Insulin Agents

Question 1

what are glucose dependent insulin agents

Answer 1

GLP-1 agonists, DPP-4 inhibitors

Question 2

what are glucose independent insulin agents

Answer 2

sulfonylurea, meglitinides

Question 3

what is the moa of glucose dependent agents

Answer 3

Insulin secretion is stimulated by elevated blood glucose levels

Question 4

what is the moa of glucose independant agents

Answer 4

Insulin is secreted regardless of the blood glucose level, even if blood glucose levels are low

Question 5

what is the moa of Sulfonylureas

Answer 5

Block ATP-sensitive potassium channels of the pancreatic β cells → depolarization of the cell membrane → calcium influx → insulin secretion

Question 6

what are first generation Sulfonylureas

Answer 6

Chlorpropamide
Tolbutamide

Question 7

what are second generation Sulfonylureas

Answer 7

Glyburide
Glimepiride
Glipizide

Question 8

what are side effects of Sulfonylureas

Answer 8

hypoglycaemia
weight gain
agranulocytosis

Question 9

what interactions are common with Sulfonylureas

Answer 9

using biguanides can cause increase in cardiovascular diseases

Question 10

what are types of meglitinides

Answer 10

Nateglinide
Repaglinide

Question 11

what is the moa of meglitinides

Answer 11

Block ATP-sensitive potassium channels of the pancreatic β cells → depolarization of the cell membrane → calcium influx → insulin secretion

Question 12

what side effects of meglitinides

Answer 12

Risk of hypoglycemia
Weight gain

Question 13

what are contraindications of Sulfonylureas

Answer 13

cardiovascular diseases
obesity
renal failure
liver failure

Question 14

what contraindications when using meglitinides

Answer 14

renal failure

Question 15

what are drug interactions with meglitinides

Answer 15

Sulfonylureas: ↑ risk of hypoglycemia

Question 16

what are types of DPP4-inhibitors

Answer 16

Saxagliptin
Sitagliptin
Linagliptin

Question 17

what is the moa of DPP4-inhibitors

Answer 17

Inhibit GLP-1 degradation → ↑ glucose-dependent insulin secretion

Question 18

what are side effects of DPP4-inhibitors

Answer 18

Gastrointestinal symptoms
Pancreatitis
Nasopharyngitis, upper respiratory tract infection
Headache, dizziness
Arthralgia
Edema

Question 19

what are contraindications of DPP4

Answer 19

Liver failure
Moderate to severe renal failure

Question 20

what are drug interations of DPP4

Answer 20

CYP3A4/5 inhibitors: ↑ concentration of saxagliptin [1]

Question 21

what are types of GLP-1

Answer 21

Exenatide
Liraglutide
Albiglutide
Semaglutide

Question 22

what are the MOA of GLP-1

Answer 22

Stimulate the GLP-1 receptor directly

Question 23

what are the side effects of GLP-1

Answer 23

Risk of pancreatitis and possibly pancreatic cancer
Nausea

Question 24

what are drug interactions of GLP-2

Answer 24

warfarin

Question 25

what are contraindications of sulfonyreus

Answer 25

Beta-blockers may mask the warning signs of hypoglycemia (e.g., tachycardia) and decrease serum glucose levels even further (see hypoglycemia). Since sulfonylureas also increase the risk of hypoglycemia, the combination of these two substances should be avoided

Question 26

what are the indications of sufonylureus

Answer 26

Patients who are not overweight, do not consume alcohol, and adhere to a consistent dietary routine

Question 27

indications for Meglitinides

Answer 27

particularly suitable for patients with postprandial peaks in blood glucose levels, but overall rarely prescribed

Question 28

when should meglitinides be taken?

Answer 28

should be taken shortly before meals.