MET2 Drugs Flashcards
What is Terlipressin used to treat?
How does it do so?
Terlipressin: treats oesph. bleeding
MoA: inhibits portal hypertension with simultaneous reduction of blood circulation in portal vessels
What is Rifamixin used to treat?
How does it do so?
Rifamixin: reduces the production of NH3 in the gut to stop hepatic encephalopathy
What is L-Ornithine L-arginine used to treat?
How does it do so?
L-Ornithine L-arginine stops the conversion of glutamate to glutamine to stop producion of NH3 and reduce hepatic encephalopathy
For DMT1 treatment, name a short acting and long term acting insulin injection [2]
- Short / Fast acting: Humalog
- Long acting: Glargine
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Inhibits liver gluconeogenesis and enahnaces insulin sensitivity
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Inhibits liver gluconeogenesis and enahnaces insulin sensitivity
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Bind and close K+ channel in beta cells to
depolarise the cell and release insulin
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Activate PPARγ to reduce insulin insensitivity and better glucose use via gene expression changes
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Activate PPARγ to reduce insulin insensitivity and better glucose use via gene expression changes
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
* Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight loss?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight loss?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors: excreting glucose
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight gain? [2]
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight gain? [2]
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following has similar action to prandial glucose regulators?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following has similar action to prandial glucose regulators?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
How do NSAIDs work? [2]
COX-1 and COX-2 inhibition
to reduce
inflammatory prostaglandins
Which drug class impairs onset of dementia? [1]
Angiotensin II blockers have been shown to slow the onset of dementia.
Arachi
What is MoA of statins? [2]
Blocks HMG-CoA reductase which reduces mevalonate production in the liver which reduces cholesterol production
(most cholesterol in blood is liver derived not diet)
How would you treat thyrotoxicosis
Treatment:
* Thionamide drugs: Propylthiouracil; Carbimazole
* Radioactive Iodine I-131
* Thyroidectomy
Treatment of HypoT? [1]
- Levothyroxine - only treatment used In UK
Name two replacements for insulin [2]
Which one is long term and which is short
Actrapid
Actraphane - lasts longer
Name the drug that replaces T4 with people in hypothyroidism or Hashimotos [1]
Levothyroxine
Name the two mainstays of treatment for hyperthyroidism and Graves’ disease [2]
Carbimazole, propylthiouracil
Which drug blocks thyroxine deiodinase I in the liver and thyroxine deiodinase II in the periphery to STOP T4 - T3 conversion
Iodine-131
Levothyroxine
Propylthiouracil
Carbimazole
Which drug blocks thyroxine deiodinase I in the liver and thyroxine deiodinase II in the periphery to STOP T4 - T3 conversion
Iodine-131
Levothyroxine
Propylthiouracil
Carbimazole
Name a drug that is not carbimozole, or propylthiouracil that is used to treat hyperthyroidism
Iodine 131
Which of the following bind and close K+ channel in beta cells to depolarise the cell and release insulin?
- Sulphonylureas (e.g. gliclazide, glibenclamide & tolbutamide)
- Thiazolidinediones like the
glitazones: Pioglitazone, Rosiglitazone - Meglitinides
- Metformin
- GLP-1
Which of the following bind and close K+ channel in beta cells to depolarise the cell and release insulin?
- Sulphonylureas (e.g. gliclazide, glibenclamide & tolbutamide)
- Thiazolidinediones like the
glitazones: Pioglitazone, Rosiglitazone - Meglitinides
- Metformin
- GLP-1
Which of the folowing anti-ulcer drugs are proton pump inhibitors
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Which of the folowing anti-ulcer drugs are proton pump inhibitors
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Which of the folowing is an antibiotic which is an anti-anaerobe and useful for H. pylori
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Which of the folowing is an antibiotic which is an anti-anaerobe and useful for H. pylori
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Which of the following are H2 antagonists to stop acid secretion [2]
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Which of the following are H2 antagonists to stop acid secretion [2]
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Which of the following DMT2 treatment promotes triglyceride storage in adipose
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following DMT2 treatment promotes triglyceride storage in adipose
- Biguanides
- Sulfonylureas
Thiazolidinediones (TZD) - GLP1R agonists
- SGLT2 Inhibitors
Dipeptidyl-peptidase 4 (DPP-4) rapidly cleaves which molecule? [1]
GLP-1
Which of the following has a potential risk of hypoglycaemia
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following has a potential risk of hypoglycaemia
- Biguanides
- Sulfonylureas and prandial glucose regulators
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following enhances
insulin secretion
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following enhances
insulin secretion
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following enhances
insulin sensitivity [2]
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following enhances
insulin sensitivity [2]
- Biguanides (i.e. metformin)
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following has risk of weight gain?
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which of the following has risk of weight gain?
- Biguanides
- Sulfonylureas
- Thiazolidinediones (TZD)
- GLP1R agonists
- SGLT2 Inhibitors
Which drug would you use as a stress test for cushings?
Dexamethasone [1]
What are the sites of action used for transplant immunosuppressive drugs? [3] and what drugs used?
Calcineurin inhibitors:
* Calcineurin is an enzyme that activates T-cells of the immune system.
* E.g. Cyclosporin and tacrolimus (learn !)
