Diabetes Flashcards by Thabby Cakes

What type of drug are Glibenclamide, Glipizide, Glimepiride, and Gliclazide?

Sulfonylureas (Insulin secretagogues)

These drugs increase insulin secretion, decrease glucagon, and decrease insulin clearance.

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What is the mechanism of action of Sulfonylureas?

↑ insulin secretion, ↓ glucagon, ↓ insulin clearance

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What is the primary indication for Sulfonylureas?

Type 2 diabetes (with functional β-cells)

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What are the contraindications for using Sulfonylureas?

Significant hepatic/renal impairment

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What are common side effects of Sulfonylureas?

Hypoglycemia
Weight gain
Nausea
Allergic reactions
Cardiotoxicity

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What drug interactions should be noted with Sulfonylureas?

Potentiated by aspirin/sulphonamides
Reduced by enzyme inducers, corticosteroids, OCPs
β-blockers mask hypoglycemia

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What type of drug is Repaglinide?

Meglitinide (Insulin secretagogue)

This drug is used for rapid-acting insulin release.

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What is the mechanism of action of Repaglinide?

Rapid-acting insulin release via K+ channels

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What is the indication for Repaglinide?

Type 2 diabetes (meal-time control)

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What contraindications exist for Repaglinide?

Avoid use with sulfonylureas

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What are the side effects of Repaglinide?

Hypoglycemia
Weight gain
URTIs
Bronchitis
Headache

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What drug combinations can Repaglinide be used with?

Can combine with metformin or TZDs

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What type of drug is Pioglitazone?

Thiazolidinedione (Insulin sensitizer)

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What is the mechanism of action of Pioglitazone?

PPARγ agonist: ↑ insulin sensitivity, ↓ hepatic glucose output

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What are the indications for Pioglitazone?

Monotherapy or with metformin/SUs/insulin

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What contraindications exist for Pioglitazone?

Heart failure, history of cardiac ischemia

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What are the side effects of Pioglitazone?

Fluid retention
Weight gain
Anemia
↑ risk of CVD

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What are the drug interactions for Metformin?

Alcohol (↑ risk of lactic acidosis)

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What type of drug is Metformin?

Biguanide (Insulin sensitizer)

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What is the mechanism of action of Metformin?

↓ hepatic glucose production, ↑ insulin sensitivity, ↓ lipids

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What are the indications for Metformin?

First-line monotherapy or in combination

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What are the contraindications for Metformin?

Renal/hepatic impairment
Alcohol abuse
CHF
Severe infection

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What are the side effects of Metformin?

GI upset
Metallic taste
Lactic acidosis

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What type of drug is Acarbose?

α-Glucosidase Inhibitor

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What is the mechanism of action of Acarbose?

Inhibits intestinal CHO breakdown → ↓ glucose absorption

What are the indications for Acarbose?

Postprandial hyperglycemia

What are the contraindications for Acarbose?

IBD, GI obstruction, cirrhosis

What are the side effects of Acarbose?

GI disturbances, dose-dependent toxicity

What type of drugs are Sitagliptin, Vildagliptin, and Saxagliptin?

DPP-IV Inhibitors (Incretin enhancers)

What is the mechanism of action of DPP-IV Inhibitors?

Inhibit DPP-IV → ↑ GLP-1 → ↑ insulin, ↓ glucagon

What are the indications for DPP-IV Inhibitors?

Type 2 diabetes, combo with metformin/SUs/insulin

What are the contraindications for DPP-IV Inhibitors?

Caution in renal impairment

What are the side effects of DPP-IV Inhibitors?

* GI discomfort * Edema * Liver dysfunction

What type of drugs are Exenatide, Liraglutide, Semaglutide, and Dulaglutide?

GLP-1 Mimetics (Incretin mimetics)

What is the mechanism of action of GLP-1 Mimetics?

↑ insulin, ↓ glucagon, slow gastric emptying

What are the indications for GLP-1 Mimetics?

Type 2 diabetes (with possible weight loss and CV benefit)

What are the contraindications for GLP-1 Mimetics?

* Type 1 DM * DKA * Severe renal impairment * Pregnancy

What are the side effects of GLP-1 Mimetics?

* Nausea * Vomiting * Rash * Pancreatitis * Hypoglycemia

What type of drugs are Dapagliflozin, Canagliflozin, and Empagliflozin?

SGLT2 Inhibitors

What is the mechanism of action of SGLT2 Inhibitors?

Inhibit glucose reabsorption in kidney → ↑ urinary glucose loss

What are the indications for SGLT2 Inhibitors?

Type 2 diabetes

What are the contraindications for SGLT2 Inhibitors?

* Renal impairment * Pregnancy * Lactation

What are the side effects of SGLT2 Inhibitors?

* Genital/UTIs * Hypotension

What types of drugs are Lispro, Aspart, and Glulisine?

Ultra-fast acting insulin

What is the mechanism of action of Ultra-fast acting insulin?

Rapidly reduces blood glucose by promoting glucose uptake and storage, inhibiting glucagon, reducing lipolysis

What are the indications for Ultra-fast acting insulin?

Type 1 & 2 DM; preprandial use

What are the contraindications for Ultra-fast acting insulin?

Hypoglycaemia

What are the side effects of Ultra-fast acting insulin?

* Hypoglycaemia * Lipohypertrophy * Allergic skin reactions

What are the drug interactions for Ultra-fast acting insulin?

* Hyperglycaemic: glucocorticoids, estrogens, glucagon, diuretics * Hypoglycaemic: alcohol, salicylates, ACE inhibitors * Masks hypoglycaemia: β-blockers

What is the onset time for Ultra-fast acting insulin?

10–15 min

What is the peak time for Ultra-fast acting insulin?

45–90 min

What is the duration of action for Ultra-fast acting insulin?

3–5 hrs

What type of drug is Regular / Soluble / Human Insulin?

Short-acting insulin

What is the mechanism of action of Short-acting insulin?

Lowers blood glucose by promoting cellular uptake; used IV in emergencies

What are the indications for Short-acting insulin?

Type 1 & 2 DM; emergencies (IV)

What are the contraindications for Short-acting insulin?

Hypoglycaemia

What is the duration of action for Short-acting insulin?

6–8 hrs

What type of drug is NPH (Isophane)?

Intermediate-acting insulin

What is the mechanism of action of Intermediate-acting insulin?

Slower absorption due to crystal formation with zinc & protamine

What are the indications for Intermediate-acting insulin?

Type 1 & 2 DM; basal insulin

What is the duration of action for Intermediate-acting insulin?

18–20 hrs

What type of drug is Premixed/Biphasic insulin?

Mixed short + intermediate insulin

What is the mechanism of action of Premixed/Biphasic insulin?

Combines short-acting and intermediate-acting insulin actions

What are the indications for Premixed/Biphasic insulin?

Type 1 & 2 DM; twice daily regimens

What is the duration of action for Premixed/Biphasic insulin?

Up to 24 hrs

What type of drug are Glargine, Detemir, and Degludec?

Long-acting insulin

What is the mechanism of action of Long-acting insulin?

Sustained glucose-lowering via delayed absorption; maintains basal insulin levels

What are the indications for Long-acting insulin?

Type 1 & 2 DM; bedtime/basal regimens

What is the duration of action for Glargine?

24 h

What is the duration of action for Detemir?

20 h

What is the duration of action for Degludec?

>24 h

Diabetes Flashcards

(71 cards)