treatment type 2 Flashcards
name 3 sulphonylureas?
gliclazide, glibenclamide, glimepiride
method of action of sulphonylureas?
the close k atp channel - cause depolarisation of the membrane, influx of calcium and release of insulin
name of receptor on muscle/fat cells to take in glucose?
GLUT4
receptor on beta cells for glucose entry?
GLUT2
which has a faster onset of action, SU or insulin sensitiser like metformin?
SU
What is its effect on microvascular complications and microvascular complications?
reduces microvascular comps but remember it causes weight gain so doesn’t reduce macrovacsular complications
with metformin, what is the cut off for EGFR? you should not use below?
30
half dose of metformin if the EGFR is between?
30 and 45
metformin in pregnancy?
safe
what is the next treatment of diabetes after metformin?
SU
What is the only PPARy drug used/thiozolidinedione used? (elv and PRG)
pioglitazone (elvis ) roseglitazone taken off market due to increased risk of MI
side effects of SU?
hypo, weight gain, GI upset/headache
When would you avoid use of SUs?
severe renal or hepatic failure
What is TZD mechanism of action?
they are lipophilic. They enter cells and bind to PPARy. They activate some of the same genes as insulin
TZDs effect on weight gain?
they inevitably cause an increase in weight gain. Due to subcutaneous fat and fluid retention
