Drug MoA's

Question 1

Biguanides

Answer 1

Metformin - decrease hepatic gluconeogenesis, increase glycolysis, decrease intestinal absorption of glucose, improve insulin sensitivity

AE: lactic acidosis

Question 2

Thiazolidinediones

Answer 2

Pioglitazone, Rosigiltazone (-giltazone) - increases insulin sensitivity via binding PPAR-y nuclear transcription regulator

SE: cardiotoxicity, weight gain, edema, hepatotoxicity

Question 3

Sulfonyureas

Answer 3

1st Gen:Tolbutamide, Chlorproamide
2nd Gen: Glipizide, Glimepiride, Glyburide

• close K+ channels in beta cells to induce Ca2+ influx –> releases insulin

SE: severe hypoglycemia, disulfram-reactions

Question 4

Glucosidase inhibitors

Answer 4

acarbose, miglitol
inhibits disaccharide enzymes in gut

SE: GI disturbance

Question 5

GLP-1 receptor agonists

Answer 5

Exenatide
enhance insulin secretion, dec glucagon secretion, slows gastric emptying
activate signaling pathways –> inc cAMP

SE: acute pancreatitis

Question 6

Statins

Answer 6

lova,prava,simva,atorva,rosuva -statin

impair synthesis of LDL via inhibition of HMG-CoA reductase
can’t form mevalonate from HMG-CoA
(dec LDL, inc HDL, dec TGs)

SE: hepatotoxicty (inc LFTs), rhabdomyolysis

Question 7

Niacin

Answer 7

Vit B3
inhibits lipolysis in adipose tissue, reduces hepatic VLDL(ApoB100) secretion into circulation
(dec LDL, INCREASE HDL, dec TGs)

SE: flushing, hyperglycemia(acanthosis nigrans), Hyperuricemia(gout)

Question 8

Bile Acid Resins

Answer 8

Cholestyramine, Colestipol, Colesevelam
prevent intestinal reabsorbtion of bile - makes liver use up cholesterol
(dec LDL)

SE: bad taste, GI discomfort, dec absorption of fat vitamins

Question 9

Cholesterol Absorption Blockers

Answer 9

Ezetimibe
prevents cholesterol absorption at brush border
(dec LDL)

SE: diarrhea, rare inc LFTs

Question 10

Fibrates

Answer 10

Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate
upregulate LPL –> increases TG clearance
(dec LDL, inc HDL, DECREASE TGs)

SE: myositis, hepatotoxicity(inc LFTs), cholesterol gallstones