Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Week 141 - Diabetes Type II > Diabetes Type II Pharmacology > Flashcards

Diabetes Type II Pharmacology Flashcards

0
Q

What group of drugs does Metformin fall within?

A

Biguanides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is currently the first line pharmacological treatment for diagnosed diabetes mellitus type 2?

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When should you tell a patient to take their Metformin prescription?

A

With food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the maximum daily dose of Metformin you can prescribe to a patient?

A

1g TDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the major side-effect of Metformin (Biguanides in general)?

A

GI disturbance (nausea, vomiting, diarrhoea - very rarely fatal lactic acidosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does Metformin act?

A

It REDUCES hepatic glucose release and INCREASES peripheral glucose uptake
(DOES NOT increase insulin release)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the best treatment for those with impaired glucose intolerance? (Pre-diabetes)

A

Lifestyle changes - exercise, reduced carbohydrate dietary intake and smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are usually considered to be second-line DM type 2 treatments?

A

Sulphonylureas (SUs) (1st line in some cases)
Thiazolidinediones (TZDs)
DDP-4 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why might sulphonylureas not be first-line for many type 2 diabetics?

A

Must have partially functioning Beta cells for them to work as they increase insulin release from them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give examples of SUs with short half-lives

A

Gliclazide and Glipizide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why might you choose to give Glibenclamide instead of Gliclazide?

A

Has a longer half-life so can prescribe od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the two significant side-effects of sulphonylureas?

A

Hypoglycaemia (as increase insulin release)

Weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which group of patients would you usually avoid prescribing SUs to?

A

The elderly - greater risk of hypo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When would you advise a patient to take their prescription of SU (Gliclazide or Glimepiride)?

A

With food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name another type of DMII treatment which acts in a very similar way to SUs?

A

Metiglanides (Repaglimide or Nateglimide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the major side effects of Repaglinide and Nateglinide

A

Mild hypoglycaemia

GI disturbance

16
Q

What type of DM II treatment is Acarbose?

A

An alpha-glucosidase inhibitor

17
Q

How does Acarbose act in the treatment of DMII?

A

Inhibits intestinal alpha-glycosidases > delaying glucose absorption / digestion of starch and sucrose

18
Q

What is commonly complained of by those prescribed Acarbose?

A

Flatulance

19
Q

Thiazolidinediones (TZDs) (AKA Glitazones) are common second-line DM II treatments. Which one is solely used in the UK currently?

A

Pioglitazone

20
Q

How do TZDs / Glitazones act?

A

They increase peripheral sensitivity to insulin (so no effect if no circulating insulin!)
They increase transcription of certain insulin-sensitive genes.

21
Q

What are the side-effects of TZDs /Glitazones?

A

Peripheral oedema
Anaemia
Pathological fractures

22
Q

when should TZDs definitely be avoided?

A

In congestive cardiac failure

23
Q

What are Sitagliptin, Vildagliptin and Linaglyptin examples of?

A

DPP-4 inhibitors

24
Q

What do DPP-4 inhibitors do pharmacologically?

A

Protect GLP-1 from inactivation by DPP-4

25
Q

What is GLP-1?

A

An incretin (released by the L-cells of the intestine upon detection of glucose to stimulate insulin release from the beta cells of the pancreas)

26
Q

What are Liraglutide and Exenatide examples of?

A

A GLP-1 receptor agonist (GLP-1 mimic)

27
Q

Sitagliptin (DPP-4 inhibitor) combined with Metformin has been proven to be as effective as Metformin combined with what other anti diabetic drug?

A

Sulphonylureas

28
Q

What advantage does the combination of Metformin and Sitagliptin have over that of SUs with Metformin?

A

Much lower incidence of hypoglycaemia and illustrated weight reduction

29
Q

Liraglutide has been shown to have what two effects on 67% of DM II sufferers?

A

HbA1c decrease and weight loss (21% showed weight gain but still with reduced HbA1c)

30
Q

GLP-1 receptors agonists and Acarbose are generally considered what line of treatment in DM II?

A

3rd line. (Officially DPP-4 inhibitors and TZDs are also but are considered alternatives to SUs in 2nd-line Tx)

31
Q

What do SGLT2 inhibitors do?

A

They reduce glucose reabsorption by the kidneys (proximal tubules) > increase urinary excretion of glucose > reducing blood glucose

32
Q

Name 3 licensed SGLT2 inhibitors

A

Canagliflozin
Dapagliflozin
Empagliflozin

33
Q

Dual therapy Met + Cana combined therapy are thought to have what effect?

A

Weight reduction

34
Q

Canagliflozin reduces what?

A

HbA1c

Week 141 - Diabetes Type II (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions