Diabetes Medications

Question 1

What is the mechanism of action of metformin?

Answer 1

Increases insulin sensitivity

Decreases hepatic gluconeogenesis

Question 2

What are the main side effects of metformin and when do you have to be careful prescribing it?

Answer 2

Lactic acidosis
GI upset

Be careful prescribing in those with an eGFR of <30

Question 3

What is the mechanism of action of sulfonylureas?

Answer 3

Stimulates pancreatic beta cells to secrete insulin

Question 4

What are the side effects of sulfonylureas? Give examples of a few sulfonylureas.

Answer 4

Hypoglycaemia
Hyponatraemia
Weight gain

Examples: gliclazide and glimepiride

Question 5

What is the mechanism of action of thiazolididiones?

Answer 5

Activates PPAR gamma receptor in adipocytes to promote adipogenesis and fatty acid uptake

Question 6

What are the side effects of thiazolididiones? Give an example of a thiazolididione.

Answer 6

Weight gain
Fluid retention

An example is pioglitazone

Question 7

What is the mechanism of action of DPP4 inhibitors and give examples?

Answer 7

Increases incretin levels which inhibit glucagon secretion

All drugs that end with -gliptins

Question 8

How do SGLT-2 inhibitors work and what is a common S.E.?

Answer 8

Inhibit reabsorption of glucose in the kidney

UTI

Question 9

What are GLP-1 agonists, how are they administered, and what are their side effects?

Answer 9

Incretin mimetic which inhibits glucagon secretion

Nausea and vomiting
Pancreatitis

S/C