Diabetic Drugs

Question 1

Give an example of a sulphonylurea.

Answer 1

tolbutamide, glibenclamide, glipizide

Question 2

Give an example of a glinide?

Answer 2

Repaglinide

Nateglinide

Question 3

Give an example of DPP-4 inhibitor.

Answer 3

sitagliptin

saxigliptin

Question 4

Give an example of a GLP-1 agonist.

Answer 4

extenatide

Question 5

Give an example of an a-glucosidase inhibitor.

Answer 5

acarbose

Question 6

Give an example of a biguanide.

Answer 6

Metformin

Question 7

Give an example of a TZD.

Answer 7

pioglitazone

Question 8

Give an example of an SGLT2 inhibitor.

Answer 8

dapagliflozin

Question 9

How do sulphonylureas work?

Answer 9

affect ADP-Mg binding to SUR1, causing the channel to close and insulin to be released INDEPENDENT of glucose concentration

Question 10

How do DPP-4 inhibitors work?

Answer 10

competitive inhibition of DPP-4 enzyme, terminating action og GLP-1 and GIP

Question 11

How do biguanides work?

Answer 11

reduce hepatic gluconeogenesis by stimulating AMP-activated protein kinase.

Question 12

What do biguanides increase?

Answer 12

insulin signalling
fatty acid oxidation
glucose uptake and use by skeletal muscle

Question 13

What do biguanides decrease?

Answer 13

carb absorption

Question 14

List the cons of sulfonylureas.

Answer 14

Weight gain
Hypoglycaemia
GI upset
Headache

Question 15

When should sulfonylureas be avoided?

Answer 15

(Don’t use first line in obese)

Renal/hepatic failure

Question 16

Do DPP-4 inhibitors cause weight loss or gain?

Answer 16

neither, weight neutral

Question 17

Is metformin safe in pregnancy?

Answer 17

Yes

Question 18

What are some cons of biguanides?

Answer 18

GI upset
interference with vit B12 absorption (though anaemia rare)
Rash