T2DM Oral Meds Review

Question 1

what drug class is metformin?
what is MoA?

Answer 1

biguanide
decreases hepatic glucose production and intestinal glucose absorption. also increases glucose uptake by skeletal muscle and fat. also activates AMP-activated protein kinase

Question 2

what overall effect does metformin have in the body?

Answer 2

reduces blood glucose, increases sensitivity to insulin, and reduces blood lipid levels

Question 3

what is a main AE of metformin?

Answer 3

lactic acidosis

Question 4

what are advantages/disadvantages of metformin?

Answer 4

no weight gain and low risk of hypoglycemia

GI SEs and rare lactic acidosis

Question 5

what are the three sulfonylureas?

Answer 5

glipizide
glimepiride
glyburide

Question 6

what is MoA of sulfonylureas?

Answer 6

stimulate pancreatic B-cell activity by binding and inhibiting ATP-dependent potassium channels causing calcium to move into the cell and increase insulin secretion

Question 7

what overall effect do sulfonylureas have?

Answer 7

reduce blood glucose and lower risk of hypoglycemia compared to insulin

Question 8

what are AEs of sulfonylureas?

Answer 8

hypoglycemia and weight gain

Question 9

what are advantages/disadvantages of sulfonylureas?

Answer 9

rapid FPG reduction and low cost

weight gain and high risk of hypoglycemia

Question 10

what are the two TZDs?

Answer 10

pioglitazone
rosiglitazone

Question 11

MoA of TZDs?

Answer 11

improve target cell response to insulin, decrease hepatic glucose output, increase insulin-dependent glucose uptake in skeletal muscle and fat.
Bind and activate PPA receptors which regulates gene expression

Question 12

AEs of TZDs?

Answer 12

altered liver function, harmful cardiac effects, edema, and weight gain

Question 13

what are advantages of TZDs?

Answer 13

decrease amount of insulin needed
low risk of hypoglycemia

Question 14

what are the 2 meglitinides?

Answer 14

repaglinide
nateglinide

Question 15

MoA of meglitinides?

Answer 15

stimulate glucose-mediated insulin secretion and upregulates ATP-dependent K+ channels

Question 16

SEs of meglitinides?

Answer 16

hypogylcemia, diarrhea, weight gain

Question 17

what is the name of the a-glucosidase inhibitor?

Answer 17

acarbose

Question 18

MoA of acarbose?

Answer 18

inhibit pancreatic a-amylase and membrane bound a-glucosidase enzymes to delay glucose absorption

Question 19

acarbose is mainly used to treat?

Answer 19

elevated postprandial glucose

Question 20

what are the names of the DPP-4 inhibitors?

Answer 20

sitagliptin
saxagliptin
linagliptin

Question 21

MoA of DPP-4 Is?

Answer 21

inhibit peptide hormone metabolism by DPP-4 enzyme and ehance activity of GLP-1

Question 22

what are advantages of DPP-4 Is?

Answer 22

no weight gain and low risk of hypoglycemia

Question 23

MoA of GLP-1 R agonists?

Answer 23

stimulate release of insulin and inhibit the release of glucose from the liver

Question 24

what are advantages of GLP-1 agonists?

Answer 24

reduced CVD risk

Question 25

MoA of SGLT2 inhibitors?

Answer 25

reduces reabsorption of filtered glucose and lowers the renal threshold for glucose to increase excretion of glucose

Question 26

what are advantages of SGLT2 Is?

Answer 26

reduced CVD risk