Pharmacology of Type 2 diabetes Flashcards
What is the route of administration of metformin?
Oral
How does Metformin decrease blood glucose?
Increases peripheral uptake of glucose
Stimulates lactate production
Decreases gluconeogenesis
Decreasing LDL and VLDL
What does Metformin not do?
Cause hypoglycaemia
Stimulate appetite
Cause weight gain
Does metformin affect the release of: Insulin Glucagon GH Cortisol Somatostatin
NO
Contraindications of metformin
Acute metabolic acidosis
Side effects of metformin
Abdominal pain Nausea Diarrhoea (usually transient) Decreases folate and vitamin b12 absorption Rare: lactate acidosis
What do sulphonylureas do acutely?
Increase insulin release
Increase plasma insulin concentration
Decrease hepatic clearance of insulin
What do sulphonylureas do chronically?
Down regulation of the sulphonylurea receptor
What are some examples of sulphonylureas?
Glicazide
Tolbutamide
Chlorpropamide
Glibenclamide
Sulphonylureas Mechanism of Action
Blocks ATP dependent potassium channels in the membrane of pancreatic beta cells
Causes depolarisation, calcium influx and insulin release
Sulphonylureas route of administration
Oral
How are sulphonylureas excreted and why does it matter?
Excreted in urine, enhanced effect in elderly and renal disease
Adverse effects of sulphonylureas
Hypoglycaemia
Weight gain
GI disturbances
Contraindications of sulphonylureas
Avoided in those with hepatic and renal impairment
Pregnant women- avoid neonatal hypoglycaemia
Examples of drugs in the gliptins class
Linagliptin
Alogliptin
