Diabetes Medication Flashcards
What is the mechanism of action of metformin
increases the utilisation of glucose
What are the side effects of Metformin
- lactic acidosis
- GI side effects
- reduces vitamin b12 levels
At which eGFR should you avoid Metformin
below 30
When should you stop Metformin
if patient is experiencing Acute Kidney Injury
What is the Mechanism of Action of Sulphonylureas
augments insulin secretion
Examples of short acting Sulphonylureas
- Gliclazide
- Tolbutamide
Examples of long acting Sulphonylureas
- Glimepiride
- Glibenclamide
Which Sulphonylurea should you avoid in elderly
Glibenclamide
(long acting)
Side effect of Sulphonylureas
- high risk of hypoglycaemia
When should you avoid using Sulphonylureas
- acute porphyria
- hepatic impairment
- renal impairment
What is the mechanism of action of Pioglitazone
reduces peripheral insulin resistance
When to avoid Pioglitazone
history of heart failure
Side effects of Pioglitazone
- bladder cancer
- bone fractures
- liver toxicity
When should Pioglitazone be reviewed after starting
3 to 6 months
What to report when taking pioglitazone
- haematauria, dysuria
- nausea, vomiting, dark urine
Mechanism of Action of DPP-4i
Inhibits DPP-4 to increase insulin secretion and decrease glucagon secretion
Examples of DPP-4i
- Alogliptin
- Linagliptin
- Vildagliptin
- Saxagliptin
Which DPP-4i is hepatotoxic
Vildagliptin
Side effect of DPP-4i
Pancreatitis (inflamed pancreas)
- report severe abdominal pain
What is the Mechanism of action of SGLT-2i
inhibits SGLT-2 in renal proximal tubule, increasing urination
What to monitor when taking SGLT-2i
- Ketones (during surgery)
- Renal Function
What are the side effects of SGLT-2i
- life threatening DKA
- Fournier’s gangrene
What is Fournier’s gangrene
swelling of genitals causing massive pain
Which SGLT-2i has the highest chance of lower limb amputation
Canagliflozin
