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Endocrine Type 2 DM november 23 > Endocrine part 2 November 23 > Flashcards

Endocrine part 2 November 23 Flashcards

T2DM |T2DM treatments

1
Q

Question

A

Answer

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2
Q
  1. What is type 2 diabetes?
A

Type 2 diabetes is characterized by insulin deficiency and insulin resistance.

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3
Q
  1. What are the main aims of treating type 2 diabetes?
A

The main aim is to

minimize the risk of long-term microvascular

macrovascular complications.

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4
Q
  1. What is the first-line treatment for type 2 diabetes?
A

Lifestyle advice and changes are the initial approach for three months.

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5
Q
  1. What drug is first-line for most type 2 diabetics?
A

Metformin (biguanide)

first-line drug, and the dose is increased gradually over time.

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6
Q
  1. How does metformin work?
A

Metformin works by
1. decreasing glycogenesis
2. increasing peripheral utilization of glucose.

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7
Q
  1. What are the main side effects of metformin?
A

The main side effects include
1. nausea, vomiting,
2. GI disorders, diarrhea,
3. Abdominal pain.

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8
Q
  1. What are the contraindications for metformin?
A

Metformin is contraindicated in
acute metabolic states,
renal failure,
certain surgical cases.

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9
Q
  1. Is metformin safe in pregnancy and breastfeeding?
A

Metformin can be used for both
pre-existing
and gestational diabetes

but should be discontinued after birth in the latter case.

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10
Q
  1. What is monitored when taking metformin?
A

Renal function
monitored before treatment

periodically, especially for high-risk patients.

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11
Q
  1. Can metformin be continued before surgery?
A

Metformin can be continued for local surgery but should be stopped for general surgery.

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12
Q
  1. What is the main patient advice for taking metformin?
A

Patients should be informed of the risk of
lactic acidosis

seek immediate medical attention if symptoms occur.

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13
Q
  1. What are the main signs of lactic acidosis?
A

Signs include’

abdominal pain,
hypothermia,
muscle cramps,
asthenia,
dyspnea

(AHMAD).

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14
Q
  1. How do sulfonylureas work?
A

Sulfonylureas work by augmenting insulin secretion.

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15
Q
  1. What are the most concerning side effects of sulfonylureas?
A

blood disorders,
liver disorders,
weight gain,
hypoglycemia.

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16
Q
  1. What must be done if a patient is having surgery while on sulfonylureas?
A

Sulfonylureas omitted on the day of surgery,

Check blood glucose levels hourly.

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17
Q
  1. When are sulfonylureas prescribed to diabetics?
A

patients who cannot take metformin

and are NOT overweight.

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18
Q
  1. Are sulfonylureas safe in pregnancy and breastfeeding?
A

AVOID

in both cases due to the risk of neonatal hypoglycemia.

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19
Q
  1. What are the main side effects associated with sulfonylureas?
A

weight gain,
hypoglycemia,
GI side effects,
allergy-type reactions,
liver damage.

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20
Q
  1. What are the main cautions and contraindications for sulfonylureas?
A

elderly,
G6PD deficiency,
acute porphyria,
ketoacidosis,
Renal or liver impairment.

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21
Q
  1. How does acarbose work?
A

Acarbose affects the absorption of sucrose and prevents the breakdown of carbohydrates into glucose.

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22
Q
  1. What are the main side effects of acarbose?
A

The main side effects of acarbose are

gastrointestinal problems

Diarrhea and nausea.

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23
Q
  1. When is acarbose indicated?
A

Acarbose is given as an add-on to triple therapy when all other oral drugs have failed.

24
Q
  1. What are the contraindications for acarbose?
A

Contraindications include
disorders of digestion or absorption,
hernia,
IBD,
intestinal obstruction,

Caution in those with renal impairment.

25
Q
  1. Is acarbose safe in pregnancy and breastfeeding?
A

Acarbose should be avoided in both cases.

26
Q
  1. What needs to be monitored when taking acarbose?
A

Liver function should be monitored.

27
Q
  1. How should hypoglycemia be treated in a patient taking acarbose?
A

Glucose should be given instead of sucrose, as acarbose prevents sucrose absorption.

28
Q
  1. How does pioglitazone work?
A

Pioglitazone reduces peripheral insulin resistance, leading to a reduction in blood glucose concentration.

