Lecture 5 - Antihyperglycemic Agents

Question 1

What is the main difference between antihyperglycemic agents and hypoglycemics?

Answer 1

• reduced risk of hypoglycemia

Question 2

What type of antihyperglycemic is metformin and what is its MOA?

(How it glucose output and uptake)

Answer 2

• biguanide
• decreases glucose output in liver
• increases insulin sensitivity on muscles and fat to increase uptake

Question 3

What are the toxicities of biguanide (metformin)?

Answer 3

• lactic acidosis (especially renal insufficiency)
• megaloblastic anemia (rare)
• diarrhrea, nausea, GIT

Question 4

Name two alpha-glucosidase inhibitors and list their MOA and toxicities

(Works in the GI tract)

Answer 4

• acarbose, miglitol
• MOA: inhibit GI tract enzyme that break down complex carbohydrates, reduce monosaccharide absorbed
• Toxicities: GIT disturbances, diarrhea, pain and gas

Question 5

Name two thiazolidinediones that work on the PPAR (Preoxisome proliferator activated receptor) and list their MOA, side effects and toxicities

(Works on gene transcription)

Answer 5

• rosiglitazone, pioglitazone
• MOA:PPAR agonist to increase gene transcription
• Increases glut-4 transporters, lipoprotein lipase, fatty acid transporters
• Side Effects: weight gain and fluid retention
• Toxicities:hepatotoxicity, congestive heart failure

Question 6

Name two thiazolidinediones that work on the GLP-1 (glucagon-like peptide 1) and list their MOA, route of administration and toxicities

Answer 6

• Liraglutide, Exenatide
• MOA: GLP-1 receptor agonist, inhibits glucagon secretion, increases insulin secretion (incretin mimetic)
• given subcutaneously
• Common toxicities: nausea, diarrhea, vomiting
• Serious toxicities: pancreatitis, thyroid carcinoma (liraglutide), anaphylactic reaction (exenatide)

Question 7

Name three thiazolidinediones that work on the DPP-4 (dipeptidyl peptidase 4) and list their MOA and toxicities

Answer 7

• Sitagliptin, Saxafliptin, Linagliptin
• MOA: DPP-4 inhibitor blocks breakdown of GLP-1. Increases duration of incretin, stimlulates insulin release and inhibits glucagon
• Common Toxicities: Upper respiratory infection, nasopharyngitis, headache
• Serious Toxicities: Pancreatitis, hypersensitive reactions

Question 8

what is a new MOA for prevent reabsorption of glucose. (MOA)

Answer 8

• inhibit type 2 sodium-glucose transporter

- prevents reabsoption of glucose in kidneys and keeps blood glucose low

Question 9

Which antihyperglycemic drug is a biguanide?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 9

D. Metformin

Question 10

Which antihyperglycemic drug is an alpha-glucosidase?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 10

C. Miglitol

Question 11

Which three antihyperglycemic drugs are thiazolidinediones?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 11

A. Sitagliptin
B. Rosiglitazone
E. Liraglutanide

Question 12

Which drug is a dipeptidhyl peptidase 4 (DPP-4) inhibitor?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 12

A. Sitagliptin

Question 13

Which drug is a glucagon-like peptide 1 (GLP-1) receptor agonist?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 13

E. Liraglutanide

Question 14

Which drug is a perixsome proliferator-activated receptor (PPAR) agonist?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 14

B. Rosiglitazone

Question 15

Which drug inhibits GI tract enzymes?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 15

. Miglitol

Question 16

Which drug decreases glucose output from liver and increases glucose uptake in cells?

A. Sitagliptin
B. Rosiglitazone
C. Miglitol
D. Metformin
E. Liraglutanide

Answer 16

D. Metformin

Question 17

Which drug is incorrectly matched with their mechanism of action?

A. Sitagliptin - GLP-1 receptor agonist
B. Rosiglitazone - Increases gene transcription for glut-4, lipoprotein lipase and fatty acid transports
C. Miglitol - inhibit GI tract enzymes
D. Metformin - decrease glucose liver output
E. Liraglutanide - Inhibits glucagon secretion

Answer 17

A. Sitagliptin - GLP-1 receptor agonist

• Is a DDP-4 inhibitor that blocks breakdown of GLP-1

Question 18

Which is NOT a toxicity of metformin?

A. Lactic acidosis
B. Diarrhea
C. Nausea
D. Pancreatitis

Answer 18

D. Pancreatitis

Question 19

Which is NOT a toxicity of acarbose?

A. Pain
B. Diarrhea
C. Headaches
D. GI disturbances

Answer 19

C. Headaches

Question 20

Which is NOT a toxicity/side effect of pioglitazone?

A. Vomiting
B. Hepatotoxicity
C. Congestive Heart Failure
D. Weight Gain

Answer 20

A. Vomiting

Question 21

Which is NOT a toxicity of Exenatide?

A. Pancreatitis
B. Nausea, Vomiting
C. Diarrhea
D. Thyroid Carcinoma
E. Analphylactic reactions

Answer 21

D. Thyroid Carcinoma

Question 22

Which is NOT a toxicity of Liraglutide?

A. Pancreatitis
B. Nausea, Vomiting
C. Diarrhea
D. Thyroid Carcinoma
E. Analphylactic reactions

Answer 22

E. Analphylactic reactions

Question 23

Which is NOT a toxicity of Linagliptin?

A. Pancreatitis
B. Headache
C. Hypersensitive reactions
D. Nasopharyngitis
E. Diarrhea

Answer 23

E. Diarrhea