Diabetic Drugs Flashcards
Name 3 drugs which increase insulin secretion.
SUs
GLP-1 agonists
DPP-4i
Name 2 drugs which increase insulin sensitivity.
Metformin
Pioglitazone
Name a drug which blocks glucose resorption in the kidneys.
SGLTi
What is the first line treatment of T2DM + drug class?
Metformin
Biguanide
Name 2 actions of metformin + proposed molecule it stimulates.
Increases insulin sensitivity
Decreases gluconeogenesis
AMPK
What is the effect on metformin on weight, vascular complications, lipids and risk of hypoglycaemia?
Weight loss
Reduces vascular complications
Lowers lipids
No hypoglycaemic risk
Name 3 side effects of metformin + CIs.
GI disturbance
Lactic acidosis
Rash
CI in hepatic/renal disease
Name 3 SUs.
Tolbutamide
Gliclazide
Glipizide
Which SU reduced microvascular complications?
Glipizide
SUs are quicker to resolve hyperglycemia than metformin. True or False?
True
How is insulin released then stopped from release from the pancreatic beta cells?
ATP binds to Kir6.1 subunit of KATP channel
Depolarisation causing Ca channel opening
Vesicles bind to cell membrane and release insulin
ADP-MG2+ binds SUR1 subunit of KATP channel to cause closure
How do SUs work?
Displace ADP-Mg2+ from SUR1 to close KATP
What is the effect of SUs on weight, vascular complications and risk of hypoglycaemia?
Weight gain
No vascular complication reduction
Hypoglycaemia
Name 3 groups in which SUs should not be given and why?
Hepatic/renal disease
Elderly
Pregnant
Hypoglycaemia risk
Name 2 side effects of SUs.
Hypoglycaemia
SIADH
Name a DPP-4i and explain how it works.
Alogliptin
Blocks DPP-4 enzyme which inhibits incretins from stimulating insulin release
What is the effect of DPP-4i on weight?
Weight neutral
Give 2 examples of incretins + relevance to BG?
GLP-1 and GIP
Increase insulin production
Reduce gluconeogenesis
Name a GLP-1 agonists and explain how it works.
Liraglutide
Mimics GLP-1 by decreasing glucagon release and resists DPP-4 breakdown
What are 2 benefits of GLP-1 agonists?
Weight loss
Reduced CVD risk
Name a rare side effect of GLP-1 agonists?
Pancreatitis
What is the only thiazolidinedione used in T2DM treatment and how does it work?
Pioglitazone
Forms a PPARgamma-RXR TF for insulin signalling to increase sensitvity
Name 3 side effects of pioglitazone and 3 conditions it can’t be used in.
Weight gain
Fluid retention
Fractures
Oedema, HF and osteoporosis
Name a SGLT2i and explain how it works + effect.
Dapagliflozin
Blocks SGLT2 glucose resorption channel in kidney
Glucosuria
What is the effect of SGLTi on weight, hypoglycaemia risk and CVD risk?
Weight loss
Hypoglycaemia
Reduced CVD risk
Name 2 side effects of SGLTI?
Hypoglycaemia
UTI
Which SGLTi is best for renal disease?
Empagliflozin
Name 2 examples of rapid insulin.
NovoRapid (aspart)
Humalog (lispro)
Name 2 examples of long-acting insulin.
Lantus (glargine)
Levemir (determir)
Name an example of a short soluble insulin.
Humulin S
Name an intermediate acting SC insulin.
Humulin I
Name 2 rapid mix and 1 short mix insulin.
Humalog Mix and Novomix
Humulin M3