29
Q
  1. When is pioglitazone indicated?
A

Pioglitazone is indicated if

there is at least a 0.5% reduction in HbA1C

within six months of starting treatment.

30
Q
  1. What are the main side effects associated with pioglitazone?
A

Side effects include
bone fracture,
bladder cancer,
increased risk of infection,
weight increase,
visual impairment,
numbness,
liver dysfunction.

31
Q
  1. What are the main contraindications for pioglitazone?
A

Contraindications include previous or current
bladder cancer,
DKA,
heart failure.

32
Q
  1. Is pioglitazone safe in pregnancy and breastfeeding?
A

Pioglitazone should be avoided in both cases.

33
Q
  1. What needs to be monitored when taking pioglitazone?
A

Liver function ——should be monitored,

Seek medical attention for signs of liver damage.

34
Q
  1. When should treatment with pioglitazone be discontinued?
A

It should be discontinued in case of

acute pancreatitis

’ planning on pregnancy.

35
Q
  1. How do DPP-4 inhibitors work?
A
  1. DPP-4 inhibitors increase insulin secretion
  2. decrease glucagon production, lowering blood sugar levels.
36
Q
  1. What are the main side effects of DPP-4 inhibitors?
A

The main side effects are gastrointestinal and skin reactions.

37
Q
  1. When are DPP-4 inhibitors indicated?
A
  1. DPP-4 inhibitors are indicated if metformin is inappropriate
  2. or in combination with other antidiabetic drugs when existing treatment fails.
38
Q
  1. What are the contraindications for DPP-4 inhibitors?
A

Contraindications include a

  1. history of pancreatitis
  2. moderate to severe heart failure.
39
Q
  1. Are DPP-4 inhibitors safe in pregnancy and breastfeeding?
A

They should be avoided in both cases due to limited information.

40
Q
  1. What needs to be monitored when taking DPP-4 inhibitors?
A
  1. Renal function
  2. before treatment and periodically.
41
Q
  1. When should treatment with DPP-4 inhibitors be discontinued?
A

Treatment should be discontinued in case

  1. Acute pancreatitis
  2. Persistent abdominal pain.
42
Q
  1. How do SGLT2 inhibitors work?
A

SGLT2 inhibitors reduce renal glucose reabsorption, leading to increased urinary glucose excretion.

43
Q
  1. What are the main side effects of SGLT2 inhibitors?
A

The main side effects include
1. genital infections,
2. urinary tract infections,
3. and volume depletion.

44
Q
  1. When are SGLT2 inhibitors indicated?
A

SGLT2 inhibitors are indicated if metformin is inappropriate or in combination with other antidiabetic drugs when existing treatment fails.

45
Q
  1. What are the contraindications for SGLT2 inhibitors?
A

Contraindications include

  1. type 1 diabetes,
  2. DKA,
  3. severe renal impairment.
46
Q
  1. Are SGLT2 inhibitors safe in pregnancy and breastfeeding?
A

They should be avoided in both cases.

47
Q
  1. What needs to be monitored when taking SGLT2 inhibitors?
A

Renal function should be assessed before and during treatment.

48
Q
  1. When should treatment with SGLT2 inhibitors be discontinued?
A

Treatment should be discontinued in case of
1. DKA,
2. Fournier’s gangrene,
3. recurrent genital mycotic infections.

49
Q
  1. How do GLP-1 receptor agonists work?
A

GLP-1 receptor agonists stimulate insulin secretion and inhibit glucagon secretion, reducing blood glucose levels.

50
Q
  1. What are the main side effects of GLP-1 receptor agonists?
A

The main side effects are gastrointestinal problems and pancreatitis.

51
Q
  1. When are GLP-1 receptor agonists indicated?
A

They are indicated if metformin is inappropriate or in combination with other antidiabetic drugs when existing treatment fails.

52
Q
  1. What are the contraindications for GLP-1 receptor agonists?
A

Contraindications include
1. history of medullary thyroid carcinoma
2. MEN2.

53
Q
  1. Are GLP-1 receptor agonists safe in pregnancy and breastfeeding?
A

They should be avoided in both cases.

54
Q
  1. What needs to be monitored when taking GLP-1 receptor agonists?
A

Renal function should be assessed before and during treatment.

55
Q
  1. When should treatment with GLP-1 receptor agonists be discontinued?
A

Treatment should be discontinued if pancreatitis is suspected.

Endocrine Type 2 DM november 23 (4 decks)

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