Anti-proliferative drugs:
* (target nucleus at end stage of T cell activation)
* e.g. Azathioprine and Mycophenolic acid
Prevent cytokine (IL-2) gene activation
* Use cortiosteroids
* e.g. Prednisolone
Standard treatment: Calcineurin inhib, steroid and anti-proliferative drugs
How do you treat hypoparathyroidism acutely and chronically? [2]
Acutely: give Ca2+
Chronically: Give activated vit D: increased gut absorb
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Inhibits liver gluconeogenesis and enahnaces insulin sensitivity
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Inhibits liver gluconeogenesis and enahnaces insulin sensitivity
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Bind and close K+ channel in beta cells to
depolarise the cell and release insulin
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Activate PPARγ to reduce insulin insensitivity and better glucose use via gene expression changes
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes utilise the followng mechanism of actions?
Activate PPARγ to reduce insulin insensitivity and better glucose use via gene expression changes
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
* Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight loss?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight loss?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors: excreting glucose
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight gain? [2]
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following drug treatments for diabetes causes weight gain? [2]
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following has similar action to prandial glucose regulators?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
Which of the following has similar action to prandial glucose regulators?
- Sulfonylureas - e.g. gliclazide, glibenclamide and tolbutamide
- Metformin
- SGLT2 Inhibitors
- Thiazolidinediones e.g Pioglitazone or Rosiglitazone
How can you treat DMT1?
Currently? [2]
Future? [2]
Insulin - short acting and long acting.
- Pumps
- Injections - pens
- Short / Fast acting: Humalog
- Long acting: Glargine
Islet transplantation
- Only patients matching a strict list of criteria, including being at risk of frequent and secere hypos/hypers.
Possible future treatment: immunotherapy
SGLT Inhibitors:.
* Prevent co-reabsorption of glucose in the PCT with Na.
* Encourages glycosuria -> wee out the excess glucose. Lowers blood glucose levels. Restores GFR in diabetics
Diagnosis [2] and Treatment of HypoT? [1]
Diagnosis of hypothyroidism:
* Low levels of TSH and low T4 in blood - biochemistry tests
Treatment:
* Levothyroxine - only treatment used In UK
[] is the first line anti-thyroid drug
[] is the second line anti-thyroid drug.
Carbimazole is the first line anti-thyroid drug
Propylthiouracil is the second line anti-thyroid drug.
What is the treatment if a STEMI is detected? [3]
Open the occluded artery as soon as possible to restore blood flow to the heart (Time is Muscle) (angioplasty) at heart attack centre. less than120 mins is aim
If can’t open artery via stent aim to thromboylse (but want to avoid because have high risk of bleeding).
Reperfusion therapy:
- Aspirin + ticagrelor or pragural (dual antiplatelets)
- Heparin
- PCI
What is the treatment if a non- STEMI is detected? [5]
A
· Treatment:
o Aspirin + ticagrelor
o +/- GP IIb/IIIa inhibitor (prevent platelet aggregation by blocking glycoprotein IIb/IIIa receptors on their platelet’s)
o Fondaparinux - factor Xa inhibitor
o Anti-ischemic drugs - BB/nitrates
o Angiography, followed by +/- PCI within 24-96 hrs.
· Idea is to thin blood to fit through the semi-occluded gap - then use angiography within 24 hours of presentation to resolve the partial occlusion.
BATMAN
B – Beta-blockers unless contraindicated
A – Aspirin 300mg stat dose
T – Ticagrelor 180mg stat dose (clopidogrel 300mg is an alternative if higher bleeding risk)
M – Morphine titrated to control pain
A – Anticoagulant: Fondaparinux (unless high bleeding risk)
N – Nitrates (e.g. GTN) to relieve coronary artery spasm
Give oxygen only if their oxygen saturations are dropping (i.e. <95%).
What are AEs of CA inhibitors like Acetazolamide? [3]
Sedation
Acidosis
What is clinical use of thiazide diuretic? [1]
Why? [2]
Antihypertensive:
reduces plasma volume and peripheral resistance
Q
What are the two type of K sparing diuretics? [2]
Name two examples of each xx [4]
Epithelial Na Channel antagonists
* Amiloride
* Triamterene
Aldosterone antagonists:
* Spironolactone
* Eplerenone
Clinical use of loop diuretics? [3]
A
Most potent diuretic
Also for:
* HTN
* Heart failure
* Volume overload from CKD
AEs of aldosterone inhibitors? [3]
Hyperkalaemia
Hyperkalaemia –> can lead to cardiac arrythmias and death
Hyperkalaemia
Gynecomastia (not eplerenone)
Hyponatraemia (Cirrhosis)
Clinical uses of amiloride?
Heart failure
Hypokalaemia (from other diuretics)
Co-amilofruse
Co-amilozide
Cirrhosis
What is a osmotic diuretic and which is the most clinically important? [2]
Any osmotically active molecule that is freely filtered in the glomerulus, and is not reabsorbed by the tubules, stopping water reabsorption
Most important clinical osmotic diuretic: Mannitol
Effects of SGLT2 inhibitors? [5]
A
Glycosuria: weight loss, reduction in blood glucose, HbA1c reduced
Uric acid reduced
Natuiresis: fall in BP
Reduced hyperinfiltration: reduced albuininuria
Reversible reduction in GFR
How can you treat variceal bleeding [4]
What can you give as primary and secondary prophylaxis for variceal bleeding? [2]
Treatment:
Resuscitation
Terlipressin (inhibits portal hypertension with simultaneous reduction of blood circulation in portal vessels) and Antibiotics
Banding or injection sclerotherapy
TIPSS
Primary + secondary prophylaxis beta blockers
Propranolol / Carvedilol
Banding
How can you stop the production of NH3 to treat encephalopathy? [2]
Rifaximin: reduces the production of NH3 in the gut
L-Ornithine L-arginine: stops the conversion of glutamate to glutamine
A 76-year-old patient, Eleri, is being investigated by her GP for episodes of dizziness when standing up which is disrupting her daily routine. Eleri is otherwise fit and well and takes no regular medications. Eleri’s GP diagnoses her with orthostatic hypotension and recommends treatment with fludrocortisone.
