Drug Treatment of Diabetes Flashcards
How does glucose cause insulin secretion in b cells?
Metabolised -> ATP
ATP sensitive K+ channels deactivated in b cells
K+ efflux decreases
Depolarisation
Ca 2+ channels open
Secretion of insulin
What is the mechanism of action for metformin?
↓ Gluconeogenesis (Liver)
-Activation of AMP-activated protein kinase which decreases gene expression
Also ↑ glucose uptake (Muscle)
What is the mechanism of action for sulphonylureas?
Binds to SU receptor on ATP sensitive K+ channels in b cells
ATP sensitive K+ channels in b cells deactivated
K+ efflux decreases
Depolarisation
Ca 2+ channels open
Secretion of insulin
What is the mechanism of action for thiazolidinediones?
1: ↑ Fatty acid uptake (adipose tissue)
↑ Lipogenesis
2: Effect of ↓ fatty acids in blood = ↑ glucose uptake and ↓ gluconeogenesis.
List 3 examples of sulphonylureas
Tolubtamide
Glibenclamide
Gliclazide
What are incretins? What do they do?
GI hormones (e.g. GLP-1) that increase insulin production.
What is exenatide? What does it do?
A GLP-1 agonist.
Slows gastric emptying.
What is acarbose?
α-Glucosidase inhibitors.
Decreases carbohydrate absorption.
What is tolbutamide?
A short acting sulphonylurea.
What is insulin lispro?
A short acting insulin therapy.
What is nicotinamide?
A prediabetic treatment used for DNA repair.
List 3 type 1 dose regimes.
3x before meals + Intermediate
Pre-mixed short and intermediate
Continuous infusion
What do gliptins do?
Block breakdown of incretins.
What do sodium-glucosetransporter-2 inhibitors do?
↓ Glucose reabsorption in proximal convoluted tubule.
Give an example of an SGLT-2 inhibitor.
Canagliflozin
