Type 2 Diabetes Drugs Flashcards
first line management of T”DM?
metformin
side effects of metformin?
GI upset lactic acidosis B12 deficiency liver failure weight loss rash
does metformin increase risk of hypoglycaemia?
no
examples of sulphonylureas (SURs)?
gliclazide
glibenclamide
glimeparide
side effects of SURs?
hypoglycaemia increased appetite and weight gain SIADH abdo pain diarrhoea nausea can cause liver dysfunction
how do SURs work?
increase insulin secretion by insulin independent action
adverse effects of pioglitazone (type of thiazolidinedione)?
weight gain increased fracture risk increased risk of bladder cancer worsens heart failure fluid retention liver dysfunction
example of incretin analogue?
exanetide (GLP1 mimetic)
- (GLP1 is one of the main incretin hormones)
other incretin hormone?
GIP
side effects of incretin analogues?
delay gastric emptying decreased appetite (weight loss)
examples of DPP-4 inhibitors?
sitagliptin
vildagliptin
how do DPP-4 inhibitors work?
DPP-4 enzyme inhibits action of incretin hormones so blocking DPP-4 promotes action of incretins
side effects of DPP-4 inhibitors?
..
do DPP-4 inhibitors cause weight gain or hypoglycaemia?
no doesnt cause either
example of SGLT-2 inhibitors?
dapagliflozin
how do SGLT2 inhibitors work?
reduce reabsorption of glucose in convoluted tubule of kidneys so glucose is passed via urine
side effects of SGLT2 inhibitors?
increased UTI risk (die to glycosuria)
weight loss
thrush (glycosuria)
example of alpha-glucosidase inhibitor?
acarbose
first line management of T2DM?
metformin
when should a second drug be added to metformin?
if HbA1c has risen to 58 while taking metformin
what second drug should be added to metformin if HbA1c is >58?
any one of
- SUR
- SGLT2 inhibitor
- gliptin (DPP-4 inhibitor)
- pioglitazone (not really used)
when is a 3rd drug added?
if HbA1c still >58 on two drugs
triple therapy combinations if HbA1c >58 on 2 drugs?
metformin + any combination of SUR, SGLT2, DPP4 and pioglitazone
