Pharm - T2D

Question 1

What is the primary focus of the pharmacology of diabetes presentation?

Answer 1

the pharmacological treatment of type 2 diabetes

Question 2

What are the key elements of type 2 diabetes?

Answer 2

insulin resistance leading to insulin deficiency and hyperglycemia

Question 3

what are the main goals of therapy for T2D

Answer 3

control symptoms, maintain glycemic control, prevent complications, and manage associated risk factors

Question 4

what is the first line therapy for new, uncomplicated T2D?

Answer 4

metformin (Biguanides)

Question 5

How does metformin work?

Answer 5

it decreases hepatic glucose production and does not cause weight gain

Question 6

what are common adverse effects of metformin?

Answer 6

• nausea
• diarrhea
• abdominal discomfort
• risk of lactic acidosis

Question 7

what is the mechanism of action for Alpha-glucosidase inhibitors like acarbose?

Answer 7

they inhibit intestinal alpha-glucosidases, delaying the digestion of starches and disaccharides

Question 8

what are the adverse effects of acarbose?

Answer 8

flatulence, diarrhea, abdominal pain, and cramps

Question 9

what do dipeptidyl peptidase-4 inhibitors do? (e.g. sitagliptin)

Answer 9

they inhibit the enzyme that degrades GLP-1, acting as incretin mimetics

Question 10

what are the common adverse effects of sitagliptin?

Answer 10

nasopharyngitis and rare cases of pancreatitis

Question 11

What is the role of GLP-1 receptor agonists like semaglutide?

Answer 11

they increase insulin secretion, suppress glucagon, and slow gastric emptying

Question 12

What are the adverse effects associated with GLP-1 Receptor Agonists?

Answer 12

GI issues, nausea, and injection site reactions.

Question 13

How do Sulfonylureas like Glyburide function?

Answer 13

They stimulate insulin release from the pancreas.

Question 14

What are the risks associated with Sulfonylureas?

Answer 14

Weight gain and increased risk of hypoglycemia.

Question 15

What is the mechanism of action for Sodium-Glucose Cotransporter 2 Inhibitors (e.g., Canagliflozin)?

Answer 15

They prevent glucose reabsorption in the kidneys, leading to increased glucose excretion.

Question 16

What are the adverse effects of Canagliflozin?

Answer 16

Increased risk of genitourinary infections and hypotension.

Question 17

What is the mechanism of action for Thiazolidinediones like Pioglitazone?

Answer 17

They act as agonists at PPARG receptors, enhancing glucose uptake.

Question 18

What are the adverse effects of Pioglitazone?

Answer 18

Weight gain, increased risk of heart failure, and fractures.

Question 19

Name some drugs that can cause dysglycemia.

Answer 19

Beta-blockers, corticosteroids, statins, thiazide diuretics, and second-generation antipsychotics.

Question 20

Which medication is generally considered first-line therapy for most patients with type 2 diabetes?

Answer 20

Metformin.

Question 21

What is the role of nonpharmacologic interventions in managing T2D?

Answer 21

Nonpharmacologic interventions, such as diet and exercise, are vital for managing T2D and should be emphasized alongside pharmacologic treatments.

Question 22

What is the mechanism of action for Meglitinides like Repaglinide?

Answer 22

Meglitinides stimulate insulin release from the pancreas but have a shorter duration of action compared to sulfonylureas.

Question 23

How do Sodium-Glucose Cotransporter 2 Inhibitors affect cardiovascular health?

Answer 23

They have been shown to reduce the risk of cardiovascular mortality and major adverse cardiovascular events.

Question 24

What is a significant risk associated with Thiazolidinediones like Pioglitazone?

Answer 24

Increased incidence of heart failure due to fluid retention and edema.

Question 25

What is the importance of monitoring kidney function when using Canagliflozin?

Answer 25

The effectiveness of Canagliflozin decreases as kidney function declines, making monitoring essential.

Question 26

What are the common adverse effects of GLP-1 Receptor Agonists upon initiation?

Answer 26

Gastrointestinal adverse effects, particularly nausea, are common when starting GLP-1 Receptor Agonists.

Question 27

Why is it important to treat hypoglycemic patients taking Acarbose with glucose rather than sucrose?

Answer 27

Acarbose inhibits the digestion of sucrose, making glucose the appropriate treatment for hypoglycemia.

Question 28

What is the significance of the HbA1c reduction associated with Metformin?

Answer 28

Metformin typically lowers HbA1c by 1 – 1.5%, making it effective for glycemic control.

Question 29

What are the contraindications for using Metformin?

Answer 29

Metformin is contraindicated in patients with existing hepatic or renal disease due to the risk of lactic acidosis.

Question 30

What is the effect of Sulfonylureas on weight?

Answer 30

Sulfonylureas, particularly Glyburide, are associated with weight gain.