NON-INSULIN ANTIDIABETIC AGENTS

Question 1

• most widely used oral agent
• first-choice drug in most patients with type 2 DM

Answer 1

1- Class: Biguanide
Drug example: Metformin

Question 2

• caution / contraindicated in patients with kidney disease

Answer 2

1- Class: Biguanide
Drug example: Metformin

Question 3

epidemiologic studies suggest that ———- use may reduce the risk of some cancers

Answer 3

metformin

Question 4

ADRs of Metformin

Answer 4

GI side effects
lactic acidosis (rare but often fatal)
B12 deficiency

Question 5

lowers triglycerides and increases high-density lipoprotein (HDL) cholesterol

Answer 5

2- Class: Thiazolidinediones
Drug example: Pioglitazone

Question 6

dangerous in patients with liver disease

Answer 6

Pioglitazone

Question 7

ADRs
* can increase risk of cardiovascular disease, e.g., heart failure

Answer 7

Pioglitazone

Question 8

cautions
* liver or kidney disease

Answer 8

Class: Sulfonylureas
Drug example: Gliclazide

Question 9

There is no sulfur in its structure
* may be used in patients with sulfonylurea allergy

Answer 9

2- Class: Meglitinide analogs
Drug example: Repaglinide

Question 10

metabolized in liver and excreted in feces (~90%)
* can be used in patients with renal impairment and in the elderly

Answer 10

2- Class: Meglitinide analogs
Drug example: Repaglinide

Question 11

ADRs of Dapagliflozin

Answer 11

• increased risk of genital and urinary tract infections
• diuretic effect
• minimal hypoglycemia risk
• no direct effects on insulin

Question 12

——- rapidly degraded by dipeptidyl peptidase 4 (DPP-4)

Answer 12

GLP-1

Question 13

—— is GLP1- agonist, is also prescribed for weight management

Answer 13

Semaglutide

Question 14

ADRs
* nausea
* possible thyroid tumors, pancreatitis

Answer 14

Exenatide

Question 15

GLP-1 agonist has a lower risk for hypoglycemia than SU. Why?

Answer 15

because GLP-1 is glucose-dependent while SU is glucose independent

Question 16

• Side effects, concerns
• predisposition to nasopharyngitis or upper respiratory tract infection

Answer 16

Sitagliptin

Question 17

• Class: Biguanide
  Drug example:

Answer 17

Metformin

Question 18

• Class: Thiazolidinediones
  Drug example:

Answer 18

Pioglitazone

Question 19

Class: Sulfonylureas
Drug example:

Answer 19

Gliclazide

Question 20

• Class: Meglitinide analogs
  Drug example:

Answer 20

Repaglinide

Question 21

Class: α-Glucosidase inhibitors
Drug example:

Answer 21

Acarbose

Question 22

Class: Sodium-glucose transporter 2 (SGLT2) inhibitors
Drug example:

Answer 22

Dapagliflozin

Question 23

• Class: Glucagon-like peptide-1 (GLP-1) receptor agonists
  Drug example:

Answer 23

Exenatide

Question 24

Class: Dipeptidyl peptidase 4 (DPP-4) inhibitors
Drug example:

Answer 24

Sitagliptin