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Endocrine Week 2 2017/18 > Mechanisms of T2 DM drugs > Flashcards

Mechanisms of T2 DM drugs Flashcards

1
Q

How does metformin work?

A

Reduces hepatic gluconeogenesis

Increases peripheral uptake of glucose

Decreases carbohydrate absorption

Increases fatty acid oxidation

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2
Q

Sulphonylureas are known as insulin ___.

A

secretagogues

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3
Q

What effect do sulphonylureas have?

A

Insulin secretion by beta cells

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4
Q

How do sulphonylureas cause insulin secretion by beta cells?

A

Displace ADP-Mg2+ from SUR1 subunit of KATP channel, causing it to close

Depolarisation

Opening of Ca2+ channels and influx of Ca2+

Insulin secretion

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5
Q

Sulphonylurea action is (dependent on / independent of) glucose concentration.

A

independent of glucose concentration

This is why they can cause hypoglycaemia

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6
Q

What do TZDs cause?

A

Increased fatty acid uptake by adipocytes

Reduced hepatic gluconeogenesis (similar to metformin)

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7
Q

How do TZDs work?

A

Binds to PPAR-γ​ nuclear receptor in adipocytes / hepatocytes

Affecting gene expression for fatty acid uptake and gluconeogenesis

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8
Q

GLP-1 agonists imitate what general type of hormone?

A

Incretins

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9
Q

Where is GLP-1 normally secreted from?

A

L cells in the ileum

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10
Q

What effects do incretins normally cause?

A

Increased insulin secretion by beta cells

Decreased glucagon secretion by alpha cells

Reduced gastric emptying

Reduced appetite

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11
Q

What effects do GLP-1 agonists cause?

A

Increased insulin secretion by beta cells

Decreased glucagon secretion by alpha cells

Reduced gastric emptying

Reduced appetite

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12
Q

What is DPP-4?

A

Enzyme which breaks down incretins

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13
Q

How do DPP-4 antagonists work?

A

Competitively inhibit DPP-4, allowing incretins to act for longer, producing:

Increased insulin secretion by beta cells

Decreased glucagon secretion by alpha cells

Reduced gastric emptying

Reduced appetite

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14
Q

What is SGLT2?

Where is it found?

A

Sodium-glucose linked transporter 2

Proximal tubules of kidney

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15
Q

What are the differences between SGLT1 and SGLT2?

A

SGLT1 found in GI tract, SGLT2 found in proximal tubules

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16
Q

How does SGLT2 work?

A

Actively transports 3 Na+ out

Then uses that energy to transport the 3 Na+ and one glucose molecule in (causing glucose reabsorption)

17
Q

How do SGLT2 inhibitors work?

What renal sign do they produce?

A

Block SGLT2 transporter, decrease glucose reabsorption

Glycosuria

18
Q

How does insulin work?

A

Increases uptake of glucose into cells

Liver and skeletal muscle cells - glycogen

Adipocytes - triglycerides

Endocrine Week 2 2017/18 (10 decks)

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