L30- Antidiabetic Drugs II (buguanides)

Question 1

Biguanides- mainly (1):

-main effect is (2)- same as secretagogues, except with (3) as main difference

Answer 1

1- metformin

2- lower FPG, HbA1c
3- does not cause insulin secretion, does not cause hypoglycemia (even at large doses)

Question 2

Metformin:

• (1) is the main MOA mediated by (2) enzyme
• (3) is an additional effect
• (4) is the overall improvement

Answer 2

1- inhibits gluconeogenesis gene expression
2- AMP-activated protein kinase

3- inc insulin mediated glucose utlization in muscle and liver

4- slight serum insulin concentration decline

Question 3

‘other effects’ of metformin (positive)

Answer 3

reduces plasma TGs by 15-20%

dec body weight

Question 4

metformin indications

Answer 4

1st line agent in type II DM

Question 5

Biguanide AEs (+ contraindications)

Answer 5

(metformin)
GI: anorexia, n/v/d, abdominal discomfort

long-term: B12 absorption

small risk of FATAL lactic acidosis

Contraindications: renal / hepatic disease, alcoholism, hypoxia