Drugs in diabetes AB Flashcards
What is the mechanism of metformin?
Decreased hepatic gluconeogenesis
Increased peripheral utilisation of glucose
What are the side effects of metformin?
Malabsorption of B12 (common)
Rash
Lactic acidosis
Acute hepatitis
What is the mechanism of sulfonylureas?
Increase pancreatic insulin secretion
What are the side effects of sulfonylureas?
Hypoglycaemia Weight gain Blood dyscrasias Rash Hepatotoxicity
What is the mechanism of thiazolidinediones (e.g. Pioglitazone)?
PPAR receptor agonist
- regulates genes involved in lipid and glucose metabolism
- increases insulin sensitivity
- decreases hepatic glucose output
What are the side effects of thiazolidinediones?
Peripheral oedema Weight gain Decrease Hb Fractures Hepatotoxicity CCF Macular oedema
What is the mechanism of gliptins?
DPP-4 inhibitors
- Increase concentration of the incretin hormone GLP-1, therefore glucose-dependent insulin secretion is increased and glucagon production is reduced
What are some adverse effects of gliptins?
(Gliptins are DPP-4 inhibitors)
Hypoglycaemia
MSK pain
Pancreatitis
What is an example of a GLP-1 analogue?
Exenatide
What is the mechanism of action of GLP-1 analogues?
Increase glucose-dependent insulin secretion and suppress inappropriate glucagon secretion
Also delay gastric emptying which slows glucose absorption and decreases appetite
What are some side effects of GLP-1 analogues?
Significant nausea + vomiting and other GI side effects
Pancreatitis
Renal failure
What is an example of a SGLT-2 inhibitor?
Dapagliflozin
What is the mechanism of action of SGLT-2 inhibitors?
Inhibit sodium-glucose co-transporter -2, reducing glucose reabsorption in the kidney
Which hypoglycaemics may cause?
Metformin
SGLT2 inhibitors
Which hypoglycaemics may cause weight gain?
Sulfonylureas (Gliclazide)
Thiazolidinedones (Pioglitazone)
GLP-1 receptor agonists (Exenatide)
Insulin
