diabetes drugs Flashcards
(16 cards)
insulin MoA
direct repllacement off endogenous insulin
- subcutaneous
insulin main side effects
hypoglycaemia
weight gain
lipodystrophy
metformin MoA
increases insulin sensitivity + decreases hepatic gluconeogenesis
(acts by activation of the AMP-activated protein kinase)
side effects of metformin
GI upset
lactic acidosis
MoA of sulfonylureas
stimulate pancreatic beta cells to secrete insulin
(gliclazide)
side effects of sulfonyureas
(Gliclazide, glimepiride)
- hypoglycaemia
- weight gain
- hyponatraemia (SIADH)
- liver dysfunction (cholestatic)
thiazolidinediones (pioglitazone) MoA
activate PPAR-gamma receptor in adipocytes to promote adipogenesis + fatty acid uptake
thiazolidinediones (pioglitazone) side effects
weight gain
fluid retention
bladder cancer !
fractures
DPP-4 inhibitors (-gliptins) MoA
increases incretin levels (by decreasing peripheral breakdown) which inhibit glucagon secretion
examples of DPP-4 inhibitors + their side effects
sitagliptin !!
pancreatitis
does NOT cause weight gain - pregerable to thiazolidinedione if overweight
SGLT-2 inhibitors (-gliflozins) MoA
inhibits reabsorption of glucose in the kidneys
-> reversibly inhibit sodium-glucose co-transporter 2 in the renal proximal convuluted tubule
SGLT-2 inhibitors (-gliflozins) side effects
UTIs
fourniers gangrene
weight loss
increased risk of lower-limb amputation - monitor feet
GLP-1 agonists (-tides) MoA
incretin mimetic which inhibits glucagon secretion
GLP-1 agonists (-tides) side effects
N+V
pancreatitis
weight loss (ozempic)
contraindications to metformin
- chronic kidney disease - stop if eGFR <30
- tissue hypoxia - recent MI, AKI, severe dehydration/sepsis –> can cause lactic acidosis
- iodine containing contrast media - should be stopped day of + for 48hrs after
- alcohol abuse
initiating mx with metformin
should be titrated up slowlyyyy
- reduce incidence of GI upset
if develop side effects - try modified release metformin
