non insulin agents Flashcards
what is a type of biguanides
metformin
what is the moa of metformin
Reduction in insulin resistance via modification of glucose metabolic pathways
what is the indication for metformin
metformin
side effects of metformin
gastrointestinal symptoms
severe symptoms
gastrointestinal symptoms
what are the clinical characteristics of metformin
Weight loss (often desired) or weight stabilization
No risk of hypoglycemia
what are contraindications of metformin
Chronic kidney disease
Metformin must be paused before administration of iodinated contrast medium and major surgery.
what are types of Sodium-glucose cotransporter 2 (SGLT-2) inhibitors
Canagliflozin
Dapagliflozin
Empagliflozin
what is moa of SLGT-2
reversible inhibition of SGLT-2 in the proximal tubule of the kidney → ↓ glucose reabsorption in the proximal convoluted tubule of the kidney → glycosuria and polyuria
what are side effects of slgt-2 inhibitors
Urinary tract infections, genital infections (vulvovaginal candidiasis, balanitis) due to glucosuria
Dehydration → weight loss, orthostatic hypotension
what are contraindications of SLGT-2 inhibitors
Recurrent urinary tract infections
Chronic kidney disease
what is a type of alpha glucosidase inhibitors
nhibit alpha-glucosidase (a brush border enzyme expressed by intestinal epithelial cells) → delayed and ↓ intestinal glucose absorption and ↓ carbohydrate breakdown, resulting in ↓ hyperglycemia after food ingestion
effective in controlling postprandial blood glucose levels
does acarbose cause hypoglycaemia
no
what are the side effects of acarbose
gastrointestinal symptoms (flatulence, bloating, abdominal discomfort, diarrhea)
what are the contraindications of acarbose
Severe renal failure
IBD
what are types of Thiazolidinediones
Pioglitazone
Rosiglitazone
what is the moa of thiazolidineodiones
Reduce insulin resistance through the stimulation of peroxisome proliferator-activated receptors (PPARs)
Increase transcription of adipokines
what are the side effects of thiazolidineodiones
Edema
Cardiac failure
Weight gain
↑ Risk of bone fractures (osteoporosis)
↑ LDL
what are the contraindications of thiazolidinediones
Congestive heart failure
Liver failure
what are the drug interaction of thiazolidinediones
CYP2C8 inhibitors (e.g., gemfibrozil): ↑ concentration of glitazones [5]
what are Amylin analogs
Pramlintide
what is the moa of Amylin analogs
Decrease glucagon release
Slow gastric emptying
Increase feeling of satiety
what are adrs of amalin analogs
Risk of hypoglycemia
Nausea
what drugs should not be taken with amalin
Delayed effect of concomitantly administered drugs due slowed gastric emptying (e.g, ampicillin, acetaminophen)
My Pancreas Needs Fitting Treatment!” - Metformin, -gliPs, -gliNs, -gliFs, -gliTs
what should you avoid in patients with heart failure
saxagliptin
which patient group is better for SLGT-2 inhibitors
Beneficial for patients who need to lose or maintain their weight
which patient should you avoid Thiazolidinedione in
Avoid in patients with congestive heart failure
which drug increases risk of hypoglyceamia
Sulfonylureas
