Diabetes meds (AMH)

Question 1

What is the MOA of ‘gliptins’?

Answer 1

1. ‘Gliptins’ are Dipeptidyl peptidase-4 (DPP-4) inhibitors
2. Decrease metabolism of GLP-1 and glucose-dependent insulinotropic polypeptide (GDIP)
3. Glucose dependent insulin secretion increases and glucagon production reduced

Question 2

Name FOUR medications that may cause hypoglycaemia when taken with sulfonylureas or insulin.

Answer 2

• DPP-4 inhibitors (gliptins)
• GLP-1 analogues (exenatide)
• SGLT2 inhibitors (gliflozins)
• Acarbose

Question 3

What is the drug name and MOA of Byetta?

Answer 3

Drug name: Exenatide

MOA: GLP-1 analogue (decreases glucagon release)

Question 4

What is the MOA of ‘gliflozins’?

Answer 4

1. Sodium-glucose co-transporter 2 (SGLT2) inhibitor

2. Reduce glucose reabsorption in kidneys (increases excretion of glucose in urine)

Question 5

What is the drug name and MOA of Glucobay?

Answer 5

Drug name: Acarbose

MOA: Delays intestinal absorption of carbs by inhibiting alpha-glucosidase (reduces postprandial hyperglycaemia)

Question 6

How would you treat hypoglycaemia in someone who is taking Acarbose?

Answer 6

Give glucose (sucrose will have it’s absorption delayed)

Question 7

What is the drug name of Forxiga?

Answer 7

Dapagliflozin

Question 8

What is the drug name of Xigduo?

Answer 8

Dapagliflozin/Metformin

Question 9

Name THREE ultra-short-acting insulins.

Answer 9

• Insulin aspart (Novorapid)
• Insulin lispro (Humalog)
• Insulin glulisine (Apidra)

Question 10

Name TWO brands of short acting insulin

Answer 10

• Actrapid

- Humulin R

Question 11

What are the FOUR types of insulin and their corresponding dose timings?

Answer 11

• Ultra-short-acting (immediately before meals)
• Short-acting (within 30 mins before meals)
• Long-acting (od-bd)
• Long-acting analogues (od-bd, lantus od)

Question 12

What is the MOA of Metformin (TWO)?

Answer 12

• Reduces hepatic glucose production

- Increases peripheral utilisation of glucose

Question 13

Name FOUR sulfonylureas and their brand names.

Answer 13

• Glibenclamide (Glimel)
• Gliclazide (Diamicron)
• Glimepiride (Amaryl)
• Glipizide (Melizide)

Question 14

What is the MOA of sulfonylureas?

Answer 14

Increase pancreatic insulin secretion

Question 15

Does drinking alcohol increase or decrease blood sugar levels?

Answer 15

Decrease.

Caution: it may also mask Sx of hypoglycaemia

Question 16

What is the MOA of thiazolidinediones and TWO example drug and brand names?

Answer 16

MOA: Increase sensitivity of peripheral tissues to insulin and decrease hepatic glucose output (via agonist on peroxisome proliferator-activated receptor gamma)

• Pioglitazone (Actos)
• Rosiglitazone (Avandia)

Question 17

Name FOUR gliptins and their brand names.

Answer 17

• Linagliptin (Trajenta)
• Saxagliptin (Onglyza / Kombiglyze)
• Sitagliptin (Januvia)
• Vildagliptin (Galvus)