Antidiabetic medication Flashcards
when will metformin (biguanide) only work?
if some Bcells work in islet of langherhans
how does metformin (biguanide) work
decreases glucogensis and increases peripheral utilisation of glucose
s/e of metformin (biguanide)
-lactic acidosis - avoid if EGFR <30
-GI s/e = high dose slowly or give MR
-can lower vit B12
-stop if pt = AKI
sulphonylureas MoA
Augments insulin secretion
examples of short acting sulphonylureas
gliclazide
tolbutamide
examples of long-acting sulphonylurea
glibericlamide
glimepiride
why should you avoid long-acting sulphonylurea in elderly?
it is assoc with prolonged and fatal cases of hypoglyc
s/e sulphonylurea
high risk of hypoglyc
tx in hosp (target = 7.0% x 6.5%)
when should you avoid sulphonylureas?
-avoid in acute porphyria
-avoid in hepatic + renal failure
MoA of pioglitazone
decreases peripheral insulin resistance
when should you avoid pioglitazone
in pts with history of HF
high risk of?
pioglitazone S/E
-high risk of bladder cancer
-high risk of bone factors
-high risk of liver toxicity
pioglitazone s/e
what should you review with bladder cancer and when
safety and efficacy after 3-6MT
s/e pioglitazone
when should you not tx pt who develop bladder cancer
if they have an inadequate response
pioglitazone s/e
what signs should you report if bladder cancer is suspected
haematuria
dysuria
urinary urgency
