA1c rises to 7.5%, add DPP-4i/glitazone/SU/SGLT-2i. Aim for target of 7%
  3. If HbA1c rises to 7.5%, consider triple therapy. Aim for a target of 7%

Drugs Lists (14 decks)

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