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My Flashcards Year 2 > Endo- diabetes drugs > Flashcards

Endo- diabetes drugs Flashcards

1
Q

main treatment for T1DM

A

insulin

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2
Q

insulin basal-bolus regimen

A

Long-acting insulin 1-2 times a day and short-acting insulin before each meal

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3
Q

when do short acting soluble insulins reach their peak

A

2-4 hours after injection

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4
Q

short acting soluble insulins examples

A

actrapid
humulin S

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5
Q

when do short acting insulin analogues reach their peak

A

60-90 mins after injection

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6
Q

short acting insulin analogues examples

A

insulin aspart (NovoRapid)
lispro (Humalog)
glulisine (apidra)

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7
Q

what short acting insulins are preferred- soluble/analogues

A

analogues- disappear from circulation more rapidly

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8
Q

when do isophane basal insulins reach their peak

A

4-6 hours

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9
Q

when do analogue basal insulins reach their peak

A

longer duration of action with less peak activity and may be given once or twice daily

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10
Q

isophane basal insulins examples

A

insulatart
humulin

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11
Q

analogue basal insulin examples

A

Lantus (glargine)
Levemir (dertermir)

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12
Q

why should injection site be rotated when injecting insulin

A

to prevent lipohyperthrophy

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13
Q

adverse effect of insulin

A

weight gain
risk of hypoglycaemia

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14
Q

first line medication in T2DM

A

biguanide (metformin)

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15
Q

metformin has a CVS benefit true/false

A

true

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16
Q

when is metformin contraindicated

A

in renal impairment, heart failure, and hepatic failure because of the risk of lactic acidosis

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17
Q

adverse effects of metformin

A

GI- anorexia, nausea, abdominal pain, diarrhoea
lactic acidosis

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18
Q

Sulphonylureas example

A

gliclazide

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19
Q

alternative first line medication in T2DM where cost is a major issue

A

Sulphonylureas

20
Q

mechanism of action of Sulphonylureas

A

bind to the Sulphonylurea receptor of beta cells, which closes ATPase K+ channels, resulting in influx of Ca2+, which stimulates insulin release

21
Q

adverse effects of Sulphonylureas

A

weight gain
hypoglycaemia

22
Q

what is the only TZDs currently available

A

pioglitazone

23
Q

follow on to metformin where cost is a major issue

A

TZDs

24
Q

avoid TZDs in which patients

A

> 65 due to side effects

25
Q

TZDs are particularly potent in which patients

A

obese women

26
Q

adverse effects of TZDs

A

weight gain
> risk of fracture
mild anaemia

27
Q

which diabetic drug is associated with fluid retention

A

TZDs

28
Q

examples of GLP-1 receptor antagonists

A

liraglutide
semaglutide

29
Q

diabetic patients with atherosclerotic CVD should be given

A

metformin + GLP-1 receptor antagonist

30
Q

diabetic patients with heart failure or chronic kidney disease should be given

A

metformin + SGLT2i

31
Q

diabetic patients with heart failure or chronic kidney disease where SGLTi are contraindicated

A

metformin + GLP-1 receptor antagonist

32
Q

non glucose effects of GLP-1 receptor antagonists

A

reduce appetite
lower blood pressure
< CVS risk

33
Q

when are GLP-1 receptor antagonists contraindicated

A

in patients with a history of acute pancreatitis

34
Q

adverse effects of GLP-1 receptor antagonists

A

GI- bloating, nausea, vomiting, diarrhoea
small increase in incidence of gallstones

35
Q

is there is a risk of hypo with GLP-1 receptor antagonists

A

no

36
Q

examples of DPP4 inhibitors

A

sitagliptin
alogliptin
saxagliptin

37
Q

main indications of DPP4 inhibitors

A

most effective in early stages of T2DM
can be used as mono therapy where metformin is contraindicated, or as an add on

38
Q

non glucose effect of DPP4 inhibitors

A

lowers blood pressure

39
Q

adverse effects of DPP4 inhibitors

A

> risk of acute pancreatitis
nausea
weight neutral

40
Q

is there a risk of hypo with DPP4 inhibitors

A

no

41
Q

examples of SGLT2i

A

empagliflozin
dapagliflozin
canagliflozin

42
Q

when should you use SGLT2i with caution

A

in patients already on a diuretic

43
Q

adverse effects of SGLT2i

A

genital candiasis
hypovolaemia and hypotension
dehydration
DKA
slight increase in LDL and HDL cholesterol

44
Q

which class of diabetic drugs increase the risk of UTIs

A

SGLT2i

45
Q

which diabetic drug reduces hepatic gluconeogenesis

A

metformin

My Flashcards Year 2 (21 decks)

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