Pharmacology

Question 1

Give an example and the effects of a biguanide

Answer 1

Metformin

• decrease hepatic glucose production
• Increase insulin sensitivity

Question 2

What is a contraindication of metformin?

Answer 2

Renal impairment

90% of metformin is excreted by the kidneys. If GFR is low due to renal impairment, metformin will not be excreted efficiently.

Question 3

Give an example of a sulphonylurea

Answer 3

Gliclazide

Question 4

What is the MoA of gliclazide?

Answer 4

Acts on beta cells.

agonises the SUR1 K+ transporter

which stimulates the complimentary influx of Ca2+

and therefore the exocytosis of insulin

agonises SUR1 transporters on beta cells which increases the secretion of insulin

Question 5

What are the 2 classes of incretin drugs?

Answer 5

GLP1 receptor agonists

DPP4 inhibitors

Question 6

Give an example of a GLP1 receptor agonist

Answer 6

Byetta (Exenatide)

Question 7

What is the MoA of GLP1 receptor agonists?

Answer 7

Same as the function of GLP1 -

acts on pancreas to increase the amount of insulin secreted, and decrease the amount of glucagon secreted.

…………tide

Question 8

What is the MoA of DPP4 inhibitors?

Answer 8

Prevents the degredation of endogenous GLP1, therefore levels of GLP1 are highr, which acts to increase the amount of insulin, and decrease the amount of glucagon secreted by the pancreas.

Question 9

Gove an example of a DPP4 inhibitor

Answer 9

sitagliptin

Question 10

Give an example of an SGLT2 inhibitor

Answer 10

Canagliflozin

…………..gliflozin

Question 11

What is the MoA of SLGT2 inhibitors?

Answer 11

blood glucose reabsorbed in the proximal tubule in the kidney by SGLT2 (and 1) transporters.

In T2DM, SLGTs get more efficient, ie they reabsorb more glucose before they are overwhelmed and any is excreted.

SLGT2 inhibitors reduce the efficiency of SLGT2 transporters and therefore more glucose is excreted into the urine, thereby lowering the blood glucose.

Question 12

Other than reducing blood glucose, what positive effects do SGLT2 inhibitors have?

Answer 12

When glucuse is excreted, water follows, therefore water retention is decreased, this lead to:

• weight loss
• reducing blood pressure

Also, excreting glucose reuduces the calories in:out ratio.

Question 13

What do SLGT2 inhibitors increase the risk of?

Answer 13

UTIs

due to glucose in urine.

Question 14

GLP1 receptor agonists common part of name

Answer 14

……………..tide

Question 15

SGLP2 inhibitor common part of name

Answer 15

….gliflozin

Question 16

DPP4 inhibitor commons part of name

Answer 16

……….gliptin