OHGA (Pharm) Flashcards
what is the difference between T1DM & T2DM
T1DM
- body does not produce insulin
T2DM
- body does not respond well to insulin
what is 1 drug from the p/c of thiazolidinediones (TZD)
“glitazone” eg. rosiglitazone
list one drug that belong to the p/c of sulfonylurea
tolbutamide “amide”
what is the pharmacokinetic of metformin
not bound to plasma protein
not metabolised & is excreted out by the kidney in its active compound
list 1 drug example from the p/c of SGLT2 inhibitors
“gliflozin” eg. canagliflozin
what is the indication of alpha-glucosidase inhibitor
T2DM
- mono therapy
- adjunct therapy w sulfonylurea/biguanide
what is the 2 contraindications of thiazolidinediones (TZD)
- liver disease
- HF
what is the MOA of GLP-1 receptor antagonist (insulin sparring agent)
- increase cellular glucose uptake by acting on B cells in pancreas to increase insulin release = decrease BSL
- decrease hepatic glucose output by acting on A cells in pancreas to suppressed glucagon release, which suppressed glucose production in liver = decrease BSL
what is the MOA of acarbose
slow down digestion & absorption of carbs by preventing the conversion of polysaccharides to monosaccharides
what is the MOA of sulfonylurea
it binds to kATP to prevent k+ from flowing out, this increase insulin release from pancreatic B cells & decrease serum glucagon concentration
which p/c is a insulin sensitiser
biguanide
list 3 a/e of acarbose
- elevated liver enzymes
- flatulence
- diarrhea
what is the indication for sulfonylurea
T2DM
list 6 symptoms of hyperglycaemia
- polyuria
- polydipsia
- polyphagia
- weight loss
- tired
- poor vision
list 3 a/e of thiazolidinediones (TZD)
- hypoglycaemia (increase risk if use w sulfonylurea/insulin)
- hepatotoxicity
- fluid retention -> weight gain
list 5 adverse effect of tolbutamide
- hypoglycaemia
- GI disturbance
- weight gain
- allergic skin rash > bone marrow damage
- increase risk of CV death
list one drug from the p/c of biguanide
metformin
list 1 drug from the p/c of alpha-glucosidase inhibitor
acarbose
what is the MOA of DPP-4 inhibitors
inhibit DPP-4 to prevent the inactivation of GLP-1
what is the 2 a/e of metformin
- GI disturbance e.g nausea/vomiting, diarrhoea
- reduce vit b12 absorption
what is the MOA of metformin
- increase insulin sensitivity by increase insulin receptor density
- promote glucose breakdown in tissue, resulting in reduce glucose synthesis in liver & renal
- reduce glucose absorption in GI tract
- reduce plasma glucagon level
what is the 2 indication for biguanide
- T2DM
- insulin resistance syndrome
list 1 drug example from the p/c of GLP-1 receptor antagonist (insulin sparring agent)
“glutide” eg. liraglutide
what is the indication of thiazolidinediones (TZD)
T2DM
what is the pharmacokinetic of alpha-glucosidase inhibitor
adms. medication prior to meal
acarbose blunt the rise of post prandial (post-meal) BSL, resulting in lesser insulin secretory response
what is the 2 indication of SGLT2 inhibitors
- T2DM
- diabetic pt w CV disease eg. CHF
what is hyperglycaemia (range)
- fasting glucose >7 (n = <6)
- plasma glucose >11.1 2hrs after meal (n = 7.8)
list 4 contraindiaction of biguanide
- renal disease
- hepatic disease
- condition that predispose to tissue anoxia eg. sleep apnea
- alcohol
what is the MOA of SGLT2 inhibitors
inhibit the reabsorption of glucose in kidney (renal tubule), this increase glucose excretion & lower blood glucose level
what is the MOA of thiazolidinediones (TZD)
it binds to PPAR-γ-RXR complex to increase insulin sensitivity
list 1 drug example from the p/c of DPP-4 inhibitors
“gliptin” eg. sitagliptin
