Non-insulin hypoglycemic agents

Question 1

What type of drug are Tolazamide, Chlorpropamide, Acetohexamide?

Answer 1

first generation Sulfonylureas

Question 2

What are downsides to Acetohexamide, Chlorpropamide, and Tolazamide?

Answer 2

cause hypoglycemia (long half life)
possibly toxic to heart

Question 3

What are Glipizide, Glyburide, and Glimeperide?

Answer 3

Second gen sulfonylureas

-shorter half lives, cause less prolonged hypoglycemia

Question 4

What are downsides to Glimeperide, glyburide, glipizide?

Answer 4

hypoglycemia, weight gain, cardiac toxicity

hasten demise of beta cell’s insulin producing ability

Question 5

What are short acting sulfonyl ureas?

Answer 5

Meglitinides
Repaglinide
Nateglinide

Question 6

What is Metformin?

Answer 6

A Biguanide
-reduces liver production of glucose (through AMPK)
-blocks fatty acid synthesis
increases insulin sensitivity

Question 7

What is the action of Thiazolidinediones?

Answer 7

PPAR (Peroxisome proliferator activated receptor agonists)

-increase glucose uptake (increased GLUT1, GLUT4)

Question 8

What is decreased when taking TZDs?

Answer 8

PAI-1, C-reactive protein, inflammatory markers from fat

Question 9

What class of drug is Pioglitazone and Rosiglitazone?

Answer 9

Thiazolidinediones (TZDs)

Question 10

What are side fx of TZDs?

Answer 10

weight gain, edema, CHF,

boneloss, bladder tumors (Pioglitazone)

Question 11

What class of drug is Acarbose?

Answer 11

Alpha-Glucosidase Inhibitors

Question 12

What do Acarbose/Alpha-Glucosidase Inhibitors do? side fx?

Answer 12

inhibits Alpha-glucosidase (enzyme in intestine needed to break dwon complex starches to glucose)

side fx: flatulence

Question 13

What are 3 main fx of GLP-1 and GIP?

Answer 13

produced by GI mucosal cells

1. Stimulates Insulin Secretion
2. Decreases gastric absorption of Glucose
3. Decrease glucagon release by pancreatic alpha cells

Question 14

What is so great about Incretins

Answer 14

insulin levels are only increased in presence of food = no hypoglycemia if you dont eat

Question 15

What are DPP-4 how can they be applied pharmacologically?

Answer 15

degrades Incretins

Inhibitors of DPP-4 can be used as meds

Question 16

What drug class are Sitagliptin, Saxagliptin, Linagliptin

Answer 16

DPP-4 inhibitors

Question 17

What is the mechanism of Canagliflozin, Dapagliflozin, and Empagliflozin?

Answer 17

Inhibits SGLT-2 (sodium-glucose linked transporter in kidney)

• glycosuria and volum recution
• REDUCES CARDIO MORTALITY

Question 18

What are side fx of SGLT-2 inhibitors?

Answer 18

UTI
Candidal vulvovaginitis and balanitis
Postural hypotension
Lose effectiveness in patient with renal insufficiency