Endocrine Flashcards
Action of metformin
Increases insulin sensitivity by;
Inhibits mitochondrial GPD which inhibits liver gluconeogenesis and glucagon
Action if pioglitazone
Increases insulin sensitivity by;
Activates nuclear transcription factors - PPAR alpha which increases sensitivity and adiponectin
Action of glipizide
Sulphonylurea
Increases insulin secretion by;
Closes K channels which causes increase insulin release from pancreatic beta cells through Ca influx
Action of exenatide
GLP- analogue
Increases glucose dependant insulin secretion by reducing glucagon and gastric emptying
Action if linagliptan
DPP4 inhibitors
Increases glucose dependant insulin secretion by inhibiting DPP4 enzyme that deactivates GLP-1 analogue
Action if linagliptan
DPP4 inhibitors
Increases glucose dependant insulin secretion by inhibiting DPP4 enzyme that deactivates GLP-1 analogue
Action of canagliflozin
SGLT2 inhibitor
Decreases glucose absorption by blocking reuptake in the proximal convoluted tubule
Diabetic drugs which increase insulin sensitivity
Metformin
Pioglitazone
Diabetic drugs which increase insulin secretion
Sulphonylureas (glipizide)
Meglitinides
Diabetic drugs which increase glucose dependant insulin secretion
GLP-1 analogues (exenatide)
DPO-4 inhibitors (sitagliptan)
Diabetic drugs which decrease glucose aborption
SGLT-2 inhibitors (canagliflozin)
Alpha glucosidase inhibitors (acarbose)
Mechanism of action of insulin
Binds insulin receptor (tyrosine kinase)
Increases glucose storage as glycogen in liver
Increases glycogen and protein synthesis in muscle
Increases TG storage in adipose tissue
Increase K uptake in cell membrane
At what HbA1c level is third line therapy or insulin recommended?
> 7.5%
At what HbA1c level is first +/- second line therapy recommended?
> 6.5%
At what HbA1c level is first +/- second line therapy recommended?
> 6.5%
What anti diabetic drug poses risk of hypoglycaemia?
Sulphonylureas i.e. gliclazide
Second line therapy if sulphonylurea or metformin is not tolerated
DPP-4 inhibitor i.e. sitagliptan
Thiozalidione i.e. pioglitazone
In what patients should SGLT-2’s be avoided
Active foot disease due to risk of amputation
When should SGLT2 be added as 2nd line?
If they have ischaemia heart diseasee
mechanism by which lithium causes hypothyroidism
reduces release of T3 and T4 into circulation
antithyroid drug examples and their action
propythiouracil and methimazole
block tyrosine iodination and coupling by blocking thyroid peroxidase
acarbose mode of action
alpha glucosidase inhibitor
blocks CHO reabsorption in GI tract
what anti-diabetic medication causes GI symptoms
acarbose