What side effect is Eleri most likely to experience?
Depression
Fluid retention
Hyperglycaemia
Osteoporosis
Peptic ulceration
A 76-year-old patient, Eleri, is being investigated by her GP for episodes of dizziness when standing up which is disrupting her daily routine. Eleri is otherwise fit and well and takes no regular medications. Eleri’s GP diagnoses her with orthostatic hypotension and recommends treatment with fludrocortisone.
What side effect is Eleri most likely to experience?
Depression
Fluid retention
Hyperglycaemia
Osteoporosis
Peptic ulceration
Fludrocortisone is a steroid with minimal glucocorticoid activity and high mineralocorticoid activity.
Therefore, fluid retention is the correct answer as this is the side effect listed that is most associated with mineralocorticoid activity
Depression, hyperglycaemia, osteoporosis and peptic ulceration are all side effects associated with glucocorticoid activity.
A 63-year-old woman with a history of type 2 diabetes is being reviewed by her general practitioner.
She is currently taking metformin 1g twice daily. She also takes lisinopril for hypertension.
Her latest HbA1c is as follows:
HbA1c 58 mmol/L (more than 42)
After further discussion, she has agreed to add a second anti-diabetic drug to her treatment regimen. She has been advised that side-effects can include weight gain, hypoglycaemia and gastrointestinal upset.
What is the mechanism of action of this drug?
Activation of peroxisome proliferator activated receptor gamma (PPAR gamma)
Binding to KATP channels on pancreatic beta cell membrane
Activation of glucagon-like-peptide-1 (GLP-1) receptor
Inhibition of sodium-glucose co-transporter 2 (SGLT-2)
Inhibition of dipeptidyl peptidase 4 (DPP-4)
A 63-year-old woman with a history of type 2 diabetes is being reviewed by her general practitioner.
She is currently taking metformin 1g twice daily. She also takes lisinopril for hypertension.
Her latest HbA1c is as follows:
HbA1c 58 mmol/L (more than 42)
After further discussion, she has agreed to add a second anti-diabetic drug to her treatment regimen. She has been advised that side-effects can include weight gain, hypoglycaemia and gastrointestinal upset.
What is the mechanism of action of this drug?
Activation of peroxisome proliferator activated receptor gamma (PPAR gamma)
Binding to KATP channels on pancreatic beta cell membrane
Activation of glucagon-like-peptide-1 (GLP-1) receptor
Inhibition of sodium-glucose co-transporter 2 (SGLT-2)
Inhibition of dipeptidyl peptidase 4 (DPP-4)
Sulphonylureas exert their effect by binding to KATP channels on the pancreatic beta-cell membrane to stimulate endogenous insulin secretion. This explains the commonly reported side-effects of weight gain (as insulin is an anabolic hormone) and hypoglycaemia.
A 66-year-old lady with a long history of poorly controlled type-2 diabetes is started on a new medication. She is told it works by increasing urinary glucose excretion and the doctor says it is an SGLT-2 inhibitor.
Which of the following medications is in this drug class?
Tolbutamide
Dapagliflozin
Exenatide
Linagliptin
Pioglitazone
A 66-year-old lady with a long history of poorly controlled type-2 diabetes is started on a new medication. She is told it works by increasing urinary glucose excretion and the doctor says it is an SGLT-2 inhibitor.
Which of the following medications is in this drug class?
Tolbutamide
Dapagliflozin
Exenatide
Linagliptin
Pioglitazone
Gliflozins - SGLT2 inhibitors
A 42-year-old woman presents with progressively worsening weight loss, anxiety, heat intolerance, and dry skin and eyes.
Hyperthyroidism is confirmed on thyroid-function tests and the patient is commenced on carbimazole. A set dose is initially started with a plan to titrate up the drug until the patient becomes euthyroid. Further thyroid hormone testing is scheduled in 4 to 6 weeks.
What is the mechanism of action of this medication?
Blocks thyroxine-binding globulin
Enhances thyroid peroxidase
Inhibiting 5’-deiodinase
Prevents iodination of the tyrosine residue on thyroglobulin
Prevents thyroxine (T4) conversion to triiodothyronine (T3)
A 42-year-old woman presents with progressively worsening weight loss, anxiety, heat intolerance, and dry skin and eyes.
Hyperthyroidism is confirmed on thyroid-function tests and the patient is commenced on carbimazole. A set dose is initially started with a plan to titrate up the drug until the patient becomes euthyroid. Further thyroid hormone testing is scheduled in 4 to 6 weeks.
What is the mechanism of action of this medication?
