Week 2 Pharm Flashcards
What Biguanide reduces hepatic glucose production; increases glucose absorption in muscle; increase insulin sensitivity, decrease intestinal glucose absorption?
Metformin
What are the side effects of Metformin?
No hypoglycemia, weight neutral or slight weight loss. GI side effects (N/V/D) are common so start with low doses and titrate up.
What do sulfonylureas like Glipizide do?
An insulin secretagogue, binds sulfonylurea receptors on β-cells, and causes insulin secretion
What are the side effects of Glipizide
Hypoglycemia, weight gain; Rare=photosensitivity, rash
What do Sodium-glucose co-transporter 2 (SGLT2) Inhibitors like Canagliflozin do?
Blocks reabsorption of glucose by SGLT in the proximal tubule of kidney causing glycosuria
What are the side effects of Canagliflozin
No hypoglycemia, weight neutral or slight weight loss, urinary/genital infections, amputations, euglycemic DKA, reduced bone density, reduce blood pressure, monitor serum creatinine and potassium
What do Glucagon-like polypeptide-1 (GLP-1) receptor agonists (incretin mimetic) like Liraglutide and Semaglutide do?
Analog of GLP1 which stimulates glucose-induced insulin secretion, suppresses glucagon, delays gastric emptying, possible improved beta cell function, causes weight loss
What are the side effects of Liraglutide and Semaglutide?
Weight loss, GI side effects: N/V/D/constipation/bloating (30%), low risk for hypoglycemia, acute pancreatitis, thyroid tumors?, injection site issues
What do Dipeptidyl Peptidase-4 (DPP4) Inhibitors like Sitagliptin do?
Inhibits the enzyme that breaks down GLP-1, raises GLP-1 levels
What are the side effects of Sitagliptin?
Low risk of hypoglycemia, weight neutral, allergic reactions (urticaria), acute pancreatitis, pancreatic cancer (animals), headache, Infections-nasopharyngitis, URI, UTI
What do HMG-CoA Reductase Inhibitors (Statins) like Rosuvastatin, Atorvastatin, and Simvastatin do?
Reversible competitive inhibitors of 3-hydroxy-3methylglutaryl-coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol synthesis; increase synthesis and reduces degradation of LDL receptors; more LDL receptors on surface of hepatocytes=increased removal of LDL from blood
What are the side effects of Rosuvastatin, Atorvastatin, and Simvastatin?
Rare hepatotoxicity, myalgia, increase LFT possible, new onset diaetes, neurocognitive effects?
Which drug is a cholesterol absorption inhibitor that will selectively inhibit cholesterol absorption from the small intestine via the sterol transporter NPC1L?
Ezetimibe
What are the side effects of Ezetimibe?
Usually well tolerated; headache, diarrhea, or increase LFT possible
What do Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors like Alirocumab do?
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a protein that binds to the LDL receptor, reduces the LDL receptor density, and increases circulating LDL. PCSK9 inhibitors are human monoclonal antibodies that block this process, increase LDL receptors and decrease circulating LDL
What are the side effects of Alirocumab?
Injection site reactions, nasopharyngitis, diarrhea, flu-like symptoms, myalgias, neurocognitive effects?
What do Fibric Acid derivatives like Fenofibrate do?
Agonist for the nuclear transcription factor PPAR-α which increases lipolysis and decreases triglycerides
What are the side effects of Fenofibrate?
Agonist for the nuclear transcription factor PPAR-α which increases lipolysis and decreases TG.
