Kelly Oral Antihyperglycemic Agents

Question 1

What came out of the UKPDS trial?

Answer 1

Metformin shows to be an effective agent in glucose control.

• neutral weight/ loss
• Decrease in TG and TC

Question 2

Compared to SU, what is the relative risk of hypoglycemia of metformin?

Answer 2

Metformin has a lower risk of hypoglycemia

Question 3

Who should not get metformin?

Answer 3

Renal impairment:
- SCr > 1.5mg/dL (men) SCr > 1.4mg/dL (women)

Consider anyone over 80 years old

Also avoid use in patients that used iodinated contrast material

Question 4

What is a major ADR associated with metformin?

Answer 4

Lactic acidosis

Question 5

Why do you have to take SUs and meglinitides with food?

Answer 5

To lower risk of hypoglycemia

Question 6

What are major ADR associated with TZDs?

Answer 6

Worsening of HF
Bone fractures in women
Peripheral edema
Weight gain

Question 7

What came out of the PROactive trial?

Answer 7

Pioglitazone reduced MI and stroke by 16% in pts. with preexisting macrovascular disease

Also found that glitazones worsen HF and creates incidences of bladder cancer

Question 8

What did the RECORD and re-RECORD trial aim to do?

Answer 8

Show that glitazones have no increased risk of MI or CV deaths (compared it to metformin and SU)

Question 9

What did the SAVOR and EXAMINE trials show?

Answer 9

Showed that DPP-4 inhibitors did not results in CV benefits in diabetes patients

Question 10

Where is the SGLT2 located at? Inhibiting this with SGLT2 will result in?

Answer 10

SGLT2 is located in the proximal tubule of the nephron. Inhibiting it will cause glucose to be excreted out instead of reabsorbed

Question 11

What are some ADRs associated with SGLT2 inhibitors?

Answer 11

• Aggravation of UTIs
• Hypotension/ Hypovolemia
• Increased LDL

Question 12

What is a benefit of using SGLT2 inhibitors?

Answer 12

Kidney protection in CKD 3 patients