Blocks thyroxine-binding globulin
Enhances thyroid peroxidase
Inhibiting 5’-deiodinase
Prevents iodination of the tyrosine residue on thyroglobulin
Prevents thyroxine (T4) conversion to triiodothyronine (T3)
A 67-year-old man with type 2 diabetes mellitus has been taking metformin 1g twice daily for the past 6 months. Despite this, his HbA1c has remained above target at 64 mmol/mol (8.0%).
He has a history of left ventricular failure following a myocardial infarction 3 years ago. He has been trying to lose weight since but still has a body mass index of 33 kg/m². He is also prone to recurrent urinary tract infections.
You plan on intensifying treatment by adding on a second medication.
What is the mechanism of action of the anti-diabetic drug that is most appropriate for him?
Activation of peroxisome proliferator-activated gamma receptors to increase insulin sensitivity
Binding to KATP channels on pancreatic beta cells to stimulate insulin release
Inhibition of intestinal alpha-glucosidase to reduce glucose absorption
Inhibition of renal sodium-glucose co-transporter-2 (SGLT2) to increase glucose excretion
Inhibition of dipeptidyl peptidase-4 (DPP-4) to increase incretin levels
A 67-year-old man with type 2 diabetes mellitus has been taking metformin 1g twice daily for the past 6 months. Despite this, his HbA1c has remained above target at 64 mmol/mol (8.0%).
He has a history of left ventricular failure following a myocardial infarction 3 years ago. He has been trying to lose weight since but still has a body mass index of 33 kg/m². He is also prone to recurrent urinary tract infections.
You plan on intensifying treatment by adding on a second medication.
What is the mechanism of action of the anti-diabetic drug that is most appropriate for him?
Activation of peroxisome proliferator-activated gamma receptors to increase insulin sensitivity
Binding to KATP channels on pancreatic beta cells to stimulate insulin release
Inhibition of intestinal alpha-glucosidase to reduce glucose absorption
Inhibition of renal sodium-glucose co-transporter-2 (SGLT2) to increase glucose excretion
Inhibition of dipeptidyl peptidase-4 (DPP-4) to increase incretin levels
DPP-4 inhibitors increase levels of incretins such as GLP-1 and GIP
Given its weight-neutral effects, it is the most appropriate add-on therapy in this man who is already obese.
A 52-year-old man presents to the surgery for diabetic review. His HBA1c is 68mmol/mol despite taking the maximum dose of metformin and gliclazide. You discuss his control with the diabetic nurse in the practice and you decide to start a new medication, dapagliflozin.
What is the principal side effect of this new medication?
Diarrhoea
Heart failure
Pancreatitis
Urinary tract infections
Weight gain
A 52-year-old man presents to the surgery for diabetic review. His HBA1c is 68mmol/mol despite taking the maximum dose of metformin and gliclazide. You discuss his control with the diabetic nurse in the practice and you decide to start a new medication, dapagliflozin.
What is the principal side effect of this new medication?
Diarrhoea
Heart failure
Pancreatitis
Urinary tract infections
Weight gain
Sodium-glucose co-transporter 2 inhibitors are associated with an increased risk of urinary tract infections
A 64-year-old woman with type 2 diabetes mellitus is reviewed by her diabetic nurse. It is noted that her glycaemic control is still poor, despite taking metformin for the last 6 months. It is decided to intensify management, by combining sitagliptin (a dipeptidyl-peptidase 4 (DPP-4) inhibitor) with her existing metformin.
Which of the following best describes the mechanism of action of the new drug?
Increases cell sensitivity to insulin
Inhibition of sodium-glucose co-transporter (SGLT2)
Increased levels of glucagon-like peptide 1 (GLP-1)
Increases adipogenesis
Increase intracellular calcium to increase insulin release
A 64-year-old woman with type 2 diabetes mellitus is reviewed by her diabetic nurse. It is noted that her glycaemic control is still poor, despite taking metformin for the last 6 months. It is decided to intensify management, by combining sitagliptin (a dipeptidyl-peptidase 4 (DPP-4) inhibitor) with her existing metformin.
Which of the following best describes the mechanism of action of the new drug?
Increases cell sensitivity to insulin
Inhibition of sodium-glucose co-transporter (SGLT2)
Increased levels of glucagon-like peptide 1 (GLP-1)
Increases adipogenesis
Increase intracellular calcium to increase insulin release
Mrs Rose is a 52-year-old woman who attends your GP clinic for her annual review of her type 2 diabetes. She tells you that it has been controlled by diet for a number of years, however recently, she has put on some weight. Her most recent HbA1C measurement is 9.8% (normal range 3.7-5.0%). You advise ongoing diet advice as well as prescribing metformin to control her blood glucose concentration. Which of the following statements regarding metformin is correct?
It can cause weight gain
It stimulates insulin secretion from pancreatic beta cells
It can cause significant hypoglycaemia
It decreases hepatic gluconeogenesis
It suppresses ghrelin secretion
Mrs Rose is a 52-year-old woman who attends your GP clinic for her annual review of her type 2 diabetes. She tells you that it has been controlled by diet for a number of years, however recently, she has put on some weight. Her most recent HbA1C measurement is 9.8% (normal range 3.7-5.0%). You advise ongoing diet advice as well as prescribing metformin to control her blood glucose concentration. Which of the following statements regarding metformin is correct?
It can cause weight gain
It stimulates insulin secretion from pancreatic beta cells
It can cause significant hypoglycaemia
It decreases hepatic gluconeogenesis
It suppresses ghrelin secretion
A 62-year-old man presents for review of his type 2 diabetes. He has been found to have HbA1c levels of 62mmol/mol despite metformin therapy. You decide to commence him on sitagliptin for dual hypoglycaemic therapy.
