endo drugs

Question 1

What is the conservative Mx for T1DM?

Answer 1

• Healthy balanced diet
• Smoking cessation
• Regular exercise
• Reduced alcohol
• refer to education programme DAFNE
• refer to specialist team for individual care plan

Question 2

What is the medical Mx for T1DM?

Answer 2

1st line - basal bolus insulin

Insulin regimen - given via SC injections with pen device or insulin infusion pump

• Insulin therapy: rapid/short acting (quick onset of action/short duration) given 30 minutes before meal
• Insulin therapy: intermediate/long acting (slow onset of action/long duration) given once a day at night

Question 3

What is the conservative Mx for T2DM?

Answer 3

Conservative

• Healthy balanced diet: vegetables, low carb, high fibre
• Smoking cessation
• Control risk factors e.g. hypertension, hyperlipidaemia, CVD
• Regular exercise
• Reduced alcohol

Question 4

What is the medical Mx of T2DM (1st and 2nd line)?

Answer 4

• 1st line low dose Metformin
• Increase dosage of Metformin

-2nd line add: sulfonylurea (gliclazide), thiazolidinedione (pioglitazone), DPP-4 inhibitor (sitagliptin) or SGLT-2 inhibitor (empagliflozin).

Question 5

Name an example of sulfonylurea?

Answer 5

gliclazide

Question 6

Name an example of thiazolidinedione?

Answer 6

pioglitazone

Question 7

Name an example of DPP-4 inhibitor?

Answer 7

sitagliptin

Question 8

Name an example of SGLT-2 inhibitor?

Answer 8

empagliflozin

Question 9

What is the action of metformin?

Answer 9

Drug class called biguanide. Lowers blood glucose by increases insulin sensitivity

Question 10

What are the common side effects of Metformin?

Answer 10

Abdominal pain, weight loss, diarrhoea, (does not typically cause hypoglycaemia).

Question 11

What are the CI of metformin?

Answer 11

Patients with Lactic acidosis (hypovolemic shock, severe heart failure).

Question 12

What is the mechanism of insulin?

Answer 12

Stimulates uptake of glucose into cells.

Question 13

What are the side effects of pioglitazone?

Answer 13

Weight gain, fluid retention, (not typically cause hypoglycaemia).

Question 14

What is a side effect of empagliflozin?

Answer 14

Glycosuria (glucose in urine)

Question 15

What medication can cause galactorhoea?

Answer 15

• Idiopathic
• Prolactinoma
• Drugs: Antipsychotics e.g. Risperidone/olanzapine, antidepressants (SSRIs), beta-blockers
• Hypothyroidism, liver disease and chronic renal impairment.

Question 16

What medication can cause hypothyroidism and hyperthyroidism?

Answer 16

-Amiodarone antiarrhythmic medication for pharmacological DC cardioversion