diabetic drugs

Question 1

Antihyperglycemic Drug Classification

Answer 1

Alpha-Glucosidase Inhibitors: e.g. acarbose

Biguanides: e.g. metformin

Dipeptidyl Peptidase-4 Inhibitors (DPP4Is) : - gliptin

Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists: - aglutide

Glucose-Dependent Insulinotropic Polypeptide (GIP) and Glucagon-Like Peptide-1 (GLP–1) Receptor Agonists: - ide

Insulin Secretagogues: Sulfonylureas; e.g. repaglinide

Insulin Secretagogues: Meglitinides
Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors: - flozin

Thiazolidinediones (TZDs): - glitazone

Question 2

3 types of insulin

Answer 2

Bolus:
- Rapid-acting insulin analogues
- Short-acting insulins
Basal
- Intermediate-acting Insulins
- Long-acting Insulins

Premixed
- Premixed regular insulin / NPH
Premixed insulin analogues

Question 3

3 common insulin regime

Answer 3

Basal only
Basla + 1-3 bolus
Premixed BID

Question 4

Drug therapy for asymptomatic diabetes

Answer 4

A1C <1.5% over target
Non-pharm intervention, start metformin if not at target within 3 months; OR start metformin + healthy behaviour changes

A1C ≥1.5% over target
Start metformin + healthy behavior interventions
AND
Consider second antihyperglycemic agent

Question 5

Drugs for symptomatic diabetes

Answer 5

insuline +/- metformin

Question 6

combine Antihyperglycemic Agents

Answer 6

Combine 2 or more agents with different mechanisms of action for synergy on blood glucose lowering

Question 7

incretin (GIP and GLP- 1) causes

Answer 7

increase insulin
decrease glucagon
decrease blood glucose
also satiaty

Question 8

____ degrade incretin

Answer 8

DPP - 4 enzyme

Question 9

acarbose side effects

Answer 9

GI side effects

Question 10

metformin side effects

Answer 10

B12 deficiency long-term use

Question 11

metformin contraindications

Answer 11

hepatic failure
renal impairment
previous lactic acidosis

Question 12

DPP4 inhibitors

Answer 12

linagliptin
saxagliptin (avoid in heart failure)
sitagliptin

Question 13

GLP-1 receptor agonist

Answer 13

CVH benefits

dulaglutide
liraglutide
semaglutide (Ozempic)
subcu injection

Question 14

SGLT2 inhbitors

Answer 14

cardiovascular and renal benefit
weight loss

canagliflozin
dapagliflozin
empagliflozin

Question 15

Sulfonylureas

Answer 15

gliclazide
glimepiride
glyburide

Question 16

Thiazolidinediones (TZDs)

Answer 16

side effets:
weight gain
fluid retention
worsening HF
increased risk of fractures