Diabetes Medication

Question 1

How should insulin be written in the drug chart?

Answer 1

• Write insulin in the standard drug chart but do the specifics in the insulin chart
• Write brand name eg. lantus
• Write regime

Question 2

How do biguanides work?

Answer 2

ORAL
Decreases gluconeogenesis
Increases glucose uptake into cells

Question 3

How does insulin work?

Answer 3

SC

Acts like the endogenous hormone to regulate blood sugar

Question 4

How do sulphonylureas work?

Answer 4

ORAL

PPAR agonists - Increase insulin secretion from the pancreas

Question 5

Give an example of a biguanide

Answer 5

Metformin

Question 6

Give an example of a sulphonylurea

Answer 6

Gliclazide

Question 7

How do thiazolidinediones work?

Answer 7

ORAL

Influences genes regulating glucose use

Question 8

Give an example of a thiazolidinedione

Answer 8

Pioglitazone

Question 9

How do GLP1 agonists work?

Answer 9

SC

Synthetic form of GLP1 (incretin)- inhibits glucagon release which increases insulin secretion

Question 10

Give an example of a GLP1 agonist

Answer 10

Exenatide

Question 11

How do DPP4 antagonists work?

Answer 11

Block the enzyme that breaks down GLP1 (therefore increase insulin release)

Question 12

Give an example of a DPP4 antagonist

Answer 12

Sitagliptin

Question 13

How do alpha glycosides inhibitors work?

Answer 13

Reduce intestinal absorption of glucose, so that more is excreted as complex carbohydrates

Question 14

Give an example of an alpha glycoside inhibitor

Answer 14

Acarbose

Question 15

Which medications cause hypos (3Gs)?

Answer 15

Gliclazide, glitazones, and gliptins

Question 16

How do SGLT2 inhibitors work?

Answer 16

Inhibit renal glucose reabsorption promoting net calories loss of 200kcal/day

(NB - increase genital infections as ‘gunk’ is coming out through the urine)

Question 17

Give an example of a SGLT2 inhibitor

Answer 17

Dapagliflozin, empaglifozin, ipraglifozin

Question 18

What are the different types of insulin treatment?

Answer 18

SHORT-ACTING - novorapid, humalog, actrapid
MEDIUM-ACTING - humulin N
LONG-ACTING - lantus (glargine), detemir (levemir)

MIXED - novomix 30, humulin M3, Humalog Mix50

Question 19

How long does short-acting insulin last?

Answer 19

2-5 hours

Question 20

How long does medium-acting insulin last?

Answer 20

18-24 hours

Question 21

How long does long-acting insulin last?

Answer 21

24 hours

Question 22

How should hypoglycaemia be managed?

Answer 22

ABCDEFG (dont ever forget glucose)
Conscious 
- oral glucose
Unconscious 
- IV dextrose, glucogel, IM glucagon
- monitor BMs every 15 min
- give long acting carbohydrate
- review medication

Question 23

What are the 3 regimes for insulin therapy?

Answer 23

Basal insulin - long acting 1/2 times a day
Premixed insulin - mixed, 1/2/3 times a day
Basal-blos - short acting with meals