Diabetic Pharma Flashcards
Q1- Avoid Metformin :
Q2- side effect :
Q3- When stop Metaformin :
Metformin
Start with lifestyle and metformin (low/moderate
atherosclerotic cardiovascular disease) avoid
metformin in patients GFR <30, NYHA 3&4 heart
failure, liver failure, alcoholism, and no need to stop
before procedures that require radio-contrast
administration. Side effects : Diarrhea, abdominal discomfort,
lactic acidosis.
Acting by inhibiting gluconeogenesis, and
enhancing insulin action in muscle through AMPK
pathway?.
Q-1 Sulphonylureas:
Q-2 Side effect :
3-Sulphonylureas sulphonylureas(like
glimipride,gliclazide or glibenclamide)or
glinide like repaglinide,or stimulates insulin
secretion by closing ATP-sensitive potassium
channels on the beta-cell membrane.
2-Hypoglycemia, weight gain. Reduced drug clearence in kidney failure.
Dipeptidyl peptidase inhibitors
Q-1 Avoid in (….)
Q-2Example (…..)
Side effect(….)
DPP4inhibitors: Sitagliptin,vildagliptin,linagliptin
Saxagliptin, alogliptin(avoid in heart failure).These
can be used as monotherapy in those who can not
tolerate metformin, or in combination with other
drugs or insulin. (weak effect on HbA1c, Ramadhan) No increase in weight, low risk of hypoglycemia. Side effects: Nausea, infections, gallstones possible
pancreatitis.
Thiazolidinediones
Adverse effect(….)
MOA(….)
Adverse effect (….)
Thiazolidinediones
PPARÝ inhibitors: Only pioglitazone is in use others removed due to liver
cell failure, or arrhythmias. Adverse effects: weight gain, edema, heart failure,
macular edema, osteoporosis, no evidence of cancer
of the bladder.
Glucagon Like Peptide 1 mimetics, and SGLT-2 inhibitors
When you use Metaformi
Indicated after/before metformin in patients with
established/high risk of CVD may reduce weight and
survival. Salt-glucose co-transporters inhibitors (SGLT-2i) and
GLP-1 like agonists are indicated in patients with
established ASCVD/ very high or high risk patients indicated after/before metformin in patients with
established/high risk of CVD Side effects: nausea and vomiting.
