DPP-4 Inhibitors Flashcards
Give 2 examples of DPP-4 inhibitors
- Sitagliptin
- Vidagliptin
What is the mechanism of action of DPP-4 inhibitors?
Inhibits dipeptidylpeptidase-4, an enzyme which breaks down a type of gastrointestinal hormone called incretins
What do incretins do?
Incretins increase insulin secretion and lower glucagon secretion
What are the routes of delivery of DPP-4 inhibitors?
PO
What are the indications for DPP-4 inhibitors?
Type 2 diabetes which is resistant to 1st line treatment or add-on therapy
When are DPP-4 inhibitors contraindicated?
Pregnancy and breastfeeding
When should DPP-4 inhibitors be avoided?
Diabetic ketoacidosis
When should DPP-4 inhibitors be used with caution?
- Renal insufficiency
- Heart failure
- History of pancreatitis
What might be required if DPP-4 inhibitors are used in renal insufficiency?
Dose adjustment
What might interact with DPP-4 inhibitors?
- Digoxin
- Other anti-diabetic drugs and alcohol
What might happen if DPP-4 inhibitors are given with digoxin?
Increased plasmas concentration of digoxin
What might happen if DPP-4 inhibitors are given with other anti-diabetic drugs and alcohol?
Increased risk of hypoglycaemia
What monitoring is required with DPP-4 inhibitors?
Baseline HbA1c and LFTs, and check every 3 months
What are the common side effects of DPP-4 inhibitors?
- GI disturbance
- Upper respiratory tract infections including nasopharyngitis
- Peripheral oedema
- Pain
What are the less common side effects of DPP-4 inhibitors?
- Anorexia
- Pancreatitis
- Hepatotoxicity
