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Pharmacology > Type II Diabetes > Flashcards

Type II Diabetes Flashcards

1
Q

What are the classes of drugs used to treat type II Diabetes?

A

Insulin secretagogues, insulin sensitizers, alpha-glucosidase inhibitor, Dipeptidyl Peptidase IV (DPP-IV) inhibitors, Glucagon-like peptide-1 (GLP-1) Mimetic, Sodium-glucose co-transporter 2 (SGLT2) inhibitors

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2
Q

What do Insulin secretagogues do?

A

Increase basal and/or postprandial insulin levels.
They reduce microalbuminuria
ACTIONS DEPEND OF FUNCTION BETA CELLS

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3
Q

What types of drugs are Insulin secretagogues?

A

Solfonylureas (1-2 times daily) and Meglitinides (3-4 times daily)

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4
Q

What are the adverse effects of insulin secretagogues?

A

Weight gain, hypoglycaemia

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5
Q

What is the MOA of Sulfonylureas?

A

↑ insulin secretion
↓ hepatic clearance of
insulin
↓ Glucagon levels

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6
Q

What drugs are Sulfonylureas?

A

Glibenclamide & Gliclazide (Long acting 24 hrs)
Glipazide & Glimepiride (Short acting 12-24 hrs)

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7
Q

Where are Sulfonylureas’ metabolised?

A

In the liver

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8
Q

T or F - Sulfonylureas’ do not cross the placenta

A

False, they do

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9
Q

What are the CI for Sulfonylureas’?

A

Hepatic/renal impairment

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10
Q

What are the adverse effects of Sulfonylureas’?

A

Hypoglycemia, nausea, vomiting, allergic skin reactions,
minor disulfiram-like reactions, headache, cardiotoxicity

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11
Q

What are the drug interactions of Sulfonylureas’?

A

Aspirin & Sulphonamides potentiate the effects of SUs
Hepatic enzyme inducers, corticosteroids, oral
contraceptives ↓ the effects of SUs
β-blockers mask the signs of hypoglycemia

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12
Q

What are the two types of Meglitinides?

A

Repaglinide and Nateglanide

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13
Q

T or F - Meglitinides have a slow onset and long duration of action?

A

False. They have a rapid onset and are short acting

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14
Q

What is the MOA of Meglitinides?

A

Bind to ATP-dependent K+ channels,
causing insulin release

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15
Q

What drugs can Meglitinides be combined with?

A

metformin or thiazolidinediones

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16
Q

What are the adverse effects of Meglitinides?

A

Hypoglycemia
Upper respiratory tract infections
Weight gain
Bronchitis
Headache

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17
Q

What drugs are Thiazolidinediones?

A

Rosiglitazone (withdrawn) and Pioglitazone

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18
Q

What is the MOA of Thiazolidinediones?

A

Agonist at peroxisome proliferator-activated receptor – γ (PPARγ). Induces insulin genes

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19
Q

What are the therapeutic uses of Thiazolidinediones?

A

Monotherapy
With Sulfonylureas
With Metformin
With injected insulin

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20
Q

What are the cautions with Thiazolidinediones?

A

Heart failure

21
Q

What are the adverse effects of Thiazolidinediones?

A

Fluid retention (oedema)
Weight gain
Anaemia
CVD
Increased risk of cardiac ischaemia

22
Q

What drug is a Biguanide?

A

Metformin

23
Q

What is the use of Metformin?

A

Obese pts- decrease their body weight

24
Q

What is the MOA of Metformin?

A

Decrease hepatic glucose synthesis and increase glucose uptake from muscles

25
Q

What are the therapeutic uses of Metformin?

A

In combination with SUs, meglitinide,
thiazolidinediones, insulin, or α-glucosidase
inhibitor

26
Q

What are the adverse effects of Metformin?

A

GI disturbances – abdominal discomfort and diarrhoea, metallic taste, mild anorexia
Lactic acidosis

27
Q

What are the CI of Metformin?

A

Renal Impairment & hepatic
disease
* Alcohol abuse
* If predisposed to CV
collapse, acute CHF,
severe infection
* History of lactic acidosis

28
Q

What is the drug that belongs to the α-glucosidase inhibitor class?

A

Acarbose

29
Q

What is the MOA of Acarbose?

A
  • Inhibits the breakdown of complex CHO in small
    intestine
  • Delays CHO absorption
  • Inhibits glucoamylase > sucrase > maltase
    > dextranase
30
Q

What are the benefits of Acarbose?

A
  • ↓s postprandial hyperglycemia (hypoglycemia – rare)
  • No effect on lipids or insulin levels
31
Q

What are the adverse effects of Acarbose?

A

GI disturbances
* Dose-dependent toxicity

32
Q

What can Acarbose be combined with?

A

Can be combined with insulin, metformin or sulfonylureas – additive effect

33
Q

What are the CI of Acarbose?

A
  • Inflammatory bowel disease, GI obstruction, cirrhosis
34
Q

What drugs are Dipeptidyl Peptidase IV
(DPP-IV) Inhibitors?

A

Sitagliptin, Vildagliptin, Saxagliptin

35
Q

What is the MOA of DPP-IV inhibitors?

A

Inhibits DPP-IV. Extend action of insulin while
suppressing release of
glucagon

36
Q

What can DPP-IV inhibitors be combined with?

A

Insulin, metformin or sulfonylureas – additive
effect

37
Q

What are the adverse effects of DPP-IV inhibitors?

A

Gastrointestinal discomfort, peripheral oedema, liver dysfunction

38
Q

What is the caution associated with DPP-IV inhibitors?

A

Renal impairment

39
Q

What are Glucagon-like peptide-1 (GLP-1) drugs?

A

Dulaglutide, Exenatide, Liraglutide, Semaglutide

40
Q

What is another name GLP-1 drugs?

A

Incretin Mimetics

41
Q

What is the MOA for GLP-1 drugs?

A

Incretin mimetic. Increase Insulin secretion and decrease glucagon secretion

42
Q

What are 2 additional benefits of GLP-1 drugs?

A

Promote weight loss and cardiovascular benefits

43
Q

What are the adverse effects of GLP-1 drugs?

A
  • Hypoglycemia,
  • Nausea, vomiting, rash
  • pancreatitis
44
Q

What are the contraindications for GLP-1 drugs?

A

Type 1 diabetes,
ketoacidosis, severe
renal impairment.
* Not for use in pregnancy

45
Q

What drugs are Sodium-glucose co-transporter 2
(SGLT2) inhibitors?

A

Dapagliflozin, Canagliflozin, Empagliflozin

46
Q

What is the MOA of SGLT2 inhibitors?

A

Competitive, selective inhibitor of SGLT-2 –
preventing kidneys from reabsorbing glucose into the blood

47
Q

What are the CI for SGLT2 inhibitors?

A

Renal impairment
* Not for use in pregnancy or
lactation

48
Q

What can SGLT2 inhibitors be combined with?

A

Can be combined with
metformin, pioglitazone or
sitagliptin

49
Q

What are the AE of SGLT2 inhibitors?

A

Increased risk of genital and urinary tract infections
* Hypotension

Pharmacology (11 decks)

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