Diabetic Medications Flashcards
What is the first line treatment for T2DM?
Metformin
What class of drug is metformine?
Bigunide
How does metformin work?
Prevents gluconeogenesis
Reduces insulin resistance
What are side effects of metformin?
Stomach problems
When should you stop metformin?
eGFR <30
Creatinine >50
Raised lactate
What drugs are sulphonylureas?
Gliclazide
Glipizide
What is the mechanism of sulphonylureas?
Stimulate insulin release by closing ATP K+ channels and opening voltage dependent Ca2+ channels
When should sulphonylureas be taken?
With meals
What are risks of sulphonylureas?
Hypoglycaemia
- beware the elderly
What is the mechanism of pioglitazone?
Reduces insulin resistance
How long does it take pioglitazone to start working?
6 weeks
What are side effects of pioglitazone?
Water retention
Weight gain
Visual impairment
What drugs are DPP4 inhibitors?
Linagliptin
Sitagliptin
What is the mechanism of DPP4 inhibitors?
Inhibits DPP4 - the enzyme that destroys incretin
What is incretin?
A hormone that augment the secretion of insulin
What are side effects of DPP4 inhibitors?
GI problems
Risk of pancreatitis
What drugs are SGLT2 inhibitors?
Dapagliflozin
Canagliflozin
What is the mechanism of SGLT2 inhibitors?
Reduces reabsorption of glucose at kidneys
Increases urine glucose excretion
Which patients cannot have SGLT2 inhibitors?
Renal patients
What are side effects of SGLT2?
AKI
Risk of amputations
UTI
Lactic acidosis
What drugs are GLP1 agonists?
Ozempic
Semaglutide
Liraglutide
What is the mechanism of GLP1 agonists?
Mimics incretin
- stimulates insulin release
- inhibit glucagon release
- reduce speed of stomach emptying
What are side effects of GLP1 agonists?
GI problems
