Diabetes Medication

Question 1

What is the mechanism of action of metformin

Answer 1

increases the utilisation of glucose

Question 2

What are the side effects of Metformin

Answer 2

• lactic acidosis
• GI side effects
• reduces vitamin b12 levels

Question 3

At which eGFR should you avoid Metformin

Answer 3

below 30

Question 4

When should you stop Metformin

Answer 4

if patient is experiencing Acute Kidney Injury

Question 5

What is the Mechanism of Action of Sulphonylureas

Answer 5

augments insulin secretion

Question 6

Examples of short acting Sulphonylureas

Answer 6

• Gliclazide
• Tolbutamide

Question 7

Examples of long acting Sulphonylureas

Answer 7

• Glimepiride
• Glibenclamide

Question 8

Which Sulphonylurea should you avoid in elderly

Answer 8

Glibenclamide
(long acting)

Question 9

Side effect of Sulphonylureas

Answer 9

• high risk of hypoglycaemia

Question 10

When should you avoid using Sulphonylureas

Answer 10

• acute porphyria
• hepatic impairment
• renal impairment

Question 11

What is the mechanism of action of Pioglitazone

Answer 11

reduces peripheral insulin resistance

Question 12

When to avoid Pioglitazone

Answer 12

history of heart failure

Question 13

Side effects of Pioglitazone

Answer 13

• bladder cancer
• bone fractures
• liver toxicity

Question 14

When should Pioglitazone be reviewed after starting

Answer 14

3 to 6 months

Question 15

What to report when taking pioglitazone

Answer 15

• haematauria, dysuria
• nausea, vomiting, dark urine

Question 16

Mechanism of Action of DPP-4i

Answer 16

Inhibits DPP-4 to increase insulin secretion and decrease glucagon secretion

Question 17

Examples of DPP-4i

Answer 17

• Alogliptin
• Linagliptin
• Vildagliptin
• Saxagliptin

Question 18

Which DPP-4i is hepatotoxic

Answer 18

Vildagliptin

Question 19

Side effect of DPP-4i

Answer 19

Pancreatitis (inflamed pancreas)

• report severe abdominal pain

Question 20

What is the Mechanism of action of SGLT-2i

Answer 20

inhibits SGLT-2 in renal proximal tubule, increasing urination

Question 21

What to monitor when taking SGLT-2i

Answer 21

• Ketones (during surgery)
• Renal Function

Question 22

What are the side effects of SGLT-2i

Answer 22

• life threatening DKA
• Fournier’s gangrene

Question 23

What is Fournier’s gangrene

Answer 23

swelling of genitals causing massive pain

Question 24

Which SGLT-2i has the highest chance of lower limb amputation

Answer 24

Canagliflozin

Question 25

What do you need to correct before starting a SGLT-2i

Answer 25

Hypovolaemic, as SGLT-2i can cause volume depletion

Question 26

Examples GLP-1 Agonists

Answer 26

• Dulaglutide
• Semaglutide
• Liraglutide

Question 27

What is the mechanism of action of GLP-1 Agonists

Answer 27

increase insulin secretion, slowing down glucagon secretion. slows down gastric emptying

Question 28

Side effects of GLP-1 Agonists

Answer 28

• acute pancreatitis
• dehydration

Question 29

MHRA warning for GLP-1 Agonists

Answer 29

highest risk of DKA when used with insulin

Question 30

What is the mechanism of action of Acarbose

Answer 30

delays digestion of starch and sucrose

Question 31

What does Acarbose have a high risk of and what to do

Answer 31

• GI side effects

reduce dose