Sodium Glucose Co-Transporter 2 Inhibitors (SGLT2i)

Question 1

Give examples of SGLT2is.

Answer 1

Canagliflozin, dapagliflozin, empagliflozin.

Question 2

What is the mechanism of action of the SGLT2is?

Answer 2

Inhibit the sodium-glucose co-transporter in the renal proximal convoluted tubule to reduce glucose reabsorption and increase glucose excretion.

Question 3

What are the side effects of the SGLT2is?

Answer 3

Constipation, thirst, UTIs, nausea, hypoglycemia, genital infections (thrush), polyuria, DKA.

Question 4

The risk of hypoglycemia associated with SGLT2is is increased when used with which drugs?

Answer 4

Insulins and sulfonylureas.

Question 5

What symptoms of volume depletion should patient’s on SGLT2is be made aware of?

Answer 5

Postural hypotension and dizziness.

Question 6

If a patient on SGLT2is experiences volume depletion, what course of action should be taken?

Answer 6

Consider interrupting treatment.

Question 7

Who is at greater risk of volume depletion when using SGLT2is?

Answer 7

Elderly patients over 75 years, concomitant use of hypertensives, CVD, GI illness, complicated UTI.