Lecture 3 on diabetes drugs Flashcards
A 35 year-old Asian woman comes to see her practice nurse. She has type 2 diabetes and is taking the following medication
Metformin 1g bd po
Gliclazide 80mg bd pod ←
Folic acid 5mg od po —– higher dose given in diabetes shown normal is 400mcg - this is to prevent neural tube defects
Vitamin D 800iU od po
Multivitamins 1tablet od po
Which of these medications is contraindicated in pregnancy
gliclizide as causes neonatal hypoglycaemia
Which of the following classes of drugs can be used, to treat diabetes, with an eGFR of <30
Insulin
Metformin
Thiazolidinedione
SGLT-2 Inhibitors - these are safe for higher degrees of renal failure but when EGFR goes below 45 they dont work for diabetes as glucose is not
Sulphonylureas
inuslin
thiazolidinedione
sulphonulyreas
A 54 year-old caucasian male presents for 3 month review after being diagnosed with type 2 diabetes. He has made changes to his diet and lost 2kg in weight. His HbA1c is 75mmol/mol. What is the most appropriate first line therapy? (1 Point)
metformin - make sure to titrate up before change
Simvastatin 20mg od po
Ezetemibe 10mg od po - statin intolerant pt or add on
Fenofibrate 200mg od po - (drug to lower triglycerides rather than lipid lowering therapy)
Omega 3 oil 1 OD PO
Atorvastatin 20mg od po
Atorvastatin 20mg od po
Which of the following is a clinical situation in which a statin is NOT NICE indicated for primary prevention of cardiovascular disease?(1 Point)
QRISK 2 score 10% over 10 years
Patients with type 1 diabetes of 20 years duration
A patient with type 1 diabetes aged over 40 years
QRISK 2 score 5% over 10 years
A patient with type 1 diabetes mellitus and established diabetic nephropathy
QRISK 2 score 5% over 10 years
dont bother in over 85 as need 10 years
Which of the following drugs has been associated with euglycemic diabetic ketoacidosis?
what 3 other SE are caused by these drugs
SGLT2i - flozins
UTIs
Gential thrush
Fourneris gangrene - clinical dx
