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Endocrine > Therapeutics of diabetes > Flashcards

Therapeutics of diabetes Flashcards

1
Q

Give an example of a biguanide?

A

metformin

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2
Q

Give examples of sulphonylureas?

A

glicazide; glibenclamide; glimeparide

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3
Q

Give an example of a thiazolidinedione?

A

pioglitazone

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4
Q

what dosage does metformin stop being useful?

A

more than 1g bd

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5
Q

What are the effects of metformin?

A

manages management; weight neutral/loss; prevents micro and macro complications

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6
Q

By how much does metformin reduces HbA1c?

A

15-20mmol/mol

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7
Q

Is metformin safe in pregnancy?

A

yes

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8
Q

What are the side effects of metformin?

A

GI- anorexia; nausea; vomiting; diarrhoa; abdo pain
interference with vit B12 and folic acid
lactic acidosis; liver failure
rash

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9
Q

Whic hpatients get lactic acidosis with metformin?

A

renal, cardiac or liver failure

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10
Q

What eGFR shoudl metformin be stopped?

A

less than 30ml/min

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11
Q

What liver disease may metformin be beneficial in?

A

NAFLD

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12
Q

What is the drug quantity range for SUs?

A

40mg od-160mg bd

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13
Q

What drug quantity should SU be stopped at due to lack of efficacy?

A

120mg bd

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14
Q

What are the effects of SUs?

A

hyperglycaemia manamgement; prevention of microvascular complications

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15
Q

What are the adverse effects of SUs?

A

hypoglycaemia; weight gain; GI upset/ headache;

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16
Q

Who most commonly gets hypos with SU?

A

elderly/frail, alcohol excess, liver disease

17
Q

What nuclear receptor for thiazolidinediones bind to?

A

PPAR-gamma

18
Q

What are the effects of TZDs?

A

hyperglycaemia managemtn; weight gain; fluid retention- heart failure; prevention of macrovascular complicatiosn; increased risk of fracture

19
Q

Name an incretin analogue?

A

exanetide

20
Q

What hormone do incretins mimic?

A

GLP-1

21
Q

What are the benefits of GLP-1 RAs?

A

promote insulin secretion without hypos; suppress glucagon (raised in T2DM); decrease gastric emptying- early satiety; act on hypothalamus to reduce appetite

22
Q

What are the adverse effects of GLP-1 RA?

A

nausea; has to be injected; pancreatitis

23
Q

What is the name of DPP-4I’s?

A

gliptins

24
Q

What are the benefits of DDP4 inhibitors?

A

promote insulin secretion without hypos; suppress glucagon; weight neutral

25
Q

What are the adverse effects of DPP$ inhibitors?

A

not that potent- can only block whats already there; pancreatitis

26
Q

Give an example of an SGLT2 inhibitor?

A

empagiflozin

27
Q

what is the effect of SGLT2 inhibitors?

A

decrease uptake of sugar by about 1/4; dcreass CVS risk; weight loss

28
Q

What are the adverse effects of increased sugar in the urine?

A

increase in thrush; increase in UTI

Endocrine (27 decks)

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