Misc. Diabetic Drugs

Question 1

What is a Biguanide?

Answer 1

Metformin

Question 2

What is a Biguanide?

Answer 2

Metformin

Question 3

What is the 1st line oral treatment for Type 2 DM?

Answer 3

Metformin

Question 4

All of the cards in this deck ____ be used with Type 1 DM

Answer 4

CANNOT

Question 5

All of the cards in this deck do NOT cause what if they are used alone?

Answer 5

NO hypoglycemia if used alone

Question 6

What is the MOA for Metformin?

Answer 6

(+) AMP activated protein kinase

Question 7

Half life, metabolism and excretion attributes for Metformin?

Answer 7

Half life = < 3 hours
NOT metabolized
Excreted unchanged in the kidney

Question 8

What are 2 adverse effects of Metformin?

Answer 8

GI distress

Lactic acidosis especially in settings of hypoxia/renal failure

Question 9

What are 2 contraindications for taking Metformin?

Answer 9

Conditions predisposing to hypoxia = lactic acidosis

Renal failure = lactic acidosis

Question 10

What drug (+) AMP activated protein kinase?

Answer 10

Metformin

Question 11

What are the Thiazolidinediones?

Answer 11

• AZONEs

Question 12

What are the Thiazolidinediones?

Answer 12

• AZONES

Question 13

What is the MOA for — azones?

Answer 13

(+) PPAR gamma nuclear receptor

Question 14

Once – azones (+) PPAR gamma nuclear receptor, that changes gene expression and increases?

Answer 14

Increased GLUT4 and IRS/P13K

Question 15

How long does it take to see the effects of Thiazolidinediones and why?

Answer 15

1-3 months because they are changing gene expression

–> will still see effects even after they are stopped

Question 16

– azones can delay the progression of?

Answer 16

Prediabetes –> Diabetes

Question 17

What are 4 adverse effects of – azones?

Answer 17

Weight gain
Edema and worsened CHF
Osteoporosis/fractures

Question 18

What are 4 adverse effects of Thiazolidinediones?

Answer 18

Weight gain
Edema and worsened CHF
Osteoporosis/fractures

Question 19

What will lower the half life of — azones?

Answer 19

CYP (+)s

Question 20

How does edema occur with — azones?

Answer 20

Increased vascular permeability

EnaC expression to reabsorb water and sodium

Question 21

How does Osteoporosis/fractures occur with — azones?

Answer 21

(-) MSCs from becoming osteoblasts

–> instead become fat cells

Question 22

What are the SGLT-2 Inhibitors?

Answer 22

• GLIFLOZINS

Question 23

What are the SGLT-2 Inhibitors?

Answer 23

• GLIFLOZINS

Question 24

MOA for the SGLT-2 Inhibitors?

Answer 24

(-) SGLT2 which causes glucose to only be partially reabsorbed in the kidney and the rest is excreted in the urine in order to lower the amount

Question 25

Normally, glucose is ____ reabsorbed via ____ in the proximal tubule

Answer 25

Completely reabsorbed via SGLT-2

Question 26

What are 3 adverse effects that can occur with --- gliflozins?

Answer 26

Hypovolemia Hypotension UTIs

Question 27

What are the 2 Alpha-Glycosidase Inhibitors?

Answer 27

Acarbose | Miglitol

Question 28

What are the 2 Alpha-Glycosidase Inhibitors?

Answer 28

Acarbose | Miglitol

Question 29

What occurs when Alpha-Glycosidase is (-)?

Answer 29

DECREASED absorption of starch and disaccharides in the intestines => LOWER postprandial hyperglycemia

Question 30

If you want to lower the postprandial hyperglycemia and create an insulin sparing effect, what should you do?

Answer 30

(-) Alpha - Glycosidase which decreases the absorption of starch and disaccharides in the intestines

Question 31

What are some side effects of Alpha-Glycosidase (-)s?

Answer 31

Malabsorption Flatulence Bloating

Question 32

Acarbose and Miglitol are?

Answer 32

Alpha-Glycosidase Inhibitors

Question 33

--- gliflozins

Answer 33

SGLT-2 Inhibitors

Question 34

--- azones

Answer 34

Thiazolidinediones

Question 35

Metformin

Answer 35

Biguanide

Question 36

What drugs can (+) PPAR gamma nuclear receptor to change gene expression?

Answer 36

-- azones

Question 37

What drugs (-) SGLT-2 to allow some glucose to be excreted into the urine?

Answer 37

-- gliflozins

Question 38

What drugs can (-) absorption of starch and disaccharides to lower postprandial hyperglycemia?

Answer 38

Acarbose | Miglitol