Diabetic Medications Flashcards
What are the main classes of oral diabetic medications?
Biguanides Sulphonylureas Thiazolidinediones DPP4 inhibitors α-glucosidase inhibitors SGLT2 inhibitors GLP1 analogues
What is the target HbA1c for diabetics?
6.5-7.5%
What is the recommended management if the HbA1c is 6.5%?
Diet \+ metformin OR metformin + sulphoylurea/glitazone
What is an example of a biguanide?
Metformin
What is the route of administration of metformin?
Oral
What is the mechanism of metformin?
Decrease gluconeogenesis
Decrease insulin resistance
What are the side effects of metformin?
Nausea
D+V
Loss of appetite
Lactic acidosis
When is metformin contraindicated?
eGFR <30
Metabolic acidosis
What is an example of a Sulphonylurea?
Gliclazide
What is the route of administration of gliclazide?
Oral
What is the mechanism of gliclazide?
ATP sensitive potassium channel blocer -> stimulates beta cell to release insulin
What are the side effects of gliclazide?
Weight gai
Hypoglycaemia
Constipation
When is gliclazide contraindicated?
Hepatic impairment
NBM
What are examples of Thiazolidinediones?
Pioglitazone
Rosiglitazone
What is the route of administration of pioglitazone?
Oral
What is the mechanism of pioglitazone?
PPARγ receptor agonist -> increases insulin sensitivity
Reduces insulin resistance
What are the side effects of pioglitazone?
Weight gain
Fluid retention
Heart failure
Eye problems
When is pioglitazone contraindicated?
Hepatic impairment
Heart failure
NBM
What are examples of DPP4 inhibitors?
Sitagliptin
Linagliptin
What is the route of administration of DPP4 inhibitors?
Oral
What is the mechanism of DPP4 inhibitors?
Inhibit DPP4 activity
Stops breakdown of incretin
Increases GLP1 concentrations
What are the side effects of DPP4 inhibitors?
GI symptoms
Pancreatitis
When are DPP4 inhibitors contraindicated?
History of excessive alcohol
Pancreatitis
Gall stones
NBM
What is an example of an α-glucosidase inhibitor?
Acarbose
What is the route of administration of acarbose?
Oral
What is the mechanism of acarbose?
Inhibits breakdown of carbs to glucose
What are the side effects of acarbose?
Flatulence
Diarrhoea
When is acarbose contraindicated?
IBD
Hernias
Predisposition to bowel obstruction
What is are examples of SGLT2 inhibitors?
Canagliflozin
Dapagliflozin
What is the route of administration of SGLT2 inhibitors?
Oral
What is the mechanism of SGLT2 inhibitors?
Selectively inhibit SGLT2 in the PCT
Increased urinary excretion of glucose
What are the side effects of SGLT2 inhibitors?
Polyuria
UTIs
Back pain
Dizziness
When are SGLT2 inhibitors contraindicated?
eGFR <60
NBM
History of Fournier’s gangrene
What are examples of GLP1 analogues?
Liraglutide
Exanatide
Ozempic
What is the route of administration of GLP1 analogues?
SC
What is the mechanism of GLP1 analogues?
Increase insulin secretion Decrease glucagon secretion Decrease gluconeogenesis Decreased food intake Decreased gastric emptying
What are side effects of GLP1 analogues?
GI symptoms
GORD
When are GLP1 analogues contraindicated?
eGFR <50
NBM
History of excessive alcohol/pancreatitis
