T2DM therapeutics Flashcards
What kind of drug is Metformin
Biguanide
what is the first line treatment of T2DM?
Metformin
what is the next step after Metformin?
if they’re intolerant or uncontrolled SUs are considered
what drug reduces MI
TZD = pioglitazone
what drug induces glucosuria?
SGLT2 inhibitors e.g. Dapagliflozin
when is insulin prescribed?
last resort when people fail on tablet therapies
what drugs are dependent on insulin?
SUs, incretins, glinides, DPP-4 inhibitors, biguanides, TZDs
what drugs are insulin independent?
a-glucosidase inhibitors, SGLT2 inhibitors
what are the affect of SUs?
bind to SUR1 and close the Katp channel. this causes depolarisation and insulin release (independent of the plasma glucose concentration)
what is the difference between SUs and glinides? in terms of mechanism of action
both bind to SUR1, but glinides bind at the benzamido site
why are GLP-1’s and DPP4 inhibitors used?
to enhance insulin release, and decrease glucagon
how do DPP4 inhibitors work
inhibit dipeptidyl peptidase 4 which terminates the action of GLP1 and GIP normally
what is the function of a-glucosidase?
is a brush border enzyme that breaks down starch to glucose
what is the purpose of a-glucosidase inhibitors?
delay the absorption of glucose, reducing postprandial blood glucose increase
what drug reduces hepatic gluconeogenesis and how does it achieve this?
Metformin, stimulates AMP-activated protein kinase.
where de SGLT2 inhibitors work?
the proximal tubules of the kidney nephron
