Therapeutics of diabetes Flashcards
Give an example of a biguanide?
metformin
Give examples of sulphonylureas?
glicazide; glibenclamide; glimeparide
Give an example of a thiazolidinedione?
pioglitazone
what dosage does metformin stop being useful?
more than 1g bd
What are the effects of metformin?
manages management; weight neutral/loss; prevents micro and macro complications
By how much does metformin reduces HbA1c?
15-20mmol/mol
Is metformin safe in pregnancy?
yes
What are the side effects of metformin?
GI- anorexia; nausea; vomiting; diarrhoa; abdo pain
interference with vit B12 and folic acid
lactic acidosis; liver failure
rash
Whic hpatients get lactic acidosis with metformin?
renal, cardiac or liver failure
What eGFR shoudl metformin be stopped?
less than 30ml/min
What liver disease may metformin be beneficial in?
NAFLD
What is the drug quantity range for SUs?
40mg od-160mg bd
What drug quantity should SU be stopped at due to lack of efficacy?
120mg bd
What are the effects of SUs?
hyperglycaemia manamgement; prevention of microvascular complications
What are the adverse effects of SUs?
hypoglycaemia; weight gain; GI upset/ headache;
Who most commonly gets hypos with SU?
elderly/frail, alcohol excess, liver disease
What nuclear receptor for thiazolidinediones bind to?
PPAR-gamma
What are the effects of TZDs?
hyperglycaemia managemtn; weight gain; fluid retention- heart failure; prevention of macrovascular complicatiosn; increased risk of fracture
Name an incretin analogue?
exanetide
What hormone do incretins mimic?
GLP-1
What are the benefits of GLP-1 RAs?
promote insulin secretion without hypos; suppress glucagon (raised in T2DM); decrease gastric emptying- early satiety; act on hypothalamus to reduce appetite
What are the adverse effects of GLP-1 RA?
nausea; has to be injected; pancreatitis
What is the name of DPP-4I’s?
gliptins
What are the benefits of DDP4 inhibitors?
promote insulin secretion without hypos; suppress glucagon; weight neutral