What is the mechanism of this drug?
Decreases GLP-1 breakdown
Decreases levels of GIP incretins
Increases GLP-1 production
Increases insulin secretion from the pancreas
Mimics GLP-1
A 62-year-old man presents for review of his type 2 diabetes. He has been found to have HbA1c levels of 62mmol/mol despite metformin therapy. You decide to commence him on sitagliptin for dual hypoglycaemic therapy.
What is the mechanism of this drug?
Decreases GLP-1 breakdown
Decreases levels of GIP incretins
Increases GLP-1 production
Increases insulin secretion from the pancreas
Mimics GLP-1
DPP-4 inhibitors increase levels of incretins such as GLP-1 and GIP
A 38-year-old, with a raised BMI and confirmed type II diabetes is seen in the clinic for a review of his glucose control.
Despite already being initiated on treatment several months previously his home blood glucose readings and latest Hb1Ac remain high. It is decided that the patient is to be commenced on a gliclazide. The patient is warned that this new medication may induce hypoglycaemia as an adverse effect due to an increase in the production and release of insulin.
What pancreatic cell membrane channels does this new medication bind to?
ATP-dependent potassium
Dipeptidyl peptidase-4 (DDP)
Ligand-gated chloride
Tyrosine kinase
Voltage-gated calcium
A 38-year-old, with a raised BMI and confirmed type II diabetes is seen in the clinic for a review of his glucose control.
Despite already being initiated on treatment several months previously his home blood glucose readings and latest Hb1Ac remain high. It is decided that the patient is to be commenced on a gliclazide. The patient is warned that this new medication may induce hypoglycaemia as an adverse effect due to an increase in the production and release of insulin.
What pancreatic cell membrane channels does this new medication bind to?
ATP-dependent potassium
Dipeptidyl peptidase-4 (DDP)
Ligand-gated chloride
Tyrosine kinase
Voltage-gated calcium
A 54-year-old patient presents to his general practitioner for a review of his diabetes treatment. He takes metformin. He is worried about adding additional medications that might cause hypoglycaemia. He has a past medical history of bladder cancer, which was surgically treated.
The examination is unremarkable other than an elevated body mass index (32 kg/m²).
Recent blood test results:
HbA1c 61 mmol/L (more than 48)
His GP would like to commence him on a medication that does not cause weight gain or hypoglycaemia.
What is the likely mechanism of action of this drug?
Agonist of PPAR-gamma receptor
Binding of ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells
Exogenous insulin
Inhibition of intestinal alpha glucosidases
Reduction of the peripheral breakdown of incretins such as glucagon-like peptide (GLP-1)
A 54-year-old patient presents to his general practitioner for a review of his diabetes treatment. He takes metformin. He is worried about adding additional medications that might cause hypoglycaemia. He has a past medical history of bladder cancer, which was surgically treated.
The examination is unremarkable other than an elevated body mass index (32 kg/m²).
Recent blood test results:
HbA1c 61 mmol/L (more than 48)
His GP would like to commence him on a medication that does not cause weight gain or hypoglycaemia.
What is the likely mechanism of action of this drug?
Agonist of PPAR-gamma receptor
Binding of ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells
Exogenous insulin
Inhibition of intestinal alpha glucosidases
Reduction of the peripheral breakdown of incretins such as glucagon-like peptide (GLP-1)
A 56-years-old man with a past medical history of type II diabetes mellitus returns to his GP for a follow up. He denies polyuria and polydipsia. Repeat blood tests at clinic showed:
HbA1c 67 mmol/mol
Random plasma glucose 15.6 mg/l
He currently only takes metformin and his GP decides to add in gliclazide to his regular medication. What is the mechanism of action of gliclazide?
Inhibits dipeptidyl peptides-4
Stimulates sulphonylurea-1 receptors
Inhibits alpha-glucosidase enzymes
Glucagon-like peptide-1 analogues
Inhibits sodium-glucose cotransporter 2
A 56-years-old man with a past medical history of type II diabetes mellitus returns to his GP for a follow up. He denies polyuria and polydipsia. Repeat blood tests at clinic showed:
HbA1c 67 mmol/mol
Random plasma glucose 15.6 mg/l
He currently only takes metformin and his GP decides to add in gliclazide to his regular medication. What is the mechanism of action of gliclazide?
Inhibits dipeptidyl peptides-4
Stimulates sulphonylurea-1 receptors
Inhibits alpha-glucosidase enzymes
Glucagon-like peptide-1 analogues
Inhibits sodium-glucose cotransporter 2
A 22-year-old woman attends her GP surgery as she is finding it exceedingly difficult to lose weight. She currently has a body mass index (BMI) approaching 40 kg/m², and it is severely affecting her mental and physical health. A strict diet and exercise regime has not made a significant difference. The GP decides to prescribe her an anti-obesity agent, orlistat.
How does the prescribed medication promote weight loss?
Increases metabolism through mitochondrial uncoupling
Reduces fat digestion by inhibiting lipase
Promotes glucose uptake through increased insulin secretion
Suppresses appetite through reduced uptake of serotonin
Improves satiety by reducing gastric emptying
A 22-year-old woman attends her GP surgery as she is finding it exceedingly difficult to lose weight. She currently has a body mass index (BMI) approaching 40 kg/m², and it is severely affecting her mental and physical health. A strict diet and exercise regime has not made a significant difference. The GP decides to prescribe her an anti-obesity agent, orlistat.
