Sodium-Glucose Co Transporter 2 (SGLT2) Inhibitors and Cycloset

Question 1

Sodium-Glucose Co Transporter 2 (SGLT2) Inhibitors, Dapagliflozin (Farxiga) and Canaglifolozin (Invokana) MOA:

Answer 1

Inhibits SGLT2 in proximal renal tubules

=increases urinary glucose excretion, lowering plasma glucose levels

Question 2

What is SGLT2 responsible for?

Answer 2

Reabsorption of filtered glucose from the kidneys

Question 3

When can SGLT2 inhibitors be administered?

Answer 3

With or without food (won’t cause hypoglycemia by itself)

Question 4

Peak effect and half life of SGLT2 inhibitors:

Answer 4

Peak: 1-2hrs

Half-life: 12hrs

Question 5

SGLT2 inhibitors should only be used in patients with CrCL >_____

Answer 5

60mL/min

Question 6

Laboratory changes that may happen with SGLT2 inhibitors include:

Answer 6

Increases in Scr and decreases in eGFR

Increases in LDL

Question 7

What should be corrected in patients prior to administration and why?

Answer 7

Volume depletion

Drugs causes volume contraction, putting patients at risk for hypotension

Question 8

AE of SGLT2 inhibitors include:

Answer 8

Female genital fungal infections
UTI
Hypoglycemia when used with combo therapy
Bladder cancer (unknown causal association

Question 9

Cycloset (bromocriptine) is used to treat which type of DM?

Answer 9

Type 2

Question 10

What is Cycloset’s MOA:

Answer 10

Dopamine agonist
Exact mechanism of glycemic control unknown
Improves glycemic control without increasing insulin concentrations

Question 11

Cycloset AE:

Answer 11

GI upset: N/C
CNS effects: dizziness, HA, fatigue
Impulsive/compulsive behavior (when used to treat Parkinson’s)

Question 12

How is Cycloset metabolized?

Answer 12

CYP3A4. Also inhibits 3A4.

Drug interactions