Drugs Flashcards
How do sulphonylurea’s work?
They act on the K+ATP channel. They block this and therefore the beta cell is permanently depolarised and insulin secretion is stimulated.
What can sulphonylurea’s help with?
They tend to stop symptoms such as polyuria and polydispia.
How are sulphonylureas taken?
Orally.
Side effects of sulphonylureas
Main risk is hypoglycaemia due to insulin being constantly stimulated to be secreted.
Also risk of cardiac events.
Which drugs impede the effectiveness of sulphonylureas?
Thiazide diuretics and corticosteroids.
Which drugs give an additive effect to sulphonylureas
Biguanides.
Name some sulphonylureas
Tolbutamide, choropropamide, glibenclamide
Describe some effects of biguanides?
Reduces absorption of glucose from the gut.
Facilitates non-insulin dependent movement of glucose into the cells.
Inhibits gluconeogenesis
Enhances anaerobic glycolysis.
What sort of patient would use a biguanide?
An overweight patient because they can help you to lose weight.
Side effects of biguanides?
Lactic acidosis.
Nausea, vomiting, diarrhoea and a metallic taste in the mouth.
When should you avoid giving biguanides?
Renal failure Cirrhosis Alcoholism Chronic lung disease Cardiac failure Mitochondrial myopathy Any serious illness.
Give an example of a biguanide
Metformin
Name a drug that decreases insulin resistance? And how does it do this?
Glitozones (also called thiazolidinediones)
They bind to receptors within the cell nucleus and change gene expression.
Side effects of glitazones
Fluid retention
Weight gain
In the long term- fracture risk
How do GLP-1 analogues work
They mimic the actions of glucagon like peptide-1 (GLP-1).
How does GLP-1 work?
It increases insulin secretion from the pancreas. It decreases glucagon secretion. It also increases insulin sensitivity in the peripheral tissues.
Side effects and fallbacks of GLP-1 analogues?
They have to be administered via an injection.
Nausea
Vomiting
Possible hypoglycaemia if prescribed with sulphonylureas
Name some GLP-1 analogues
exenatide and liraglutide
How do DDP-4 inhibitors work?
DDP-4 in the body acts to inhibit glucagon like peptide-1. Therefore these drugs stop this inhibition.
Name some DDP-4 inhibitors
Sitagliptin or vildagliptin.
Side effects of DDP-4 inhibitors
Nausea
Vomiting
Diarrhoea
Insulin as treatment for type 2 diabetes
Last resort but many people are on it.
