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Endocrinology > Type II Diabetes Therapeutics > Flashcards

Type II Diabetes Therapeutics Flashcards

1
Q

What is the first line drug in type II diabetes?

A

Metformin

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2
Q

How does metformin work?

A

Lowers insulin resistance by reducing hepatic gluconeogenesis

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3
Q

What is metformin’s effect on weight?

A

Reduces it

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4
Q

What are the side effects of metformin?

A

GI upset
Lactic acidosis
Liver toxicity

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5
Q

When is metformin indicated?

A

First line drug in T2DM in patients with normal hepatic/renal function

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6
Q

Give examples of sulfonylureas

A

Gliclazide

Glibenclamide

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7
Q

How do sulfonylureas work?

A

Displace ADP-Mg from the SUR1 subunit causing insulin exocytosis

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8
Q

What is the effect of sulfonylureas on weight?

A

Increase

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9
Q

Give some side effects of sulfonylureas

A

Hypoglycaemia
Weight gain
GI upset

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10
Q

When are sulfonylureas indicated?

A

First line in underweight T2DM patients with normal hepatic/renal function
Second line to metformin otherwise

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11
Q

How does pioglitazone work?

A

Agonises PPAR-gama causing promotion of gene expression encoding insulin signalling

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12
Q

What is the effect of pioglitazone on weight?

A

Increase

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13
Q

Give some side effects of pioglitazone

A

Heart failure

Increased fracture risk

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14
Q

When is pioglitazone indicated?

A

Used second line in combination with metformin/sulfonylureas

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15
Q

Give examples of GLP-1 receptor agonists

A

Exenatide

Liraglutide

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16
Q

Give some effects of GLP-1 receptor agonists

A

Reduced appetite
Delayed gastric emptying
Increased insulin secretion
Weight loss

17
Q

Give some adverse effects of GLP-1 receptor agonists

A

Nausea
Injectable
Pancreatitis

18
Q

When are GLP-1 receptor agonists indicated?

A

Used in combination with oral glucose lowering drugs as third/fourth line

19
Q

Give examples of DPP-IV inhibitors

A

Sitagliptin

Linagliptin

20
Q

How do DPP-IV inhibitors work?

A

Inhibit DPP-IV delaying the breakdown of incretin hormones

21
Q

What are some adverse effects of DPP-IV inhibitors?

A

Less potent than GLP-1 receptor agonists

Pancreatitis

22
Q

When are DPP-IV inhibitors indicated?

A

Used in combination as dual/triple therapy

23
Q

Give examples of SGLT2 inhibitors

A

Empagliflozin

Dapagliflozin

24
Q

How do SGLT2 inhibitors work?

A

Block glucose reabsorption causing it to be urinated out

25
Q

What is the effect of SGLT2 inhibitors on weight?

A

Weight loss

26
Q

Give some side effects of SGLT2 inhibitors

A

Thrush

Increased risk of UTIs

27
Q

When are SGLT2 inhibitors indicated?

A

Second line in combination with metformin

Endocrinology (14 decks)

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