Diabetic Drugs

Question 1

Metformin

Answer 1

Biguanide

Question 2

Biguanide e.g.

Answer 2

Metformin

Question 3

Metformin MOA

Answer 3

Decrease hepatic glucose production

Improve insulin sensitivity in liver + muscle

Question 4

Metformin DOES NOT

Answer 4

Affect insulin secretion
induce hypoglycaemia
Predispose to weight gain

Question 5

Metformin SEs

Answer 5

Nausea
Diarrhoea
Abdominal pain
Anorexia
Hypogylcaemia

Question 6

Metformin CIs

Answer 6

Severe hepatic disease

Severe renal disease (CKD stage 4 or eGFR<36)

Question 7

Metformin STOP IF

Answer 7

Tissue hypoxia e.g. sepsis
General anaesthesia
Before contrast medium containing iodine

Question 8

Insulin Secretagogues

Answer 8

Sulfonylureas

Meglitinides

Question 9

Sulfonylureas e.g.

Answer 9

Gliclazide
Tolbutamide
Glipizide

Question 10

Gliclazide

Answer 10

Sulfonylurea

Question 11

Sulfonylureas MOA

Answer 11

Oral
Increases insulin release from pancreas
Opens K+ channels in Beta cells

Question 12

Sulfonylureas SEs

Answer 12

Hypoglycaemia

Weight gain

Question 13

Meglitinides e.g.

Answer 13

Repaglinide

Nateglinide

Question 14

Repaglinide

Answer 14

Meglitinide

Question 15

Meglitinides MOA

Answer 15

Opens K+ channels in Beta cells to increase insulin release

Question 16

Meglitinide MOA

Answer 16

Short acting
Promote postprandial release of insulin
Prandial glucose regulators (PGRs)

Question 17

Thiazolidinediones (TZDs)/Glitazones

Answer 17

Pioglitazone

Question 18

Pioglitazone

Answer 18

TZD

Question 19

TZD MOA

Answer 19

PPAR-gamma agonist
Receptor modulates gene transcription of regions controlling lipid metabolism in muscle, adipose tissue and liver
Decreases insulin resistance peripherally and increasing insulin sensitivity

Question 20

TZD Side effects

Answer 20

Hypoglycaemia 
Weight gain
Fluid retention
HF
Liver impairment
Bladder cancer
Mild anaemia
Osteoporosis
Fractures

Question 21

TZD contraindications

Answer 21

Past/present HF

Osteoporosis

Question 22

GLP 1 receptor anaologues e.g.

Answer 22

Exenatide
Liraglutide
Lixisenatide

Question 23

Exenatide

Answer 23

GLP 1 receptor analogue

Question 24

GLP1 receptor analogues MOA

Answer 24

Increase GLP1
- augments insulin release, decreases glucagon secretion, slows gastric emptying, induces satiety, stimulates + preserves beta cells

Question 25

GLP1 use

Answer 25

Injected

Only in Overweight BMI>35 with poor glucose control

Question 26

GLP1 SEs

Answer 26

Nausea
Diarrhoea
Pancreatitis
Pancreatic cancer

Question 27

DPP4 inhibitors/Gliptins e.g.

Answer 27

Sitagliptin
Vildagliptin
Alogliptin
Linagliptin
Saxagliptin

Question 28

Sitagliptin

Answer 28

DPP4 inhibitors

Question 29

DPP4 inhibitors MOA

Answer 29

Inhibit GLP1 breakdown

Oral once daily

Question 30

DPP4 inhibitors SE

Answer 30

Well tolerated

SE uncommon- nausea, acute pancreatitis

Question 31

Alpha Glucosidase inhibitors e.g.

Answer 31

Acarbose

Question 32

Acarbose

Answer 32

Alpha glucosidase inhibitor

Question 33

Alpha glucosidase inhibitor MOA

Answer 33

Decreases breakdown of starch into glucose

Question 34

Alpha glucosidase inhibitor SEs

Answer 34

Flatulence
Diarrhoea
Abdo pain/distension

Question 35

TZDs

Answer 35

Increase risk bladder cancer

Question 36

SGLT2 inhibitors

Answer 36

Increase glucose in urine

increase risk of thrush

Question 37

Pioglitazone

Answer 37

Can cause fluid retention

Contraindicated in patient with HF

Question 38

Sulfonylureas

Answer 38

Cause weight gain

Question 39

Gliclazide overdose

Answer 39

Hyperinsulinaemia + high C peptide levels

Question 40

TZDs

Answer 40

Osteoporosis and fractures