medicines for type 2 diabetes Flashcards
1
Q
metformin
A
- a biguanide
- first-line oral glucose-lowering agent for type 2
- no weight gain (unlike insulin/sulfonylureas)
- does not cause hypoglycaemia
- mechanism of action uncertain
2
Q
metformin mechanism action
A
- reduces hepatic glucose production
- can affect multiple cellular processes like the inhibition of mitochondrial respiratory-chain complex 1
3
Q
metformin side effects
A
- diarrhoea
- nausea/vomiting
- abdominal bloating/gas
- reduced appetite
- vitamin B12 deficiency
- tiredness/tingling hands and feet
- rare: lactic acidosis
4
Q
sulfonylureas
A
- stimulate insulin secretion from pancreatic beta cells
- bind to ATP-gated K+ channels causing channel closure and membrane depolarisation leads to insulin secretion
5
Q
sulfonylureas drugs
A
- glibenclamide
- gliclazide
- glipizide
- glimepiride
- tolbutamide
6
Q
sulfonylureas side effects
A
- hypoglycaemia
- weight gain (more suitable for patients who are not overweight)
7
Q
meglitinides
A
- prandial glucose regulators
- similar mechanism of action as sulfonylureas but rapid onset-short duration
- taken before meals
- repaglinide, nateglinide
8
Q
thiazolidinediones
A
- pioglitazone
- increase insulin sensitivity by stimulating the expression of insulin-sensitising genes
- thiazolidinediones bind to and activate the nuclear receptor PPARy
- side effects: water retention (oedema) and weight gain
9
Q
GLP-1 analogues
A
- incretin mimetics
- release of active GLP-1 and GIP in response to an increased concentration of glucose in the digestive tract lumen
- DPP-4 rapidly degrades incretins
- incretin effect increased insulin release
10
Q
GLP-1 analogues medicines
A
- exenatide (twice daily injection)
- exenatide (once weekly injection)
- liraglutide (once daily injection)
- lixisenatide (once daily injection)
- dulaglutide (once weekly injection)
- semaglutide (once weekly injection)
11
Q
DPP-4 inhibitors
A
- gliptins
- DPP-4 inhibitor blocks incretin degradation
- incretins stimulate insulin secretion
- potentiates incretin effect increases insulin release
12
Q
DPP-4 medicines
A
- sitagliptin
- vildagliptin
- saxagliptin
- alogliptin
- linagliptin
- can all come with metformin
13
Q
alpha glucosidase inhibitor (acarbose)
A
slows down absorption of starchy foods by intestine
slow rise in blood glucose after a meal
14
Q
SGLT2 inhibitors
A
act by inhibiting the glucose transporter SGLT2 which functions in the kidney to mediate glucose reabsorption
examples: dapagliflozin, canagliflozin, empagliflozin
15
Q
if HbA1c rises to 48 mmol/mol
A
consider monotherapy - metformin
