OHGA Flashcards
1
Q
E.g of SGLT-2 inhibitors
A
- Canagliflozin
- Dapagliglozin
- Empagliflozin
2
Q
MOA of SGLT-2 INhibitor:
A
- Works om the S1 segment of the proximal tubules, and Block the reabsorption of glucose in the kidney, increase glucose excretion and lower blood glucose
- Allowing increased insulin sensitivity
- ( increased glucose uptake into the muscle cells);
- (decrease gluconeogenesis
- Improve first phase insulin release from the beta cells
3
Q
S.e. of SGLT-2 Inhibitor?
A
- Incidence of genital infection
- UTI
- Euglycemic DKA
- dehydration
Advice:
1. Adequate hydration
2. Good perineal hygiene
4
Q
Acarbose is:
A
- Alpha glucosidase inhibitors
- Acarbose has 1000x stronger affinity for the active binding site of glucosidase enzyme, as compared with dietary carbohydrates. It delays the digestion of specific polysacharides and decrease the absorptiom of sugars
- To take acarbose just prior to taking a meal
- Acarbose blunts the rise in post prandial blood sugar level by 30 to 50%, so that the insulin secretary response is also less
- ADE:
- Elevated liver enzyme, jaundice (stop acarbose)
- GI side effects
5
Q
DPP-4 inhibitors , e.g.
A
- Sitagliptin
- linagliptin (do not need to do renal adjustment, the others need)
- saxagliptin
- Alogliptin
- vildagliptin
6
Q
What precaution should be observed when giving DPP-4 inhibitors?
A
- Pancreatitis (abdominal pain, fever)
- Skin reaction
- Joint pain
7
Q
Semaglutide, exenatide, liraglutide, albiglutide and gulaglutide, belong to which drug group? MOA?
A
- GLT-1 Receptor agonist
- MOA:
- after a meal ingestion, GIT secrete active GLT-1 and GIP
- GLT-1 stimulate beta cell in pancreas to increase insulin release
- GLT-1 also works on alpha cells in pancreas to suppress glucagon release
(DPP-4 break down GLT-1 into inactive form. DPP-4 Inhibitor blocks the breakdown of GLT-1. DPP-4 inhibitor and GLP-1 Receptor agnonist work on the same pathway, thus do not combined use)