How does the prescribed medication promote weight loss?
Increases metabolism through mitochondrial uncoupling
Reduces fat digestion by inhibiting lipase
Promotes glucose uptake through increased insulin secretion
Suppresses appetite through reduced uptake of serotonin
Improves satiety by reducing gastric emptying
A 55-year-old man with type 2 diabetes mellitus has his yearly health check-up at his GP surgery. His HbA1c is 86mmol/L and his GP is considering adding empagliflozin to help manage his diabetes.
HbA1c (mmol/L) Interpretation
<42 Normal Glycaemic Control
42-47 Impaired Glucose Tolerance
>48 Diabetes Mellitus
86 Patient’s Result
What is the mechanism of action of this medication?
Blocks potassium channels on β islet cells in the pancreas
Inhibition of the sodium-glucose transporter in the kidney
Inhibition of dipeptidyl peptidase 4
Inhibition of α glucosidase in the small intestine
Stimulation of peroxisome proliferator-activated receptor
A 55-year-old man with type 2 diabetes mellitus has his yearly health check-up at his GP surgery. His HbA1c is 86mmol/L and his GP is considering adding empagliflozin to help manage his diabetes.
HbA1c (mmol/L) Interpretation
<42 Normal Glycaemic Control
42-47 Impaired Glucose Tolerance
>48 Diabetes Mellitus
86 Patient’s Result
What is the mechanism of action of this medication?
Blocks potassium channels on β islet cells in the pancreas
Inhibition of the sodium-glucose transporter in the kidney
Inhibition of dipeptidyl peptidase 4
Inhibition of α glucosidase in the small intestine
Stimulation of peroxisome proliferator-activated receptor
A 56-year-old man presents for review in the diabetes clinic. His medical background includes type 2 diabetes, for which he is currently prescribed metformin and sitagliptin, and hypertension, for which he takes ramipril. On his most recent blood tests, his HbA1c has risen from 51mmol/L to 59mmol/L. He has had no issues with hypoglycaemic events and reports good compliance with both blood glucose monitoring and his prescribed medication. He is keen to try an additional antidiabetic medication, and, after counselling on hypoglycaemic awareness, is started on tolbutamide.
Which of the following most accurately describes the mechanism of action of this new medication?
Increases insulin release by mimicking the binding of glucagon-like peptide-1 (GLP-1) to its receptor
Inhibits the enzyme dipeptyl peptidase-4 (DPP-4), preventing the degradation of incretins such as GLP-1
Reduces renal glucose reabsorption via inhibition of sodium-glucose transport protein 2 (SGLT2)
Stimulates peroxisome proliferator-activated receptor gamma (PPAR-γ), reducing insulin resistance
Binds to and shuts pancreatic beta cell ATP-dependent K+ channels, causing membrane depolarisation and increased insulin exocytosis
A 56-year-old man presents for review in the diabetes clinic. His medical background includes type 2 diabetes, for which he is currently prescribed metformin and sitagliptin, and hypertension, for which he takes ramipril. On his most recent blood tests, his HbA1c has risen from 51mmol/L to 59mmol/L. He has had no issues with hypoglycaemic events and reports good compliance with both blood glucose monitoring and his prescribed medication. He is keen to try an additional antidiabetic medication, and, after counselling on hypoglycaemic awareness, is started on tolbutamide.
Which of the following most accurately describes the mechanism of action of this new medication?
Increases insulin release by mimicking the binding of glucagon-like peptide-1 (GLP-1) to its receptor
Inhibits the enzyme dipeptyl peptidase-4 (DPP-4), preventing the degradation of incretins such as GLP-1
Reduces renal glucose reabsorption via inhibition of sodium-glucose transport protein 2 (SGLT2)
Stimulates peroxisome proliferator-activated receptor gamma (PPAR-γ), reducing insulin resistance
Binds to and shuts pancreatic beta cell ATP-dependent K+ channels, causing membrane depolarisation and increased insulin exocytosis
A 45-year-old man with type 2 diabetes mellitus, currently taking metformin, comes in for his diabetic review. His glycaemic control is deemed to be not under control and gliclazide is added to his treatment regimen. The doctor is advising the patient about the side effects of sulfonylureas. Which of the following is a side effect of sulfonylureas?
Flatulence
Fluid retention
Nausea
Hypoglycaemia
Diarrhoea
A 45-year-old man with type 2 diabetes mellitus, currently taking metformin, comes in for his diabetic review. His glycaemic control is deemed to be not under control and gliclazide is added to his treatment regimen. The doctor is advising the patient about the side effects of sulfonylureas. Which of the following is a side effect of sulfonylureas?
Flatulence
Fluid retention
Nausea
Hypoglycaemia
Diarrhoea
A 56-year-old woman presents to the emergency department with a 4-day history of severe nausea and vomiting that is not responsive to cyclizine or metoclopramide. She has a past medical history of lung cancer with cerebral metastases, for which she is receiving palliative care.
After consulting the palliative care team, the decision is made to prescribe a steroid with very high glucocorticoid activity and minimal mineralocorticoid activity.
What drug is the patient most likely to have been prescribed?
