Pharm - T2D Flashcards
What is the primary focus of the pharmacology of diabetes presentation?
the pharmacological treatment of type 2 diabetes
What are the key elements of type 2 diabetes?
insulin resistance leading to insulin deficiency and hyperglycemia
what are the main goals of therapy for T2D
control symptoms, maintain glycemic control, prevent complications, and manage associated risk factors
what is the first line therapy for new, uncomplicated T2D?
metformin (Biguanides)
How does metformin work?
it decreases hepatic glucose production and does not cause weight gain
what are common adverse effects of metformin?
- nausea
- diarrhea
- abdominal discomfort
- risk of lactic acidosis
what is the mechanism of action for Alpha-glucosidase inhibitors like acarbose?
they inhibit intestinal alpha-glucosidases, delaying the digestion of starches and disaccharides
what are the adverse effects of acarbose?
flatulence, diarrhea, abdominal pain, and cramps
what do dipeptidyl peptidase-4 inhibitors do? (e.g. sitagliptin)
they inhibit the enzyme that degrades GLP-1, acting as incretin mimetics
what are the common adverse effects of sitagliptin?
nasopharyngitis and rare cases of pancreatitis
What is the role of GLP-1 receptor agonists like semaglutide?
they increase insulin secretion, suppress glucagon, and slow gastric emptying
What are the adverse effects associated with GLP-1 Receptor Agonists?
GI issues, nausea, and injection site reactions.
How do Sulfonylureas like Glyburide function?
They stimulate insulin release from the pancreas.
What are the risks associated with Sulfonylureas?
Weight gain and increased risk of hypoglycemia.
What is the mechanism of action for Sodium-Glucose Cotransporter 2 Inhibitors (e.g., Canagliflozin)?
They prevent glucose reabsorption in the kidneys, leading to increased glucose excretion.
What are the adverse effects of Canagliflozin?
Increased risk of genitourinary infections and hypotension.
What is the mechanism of action for Thiazolidinediones like Pioglitazone?
They act as agonists at PPARG receptors, enhancing glucose uptake.
What are the adverse effects of Pioglitazone?
Weight gain, increased risk of heart failure, and fractures.
Name some drugs that can cause dysglycemia.
Beta-blockers, corticosteroids, statins, thiazide diuretics, and second-generation antipsychotics.
Which medication is generally considered first-line therapy for most patients with type 2 diabetes?
Metformin.
What is the role of nonpharmacologic interventions in managing T2D?
Nonpharmacologic interventions, such as diet and exercise, are vital for managing T2D and should be emphasized alongside pharmacologic treatments.
What is the mechanism of action for Meglitinides like Repaglinide?
Meglitinides stimulate insulin release from the pancreas but have a shorter duration of action compared to sulfonylureas.
How do Sodium-Glucose Cotransporter 2 Inhibitors affect cardiovascular health?
They have been shown to reduce the risk of cardiovascular mortality and major adverse cardiovascular events.
What is a significant risk associated with Thiazolidinediones like Pioglitazone?
Increased incidence of heart failure due to fluid retention and edema.
What is the importance of monitoring kidney function when using Canagliflozin?
The effectiveness of Canagliflozin decreases as kidney function declines, making monitoring essential.
What are the common adverse effects of GLP-1 Receptor Agonists upon initiation?
Gastrointestinal adverse effects, particularly nausea, are common when starting GLP-1 Receptor Agonists.
Why is it important to treat hypoglycemic patients taking Acarbose with glucose rather than sucrose?
Acarbose inhibits the digestion of sucrose, making glucose the appropriate treatment for hypoglycemia.
What is the significance of the HbA1c reduction associated with Metformin?
Metformin typically lowers HbA1c by 1 – 1.5%, making it effective for glycemic control.
What are the contraindications for using Metformin?
Metformin is contraindicated in patients with existing hepatic or renal disease due to the risk of lactic acidosis.
What is the effect of Sulfonylureas on weight?
Sulfonylureas, particularly Glyburide, are associated with weight gain.
