Diabetic Drugs

Question 1

Insulin mechanism of action

Answer 1

Direct replacement for endogenous insulin

Question 2

Metformin class of drug

Answer 2

biguanides

Question 3

Metformin MOA

Answer 3

acts by activation of the AMP-activated protein kinase (AMPK)
Increases insulin sensitivity
Decreases hepatic gluconeogenesis

may also reduce gastrointestinal absorption of carbohydrates

Question 4

Metformin side effects

Answer 4

Gastrointestinal upset
Lactic acidosis

Question 5

When can metformin NOT be used?

Answer 5

Cannot be used in patients with an eGFR of < 30 ml/min

Question 6

Gliclazide class of drug

Answer 6

Sulfonylurea

Question 7

Gliclazide mode of action

Answer 7

Stimulate pancreatic beta cells to secrete insulin
On a molecular level they bind to an ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells.

Question 8

gliclazide side effects

Answer 8

Hypoglycaemia
Weight gain
Hyponatraemia

Question 9

Sulfonylurea examples

Answer 9

gliclazide, glimepiride

Question 10

Thiazolidinediones example

Answer 10

pioglitazole

Question 11

Thiazolidinediones mode of action

Answer 11

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

Question 12

Thiazolidinediones side effects

Answer 12

Weight gain
Fluid retention

Question 13

DPP-4 inhibitors (-gliptins) example

Answer 13

Linaglipton, alogliptin

Question 14

DPP-4 inhibitors mode of action

Answer 14

Increases incretin levels which inhibit glucagon secretion
increase levels of incretins (GLP-1 and GIP) by decreasing their peripheral breakdown

Question 15

Dpp-4 inhibitors adverse effects

Answer 15

Pancreatitis

Question 16

SGLT-2 inhibitors (-gliflozins) example

Answer 16

empagliflozin, dapagliflozin

Question 17

SGLT-2 inhibitors mode of action

Answer 17

Inhibits reabsorption of glucose in the kidney

SGLT-2 inhibitors reversibly inhibit sodium-glucose co-transporter 2 (SGLT-2) in the renal proximal convoluted tubule to reduce glucose reabsorption and increase urinary glucose excretion.

Question 18

SGLT-2 inhibitors adverse effects

Answer 18

Urinary tract infection

Question 19

GLP-1 agonists (-tides) example

Answer 19

Dulaglutide
exanatide

Question 20

GLP-1 agonists (-tides) mode of action

Answer 20

Incretin mimetic which inhibits glucagon secretion

Question 21

GLP agonists adverse reactions

Answer 21

Nausea and vomiting
Pancreatitis

Question 22

Meglitinides examples

Answer 22

repaglinide, nateglinide

Question 23

meglitinides MOA

Answer 23

increase pancreatic insulin secretion
bind to an ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells

Question 24

Who are meglitinides used in?

Answer 24

often used for patients with an erratic lifestyle

Question 25

meglitinides adverse effects

Answer 25

adverse effects include weight gain and hypoglycaemia (less so than sulfonylureas)