Dexamethasone
Fludrocortisone
Hydrocortisone
Methylprednisolone
Prednisolone
A 56-year-old woman presents to the emergency department with a 4-day history of severe nausea and vomiting that is not responsive to cyclizine or metoclopramide. She has a past medical history of lung cancer with cerebral metastases, for which she is receiving palliative care.
After consulting the palliative care team, the decision is made to prescribe a steroid with very high glucocorticoid activity and minimal mineralocorticoid activity.
What drug is the patient most likely to have been prescribed?
Dexamethasone
Fludrocortisone
Hydrocortisone
Methylprednisolone
Prednisolone
A 29-year-old rugby player presents with a vague history of polyuria and polydipsia. He also states he was in hospital 4 months ago for a head injury he received whilst playing rugby. Biochemistry and a water-deprivation test indicate he has central diabetes insipidus. The patient undergoes a pituitary MRI which shows a thickened pituitary stalk, supporting this diagnosis.
What medication should be prescribed to this patient?
Carbimazole
Desmopressin
Goserelin
Indapamide
Terlipressin
A 29-year-old rugby player presents with a vague history of polyuria and polydipsia. He also states he was in hospital 4 months ago for a head injury he received whilst playing rugby. Biochemistry and a water-deprivation test indicate he has central diabetes insipidus. The patient undergoes a pituitary MRI which shows a thickened pituitary stalk, supporting this diagnosis.
What medication should be prescribed to this patient?
Carbimazole
Desmopressin
Goserelin
Indapamide
Terlipressin
A 64-year-old man has just been started on dapagliflozin by his GP for better control of his established type 2 diabetes mellitus after a high HbA1c result.
Where is the primary site of the action of this drug?
Pancreatic acinar cells
Pancreatic beta cells
Renal cortical collecting duct
Renal distal convoluted tubule
Renal proximal convoluted tubule
A 64-year-old man has just been started on dapagliflozin by his GP for better control of his established type 2 diabetes mellitus after a high HbA1c result.
Where is the primary site of the action of this drug?
Pancreatic acinar cells
Pancreatic beta cells
Renal cortical collecting duct
Renal distal convoluted tubule
Renal proximal convoluted tubule
Dapagliflozin is a reversible sodium-glucose co-transporter 2 (SGLT-2) inhibitor that acts on the renal proximal convoluted tubule to reduce glucose reabsorption
A 71-year-old woman, with a past medical history of diabetes, hypertension and stable angina attends an appointment with her family physician for a regular follow-up. She is currently taking insulin glargine, daily aspirin and metoprolol. She reports that she is doing well and is compliant with her medications. She currently lives alone and is able to carry out her activities of daily living. She is a retired primary school teacher and her husband passed away from a stroke 6 years ago. She reports that she is doing well and is compliant with her medications. On examination, she has a heart rate of 61 beats per minute, a respiratory rate of 13 breaths per minute and a blood pressure of 123/79 mmHg. Which of the following is a direct action of this lady’s metoprolol medication?
Dilation of arterioles
Decrease in angiotensin I secretion
Decrease in angiotensin II secretion
Decrease in renin secretion
Increase in urine excretion
A 71-year-old woman, with a past medical history of diabetes, hypertension and stable angina attends an appointment with her family physician for a regular follow-up. She is currently taking insulin glargine, daily aspirin and metoprolol. She reports that she is doing well and is compliant with her medications. She currently lives alone and is able to carry out her activities of daily living. She is a retired primary school teacher and her husband passed away from a stroke 6 years ago. She reports that she is doing well and is compliant with her medications. On examination, she has a heart rate of 61 beats per minute, a respiratory rate of 13 breaths per minute and a blood pressure of 123/79 mmHg. Which of the following is a direct action of this lady’s metoprolol medication?
Dilation of arterioles
Decrease in angiotensin I secretion
Decrease in angiotensin II secretion
Decrease in renin secretion
Increase in urine excretion
A 21-year-old man is referred by his family physician to a cardiologist after his blood tests have repeatedly revealed abnormally high cholesterol levels. After assessing the patient, the cardiologist notices that there are some yellowish skin nodules around the patient’s Achilles tendon and that the outer region of the patient’s iris appears white. The cardiologist explains to the patient that he has inherited the condition from his biological parents and that the patient’s offspring have a 1 in 2 chances of getting the condition as well even if his female partner does not have it. The patient confirms that he had one paternal uncle who passed away at the age of 31 due to a heart-related condition. The patient is explained that he would need treatment to control his cholesterol levels and to prevent the risk of any future cardiovascular events. Which of the following is the most likely pathology underlying this patient’s condition?
Defective apolipoprotein E
Overproduction of very low-density lipoprotein
Deficiency of lipoprotein lipase
Defective low-density lipoprotein receptors
Deficiency of apolipoprotein C-II
A 21-year-old man is referred by his family physician to a cardiologist after his blood tests have repeatedly revealed abnormally high cholesterol levels. After assessing the patient, the cardiologist notices that there are some yellowish skin nodules around the patient’s Achilles tendon and that the outer region of the patient’s iris appears white. The cardiologist explains to the patient that he has inherited the condition from his biological parents and that the patient’s offspring have a 1 in 2 chances of getting the condition as well even if his female partner does not have it. The patient confirms that he had one paternal uncle who passed away at the age of 31 due to a heart-related condition. The patient is explained that he would need treatment to control his cholesterol levels and to prevent the risk of any future cardiovascular events. Which of the following is the most likely pathology underlying this patient’s condition?
