Endocrine drugs

Question 1

CI, action + interactions of metformin

Answer 1

CI: DKA, AKI, tissue hypoxia, alcohol intoxication
Action: decreases gluconeogenesis, increases peripheral use of glucose + increases sensitivity to insulin

Interacts with contrast media used in CT - stop for 48hrs after CT
Reduced renal function with other nephrotoxic drugs (ACEi, NSAIDs, diuretics)
Drugs that elevate BM reduce efficacy (steroids, thiazide + loop diuretics)

Question 2

SE of metformin

Answer 2

Lactic acidosis 
Vomiting 
Abdo pain 
Muscle cramps 
SOB

Question 3

Indications, action + CI of bisphosphonates

Answer 3

Used for osteoporosis, Paget’s disease, hypercalcaemia in malignancy
Reduces bone turnover + inhibits action of osteoclasts

CI: upper GI disorders, hypocalcaemia

Question 4

Key info + SE of bisphosphonates

Answer 4

Take with full glass of water and sit up due to risk of oesophagitis
See dentist throughout treatment
SE: jaw osteonecrosis, low phosphate, oesophagitis

Question 5

SE of glimepiride

Answer 5

SIADH

Question 6

SE of pioglitazone

Answer 6

Fluid retention