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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
24. Is acarbose safe in pregnancy and breastfeeding?
Acarbose should be avoided in both cases.
26
25. What needs to be monitored when taking acarbose?
Liver function should be monitored.
27
26. How should hypoglycemia be treated in a patient taking acarbose?
Glucose should be given instead of sucrose, as acarbose prevents sucrose absorption.
28
27. How does pioglitazone work?
Pioglitazone reduces peripheral insulin resistance, leading to a reduction in blood glucose concentration.
29
28. When is pioglitazone indicated?
Pioglitazone is indicated if there is at least a 0.5% reduction in HbA1C within six months of starting treatment.
30
29. What are the main side effects associated with pioglitazone?
Side effects include bone fracture, bladder cancer, increased risk of infection, weight increase, visual impairment, numbness, liver dysfunction.
31
30. What are the main contraindications for pioglitazone?
Contraindications include previous or current bladder cancer, DKA, heart failure.
32
31. Is pioglitazone safe in pregnancy and breastfeeding?
Pioglitazone should be avoided in both cases.
33
32. What needs to be monitored when taking pioglitazone?
Liver function ------should be monitored, Seek medical attention for signs of liver damage.
34
33. When should treatment with pioglitazone be discontinued?
It should be discontinued in case of acute pancreatitis ' planning on pregnancy.
35
34. How do DPP-4 inhibitors work?
1. DPP-4 inhibitors increase insulin secretion 2. decrease glucagon production, lowering blood sugar levels.
36
35. What are the main side effects of DPP-4 inhibitors?
The main side effects are gastrointestinal and skin reactions.
37
36. When are DPP-4 inhibitors indicated?
1. DPP-4 inhibitors are indicated if metformin is inappropriate 2. or in combination with other antidiabetic drugs when existing treatment fails.
38
37. What are the contraindications for DPP-4 inhibitors?
Contraindications include a 1. history of pancreatitis 2. moderate to severe heart failure.
39
38. Are DPP-4 inhibitors safe in pregnancy and breastfeeding?
They should be avoided in both cases due to limited information.
40
39. What needs to be monitored when taking DPP-4 inhibitors?
1. Renal function 2. before treatment and periodically.
41
40. When should treatment with DPP-4 inhibitors be discontinued?
Treatment should be discontinued in case 1. Acute pancreatitis 2. Persistent abdominal pain.
42
41. How do SGLT2 inhibitors work?
SGLT2 inhibitors reduce renal glucose reabsorption, leading to increased urinary glucose excretion.
43
42. What are the main side effects of SGLT2 inhibitors?
The main side effects include 1. genital infections, 2. urinary tract infections, 3. and volume depletion.
44
43. When are SGLT2 inhibitors indicated?
SGLT2 inhibitors are indicated if metformin is inappropriate or in combination with other antidiabetic drugs when existing treatment fails.
45
44. What are the contraindications for SGLT2 inhibitors?
Contraindications include 1. type 1 diabetes, 2. DKA, 3. severe renal impairment.
46
45. Are SGLT2 inhibitors safe in pregnancy and breastfeeding?
They should be avoided in both cases.
47
46. What needs to be monitored when taking SGLT2 inhibitors?
Renal function should be assessed before and during treatment.
48
47. When should treatment with SGLT2 inhibitors be discontinued?
Treatment should be discontinued in case of 1. DKA, 2. Fournier's gangrene, 3. recurrent genital mycotic infections.
49
48. How do GLP-1 receptor agonists work?
GLP-1 receptor agonists stimulate insulin secretion and inhibit glucagon secretion, reducing blood glucose levels.
50
49. What are the main side effects of GLP-1 receptor agonists?
The main side effects are gastrointestinal problems and pancreatitis.
51
50. When are GLP-1 receptor agonists indicated?
They are indicated if metformin is inappropriate or in combination with other antidiabetic drugs when existing treatment fails.
52
51. What are the contraindications for GLP-1 receptor agonists?
Contraindications include 1. history of medullary thyroid carcinoma 2. MEN2.
53
52. Are GLP-1 receptor agonists safe in pregnancy and breastfeeding?
They should be avoided in both cases.
54
53. What needs to be monitored when taking GLP-1 receptor agonists?
Renal function should be assessed before and during treatment.
55
54. When should treatment with GLP-1 receptor agonists be discontinued?
Treatment should be discontinued if pancreatitis is suspected.

Endocrine Type 2 DM november 23 (4 decks)

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