Endocrine (diabetes) drugs

Question 1

Blood glucose-reducing hormones

Answer 1

Insulin

MoA - Stimulation of glucose uptake by cells

Adverse effects - Hypoglycaemia

Interactions - Digoxin, beta-blockers

Question 2

Oral biguanide

Answer 2

Metformin

Acts on liver

MoA - Increases insulin sensitivity, inhibits hepatic gluconeogenesis

Adverse effects - N+V

Interactions - diuretics, digoxin

Question 3

Sulphonylureas

Answer 3

Gliclazide

Acts on beta-cells in pancreas

MoA - Stimulates pancreatic (beta-cell) insulin secretion

Adverse effects - hypoglycaemia

Interactions - Warfarin, NSAIDs

Question 4

Thiazolidinediones

Answer 4

Pioglitazone

Acts on adipose tissue

MoA - increases insulin sensitivity in muscle and adipose tissue

Adverse effects - weight gain

Question 5

GLP-1 agonist

Answer 5

Exenatide

Incretin analogue - improves glucose control

Adverse effects - Asthenia

Question 6

Dipeptidyl peptidase-4 (DPP-4) inhibitor

Answer 6

Sitagliptin

MoA - reduces inactivation of incretins

Adverse effects - Headache

Question 7

SGLT-2 inhibitor

Answer 7

Empagliflozin, dapagliflozin

MoA - Blockade of renal Na-glucose transporter - increases urinary excretion of blood glucose

Adverse effects - urinary infection

Question 8

Lipase inhibitor

Answer 8

Orlistat

MoA - Inhibition of GI uptake of dietary fat

Indications - obesity, especially in presence of Type-2 diabetes

Adverse effects - oily stools, faecal urgency

Question 9

Thyroid hormones

Answer 9

Levothyroxine sodium (T4)
Liothyronine sodium (T3)

MoA - synthetic hormones

Indications - hypothyroidism

Adverse effects - D+V

Interactions - oral anticoagulants