Thiazolidines - Pioglitazone Flashcards

1
Q

What is an example of a thiazolidine?

A

Pioglitazone

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2
Q

What are contrainidications for thiazolidines?

A
  • Hepatic impairment
  • History of bladder cancer
  • Heart failure
  • Pregnancy / breast feeding
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3
Q

When would you want to be cautious when using thiazolidines?

A
  • Cardiovascular disease
  • Risk of fractures
  • Acute porphyria
  • Risk of bladder cancer/ uninvestigated macroscopic haematuria
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4
Q

When would you consider prescribing a pioglitazone?

A
  1. Single agent in overweight patients where metformin is contraindicated or not tolerated.
  2. Second agent to metformin/sulphonylurea where blood glucose control is inadequate on one drug and the metformin/sulphonylurea combination is contraindicated or not tolerated.
  3. Third agent with metformin and a sulphonylurea where blood glucose control is inadequate as an alternative to starting
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5
Q

What is the mechanism of action of pioglitazone?

A

Act via a range of actions by activating PPARy. These lead to increased sensitivity of muscle and fat tissue to insulin, thereby increasing glucose uptake.

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6
Q

Do Thiazolidines increase weight?

A

Yes

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7
Q

What are side effects of thiazolidines?

A
  • Gastrointestinal upset
  • Weight gain
  • Oedema
  • Hepatic toxicity
  • Visual disturbance
  • Impotence
  • Anaemia
  • Hypoaesthesia
  • Bladder cancer (very rare)
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8
Q

Does pioglitazone cause hypoglycaemia?

A

No

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9
Q

What drugs can pioglitazone interact with?

A

Antidiabetic drugs - can cause hypoglycaemia and cardiac failure

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