Defective apolipoprotein E
Overproduction of very low-density lipoprotein
Deficiency of lipoprotein lipase
Defective low-density lipoprotein receptors
Deficiency of apolipoprotein C-II
A 63-year-old man is reviewed in the endocrinology clinic. He has been taking metformin and gliclazide for his type II diabetes. His HbA1c is 68 mmol/mol at the appointment today. You decide to start him on empagliflozin as a third agent to try and improve his glycaemic control.
Where does this medication act to achieve its mechanism of action?
Cellular membranes throughout the body
Distal convoluted tubule of the nephron
Loop of Henle
Pancreatic beta cells
Proximal convoluted tubule of the nephron
A 63-year-old man is reviewed in the endocrinology clinic. He has been taking metformin and gliclazide for his type II diabetes. His HbA1c is 68 mmol/mol at the appointment today. You decide to start him on empagliflozin as a third agent to try and improve his glycaemic control.
Where does this medication act to achieve its mechanism of action?
Cellular membranes throughout the body
Distal convoluted tubule of the nephron
Loop of Henle
Pancreatic beta cells
Proximal convoluted tubule of the nephron
The patient here has been started on empagliflozin, which acts as an inhibitor of the SGLT-2 receptor
SGLT2 inhibitors are also called [] or [],
SGLT2 inhibitors, also called gliflozins or flozins
A 15-year-old girl presents to the emergency department with an acute exacerbation of asthma. As part of her treatment, she is given salbutamol and ipratropium bromide nebulisers with IV steroids. Salbutamol is a β2 receptor agonist. What metabolic effect can this drug have that you might need to monitor?
Hyperkalaemia
Hypernatraemia
Hypocalcaemia
Hyponatraemia
Hypokalaemia
A 15-year-old girl presents to the emergency department with an acute exacerbation of asthma. As part of her treatment, she is given salbutamol and ipratropium bromide nebulisers with IV steroids. Salbutamol is a β2 receptor agonist. What metabolic effect can this drug have that you might need to monitor?
Hyperkalaemia
Hypernatraemia
Hypocalcaemia
Hyponatraemia
Hypokalaemia
Which diuretic causes hypercalcemia
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which diuretic causes hypercalcemia
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which diuretic causes hypocalcemia
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which diuretic causes hypocalcemia
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which diuretics causes hyperkalemia [2]
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which diuretics causes hyperkalemia [2]
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which drug class does Tiamterene fall into?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which drug class does Tiamterene fall into?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which of the following causes hyperglycaemia or / and hypercholesterolaemia?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which of the following causes hyperglycaemia or / and hypercholesterolaemia?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which of the following can cause cardiac tacchyarthmias / seizures due to hypocalcemia?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which of the following can cause cardiac tacchyarthmias?
Thiazide Diuretics
Loop Diuretics - due to hypocalcaemia
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which of the following can cause cardiac tacchyarthmias / seizures due to hypokalaemia?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which of the following can cause cardiac tacchyarthmias / seizures due to hypokalaemia?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Which thyroid medication is the synthetic form of T4?
Levothyroxine
Carbimazole
Propylthiouracil
Radioactive iodine
Which thyroid medication is the synthetic form of T4?
Levothyroxine
Carbimazole
Propylthiouracil
Radioactive iodine
Which thyroid medication inhibits thyroid peroxidase (TPO) and thus inhibits T3/4 production
Levothyroxine
Carbimazole
Propylthiouracil
Radioactive iodine
Which thyroid medication inhibits thyroid peroxidase (TPO) and thus inhibits T3/4 production
Levothyroxine
Carbimazole
Propylthiouracil
Radioactive iodine
Explain the mechanism of action of Propylthiouracil [2]
Blocks thyroxine deiodinase I in the liver
Blocks thyroxine deiodinase II in the periphery to stop T4 to T3 conversion
What is the name of synthetic cortisol? [1]
What is the name of synthetic aldosterone? [1]
Synthetic cortisol: Hydrocortisone
Synthetic Aldosterone: Fludrocortisone
Explain the mechanism of botox to treat an overactive bladder [1]
Prevent ACh release at synaptic terminal
What effect does mirabegron have on destrusor muscle? [1]
Cause detrusor muscle relaxation.
Name two Calcineurin Inhibitors (Immunosuppresants) [2]
Tacrolimus
Ciclosporin
Which of the following treatment for diabetes causes increased GLUT 4 expression and increased insulin sensitivity
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes causes increased GLUT 4 expression and increased insulin sensitivity
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes is an PPAR gamma agonist
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Thiazolidinediones
PPAR gamma in adipocytes, stimulation = increased uptake of circulating FA
Which of the following treatment for diabetes increases peripheral glucose uptake, increases insulin sensitivity and inhibits gluconeogenesis
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes increases peripheral glucose uptake, increases insulin sensitivity and inhibits gluconeogenesis
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes increases glucose uptake in adipose tissue, increased adipogenesis and decrease circulating lipids
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes increases glucose uptake in adipose tissue, increased adipogenesis and decrease circulating lipids
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
SGLT2 inhibitors work in which part of the kidneys?
Glomerulus
Proximal tubule
Distal tubule
Collection ducts
SGLT2 inhibitors work in which part of the kidneys?
Glomerulus
Proximal tubule
Distal tubule
Collection ducts
