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Endo - Pharmacology > OHAs > Flashcards

OHAs Flashcards

1
Q

Drug classes

A
  • Meglitinides
  • Alpha glucosidase inhibitors
  • Sulfonylureas
  • Thiazolidinediones/Glitazones
  • Biguanides
  • DPP-4 inhibitors
  • GLP-1 analogs
  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors
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2
Q

Effect on weight

  • Biguanides
  • Sulfonylureas
  • Glitazone
  • GLP-1 analogs
  • DPP-4 inhibitors
  • Meglitinides
A
  • Biguanides
    • Loss
  • Sulfonylureas
    • Gain
  • Glitazone
    • Gain
  • GLP-1 analogs
    • Loss
  • DPP-4 inhibitors
    • Neutral
  • Meglitinides
    • Gain
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3
Q

First-line therapy in type 2 DM

A

Metformin

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4
Q

Which diabetes drugs can cause a disulfiram-like reaction?

A

First-generation sulfonylureas

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5
Q

To which class of diabetes drugs do pioglitazone and rosiglitazone belong?

A

Thiazolidinedione/Glitazones

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6
Q

Examples of 1st and 2nd generation sulfonylureas

A
  • 1st generation
    • Chlorpropamide
    • Tolbutamide
  • 2nd generation
    • Glimepiride
    • Glipizide
    • Glyburide
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7
Q

Will sulfonylureas work in type 1 diabetes mellitus?

A

No; these drugs require islet cell function and the ability to secrete endogenous insulin (defective in type 1 diabetes)

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8
Q

Describe the mechanism of action of sulfonylureas

A

Close the K+ channel on the β-cell membrane

↓

Cell depolarization

↓

Insulin release by increased calcium influx

Memory aid:

  • _S_ulfonyurea
  • _S_ecretion of insulin by beta-cells
    • Require some islet function, so useless in type 1 DM
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9
Q

What is an adverse effect of second-generation sulfonylureas?

A

Hypoglycemia

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10
Q

Metformin drug class

A

Biguanides

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11
Q

What is the mechanism of action of metformin?

A

Unknown; may decrease gluconeogenesis, increase glycolysis, thereby decreasing serum glucose levels; overall, it acts as an insulin sensitizer

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12
Q

True or False: Metformin can be used in patients without islet function

A

True

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13
Q

Before prescribing metformin, it is important to assess the function of what organ?

A

Kidney; if metformin cannot be excreted it may build up leading to lactic acidosis

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14
Q

How do glitazones work?

A

They increase target cell response to insulin via the peroxisome proliferator-activated receptor-γ pathway

Memory aid:

  • GLItazone
    • Gains
    • Lifts
    • Increases
      • insulin sensitivity
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15
Q

What are the side effects of glitazones?

A
  • Weight gain
  • Edema
  • Hepatotoxicity
  • Cardiovascular toxicity
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16
Q

Name two alpha-glucosidase inhibitors

A
  • Acarbose
  • Miglitol
17
Q

T/F. Glitazones are safe to use in renal impairment

A

True; But they are hepatotoxic and cardiotoxic

18
Q

Acarbose and miglitol mechanism of action

A
  • Inhibit intestinal brush-border α-glucosidases
    • Delayed carbohydrate hydrolysis and glucose absorption → decreased postprandial hyperglycemia
19
Q

What is the principal toxicity of -glucosidase inhibitors?

A

GI disturbance

20
Q

A peptide hormone that is cosecreted with insulin from the pancreatic β-cell and is thus deficient in diabetic people

A

Amylin

21
Q

What is the mechanism of action of pramlintide?

A

Pramlintide is a mimetic of an endogenous hormone and acts by inhibiting glucagon

22
Q

Actions of amylin

A
  • Inhibits glucagon secretion
  • Delays gastric emptying
  • Acts as a satiety agent

Memory aid:

  • Decreases
    • Glucagon
    • Gastric emptying
    • Gutom
23
Q

What are some toxicities of pramlintide?

A

Hypoglycemia, nausea, diarrhea

24
Q

Give an example of a glucagon-like peptide-1 mimetic drug

A

Exenatide

25
Q

What is the mechanism of action of the GLP-1 mimetics?

A

Increases insulin and decreases glucagon

26
Q

What are toxicities of exenatide use?

A

Nausea, vomiting and possibly pancreatitis

  • Memory aid:*
  • GLPancreatitis
27
Q

Meglitinides examples

A
  • Nateglinide
  • Repaglinide
28
Q

Meglitinides mechanism of action

A

Stimulate postprandial insulin release by binding to K+ channels on β cell membranes (site differs from sulfonylureas)

Memory aid:

  • MS summons insulin release
    • Meglitinides
    • Sulfonylureas
29
Q

Drugs with suffix -gliptin are classified as ____

A

DPP-4 inhibitors

30
Q

DPP-4 inhibitors mechanism of action

A

Inhibit DPP-4 enzyme that deactivates GLP-1, thereby increase glucose-dependent insulin release, decrease glucagon release, decrease gastric emptying, and increase satiety

31
Q

SGLT2 inhibitors works by ____

A

Blocking reabsorption of glucose in PCT

32
Q

SGLT2 inhibitors examples

A
  • Canagliflozin
  • Dapagliflozin
  • Empagliflozin

Endo - Pharmacology (12 decks)

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