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metabolic drugs > type 2 diabetes > Flashcards

type 2 diabetes Flashcards

1
Q

Metformin drug class

A

Biguanides

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2
Q

metformin target

A

AMP-kinase

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3
Q

metformin moa

A

increase the sensitivity of peripheral tissues to insulin and inhibits gluconeogenesis in the liver

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4
Q

metformin effect on senses

A

metallic taste

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5
Q

critical side effect of metformin

A

lactic acidosis

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6
Q

what condition and metformin are you worried about lactic acidosis

A

renal impairment

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7
Q

metformin dosent cause …

A

hypoglycaemia (requires endogenous insulin to work)

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8
Q

name a drug that causes taste distubance

A

amitriptyline = metallic taste

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9
Q

what enzyme does metformin inhibit

A

glycogen phosphorylase

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10
Q

gliclazide drug class

A

Sulfonylureas

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11
Q

gliclazide target

A

block ATP-sensitive K+ channels on β islet cell plasma membranes

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12
Q

what dont people like about gliclazide

A

weight gain

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13
Q

gliclazide moa

A

Reduced K+ efflux leading to β cell depolarisation, Ca2+ entry and insulin secretion

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14
Q

gliclazide side effects

A

Hypoglycaemia
Hyponatraemia
Hepatotoxicity
Hypersensitivity

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15
Q

when to with hold all diabetic drugs

A

ketoacidosis

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16
Q

name two Sulfonylureas

A

Glimepiride

gliclazide

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17
Q

glimepiride drug class

A

Sulfonylureas

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18
Q

glimepiride duration

A

long duration of action

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19
Q

overall action of glimepiride

A

stimulating the release of insulin from functioning pancreatic beta cells, and increasing sensitivity of peripheral tissues to insulin

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20
Q

what does glimepiride bind to

A

ATP-sensitive potassium channel receptors on the pancreatic cell surface

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21
Q

glimepiride moa

A

potassium blocking = depolarization of the membrane = calcium ion influx through voltage-sensitive channels = secretion of insulin

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22
Q

repaglinide drug class

A

Meglitinides

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23
Q

repaglinide target

A

sulphonylurea type-1 receptor

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24
Q

repaglinide moa

A

Antagonism of this receptor prevents potassium ions from exiting the cell when intracellular ATP levels are low. potassium ions (K+) accumulate inside beta cells = depolarisation = insulin release

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25
Q

why are there no cardiac side effects with repaglinide

A

acts as an agonist at Sur-1 receptors. Thus no cardiac side effects as myocytes have Sur-2a subtype of sulphonylurea receptor

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26
Q

other good thing about repaglinide

A

prevention of beta cell apoptosis under heavy glucose load and prevention of fat accumulation in arteries

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27
Q

what is the sulphonylurea type-1 receptor part of

A

ATP-modulated potassium channel

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28
Q

where is sulphonylurea type-1 receptor found

A

beta cells of the pancreas

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29
Q

Glucagon-like peptide-1 analogues

A

Exenatide

Liraglutide

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30
Q

Liraglutide drug class

A

GLP-1 analogues

31
Q

Liraglutide target

A

Glucagon-like peptide-1 (GLP-1) receptors

32
Q

Liraglutide moa

A

GLP-1 analogues bind to and activate the receptors in the same way as the endogenous hormone and Increase synthesis and release of insulin by pancreatic β cells, suppress inappropriate glucagon secretion from pancreatic α cells

33
Q

Liraglutide adverse effects

A

Severe pancreatitis
Hypoglycaemia
Antibody formation against exenatide

34
Q

what to do if someone misses a dose of Liraglutide

A

take next one as normal

35
Q

when not to take Liraglutide

A

after a meal

36
Q

what is Liraglutide dependant on

A

glucose

37
Q

Exenatide class

A

Glucagon-like peptide-1 receptor (GLP1R) agonists

38
Q

where is GLP1 released from

A

intestinal endocrine cells

39
Q

when is GLP1 released

A

after eating

40
Q

Pioglitazone drug class

A

Thiazolidinediones

41
Q

Pioglitazone target

A

PPARγ receptors

42
Q

Pioglitazone moa

A

Causes the PPARγ-RXR complex to bind to DNA, promoting transcription of genes whose products are involved in insulin signalling e.g. lipoprotein lipase, Glut-4. This increases the sensitivity of tissues to insulin by recruiting glucose transporters to cell surface.

43
Q

Pioglitazone are dependant on

A

presence of insulin

44
Q

common side effects of Pioglitazone

A

weight gain

fluid retention

45
Q

severe side effect of Pioglitazone

A

liver dysfunction

bone fractures in women

46
Q

when to be careful giving Pioglitazone

A

people with cardiovascular probs

47
Q

what are PPARγ receptors complexed with

A

retinoid X receptor

48
Q

what are PPARγ receptors complexed with

A

retinoid X receptor

49
Q

when should you stop Pioglitazone

A

if jaudice develops

50
Q

why not take Pioglitazone and insulin

A

cardiac risks

51
Q

why not take Pioglitazone and BB

A

might mask hypo

52
Q

Sitagliptin drug class

A

DPP4 inhibitors

53
Q

Sitagliptin moa

A

Inhibit degradation of incretin hormones GLP-1 and GIP by DPP4 enzymes. This increases levels of GLP-1 and GIP leading to increased synthesis and release of insulin by pancreatic β cells.

54
Q

common adverse effect of Sitagliptin

A

Upper respiratory tract infection

55
Q

Sitagliptin important side effect

A

Pancreatitis

56
Q

caution with Sitagliptin in

A

heart failure

57
Q

vildagliptin side effect

A

hepatotoxicity

58
Q

Linagliptin drug class

A

dipeptidyl peptidase (DPP)-4 enzyme inhibitor

59
Q

Linagliptin moa

A

slows the breakdown of insulinotropic hormone glucagon-like peptide (GLP)-1 and GIP

60
Q

action of GIP and GLP

A

incretin hormones that increase the production and release of insulin from pancreatic beta cells

61
Q

action of GIP and GLP

A

incretin hormones that increase the production and release of insulin from pancreatic beta cells

62
Q

Acarbose drug class

A

alpha-glucosidase inhibitor

63
Q

where is alpha-glucosidase found

A

gut

64
Q

what is alpha-glucosidase used for

A

breaking down complex carbohydrates (i.e. starch) into glucose

65
Q

Acarbose moa

A

kess gluclose is made in the gut so less glucose is released into the hepatic portal vein following a meal

66
Q

Acarbose moa

A

kess gluclose is made in the gut so less glucose is released into the hepatic portal vein following a meal

67
Q

name some Sodium-glucose co-transporter 2 (SGLT2) inhibitors

A

Canagliflozin

Dapagliflozin

68
Q

Canagliflozin inhibits

A

SGLT2

69
Q

Canagliflozin moa

A

reduces reabsorption of filtered glucose and lowers the renal threshold for glucose (RTG), and thereby increases urinary glucose excretion

70
Q

what does Sodium-glucose co-transporter 2 do

A

reabsorption of filtered glucose from the tubular lumen

71
Q

where is Sodium-glucose co-transporter 2 expressed

A

proximal renal tubule

72
Q

where is Sodium-glucose co-transporter 2 expressed

A

proximal renal tubule

73
Q

Dapagliflozin moa

A

blocks glucose reabsorption into the kidney, resulting in the elimination of blood glucose through the urine

metabolic drugs (14 decks)

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