DM

Question 1

Bigunaide
drugs?
MOA?
adverse effect?
efficacy?

Answer 1

drugs: metformin (doc)

MOA: reduce gluconeogensis of liver, increase insulin sensitivity, decrease intestinal absorption

adverse effect: epigastric pain, vomiting, diarrhea, vitb12 deficiency

efficacy: 1-2% reduction in A1C, weightloss and TG reduction

Question 2

sulfonureas
drugs?
MOA?
adverse effect?
efficacy?

Answer 2

drugs: 1st gen: tolbutamide, chlopropamide
2nd gen: glipizide, glimperide, glicazide, glibenclamide

MOA: bind to receptor on beta cell and increase secretion of insulin

adverse effect: hypoglycemia, weightgain, epigastic pain, photosensitivity

efficacy: 1-2 % reduction in A1C

Question 3

meglitinide

Answer 3

drugs: repaglinide, nateglinide
​
MOA: bind to receptor on beta cell and increase secretion of insulin fast onset of action
​
efficacy: 0.5-1.4 % reduction in A1C,

Question 4

Thiazolidinediones (TZDs)

Answer 4

drugs: glitazone

MOA: PPAR-Y (proxisome proliferator activated receptor y agnist ) increase insulin sensitivity decrease glucose production

adverse effect: weightgain, fluid retention, proximal bone fracture,
efficacy: 0.5-1.4% reduction in A1C and increase hdl

Question 5

dpp4 inhibtor
Dipeptidyl peptidase-4 inhibitors

Answer 5

drugs: sidgliptin, sexgliptin, vidgliptin

MOA: breakdown of glp secreted during meals –>
1. Increases insulin secretion.
2. Limits glucagon secretion.
3. Slows gastric emptying.
4. Promotes satiety.

adverse effect: respiratory and urinary infection hypoglycemia and increase heart failure risk,
Acute pancreatitis, angioedema, Stevens-Johnson syndrome, and anaphylaxis.

efficacy: 0.5-0.8% reduction in A1C and increase hdl