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Misc. Notes Year 2 > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

(59 cards)

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1
Q

Name a biguanide

A

Metformin

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2
Q

How do biguanides work

A

Reduces hepatic gluconeogenesis by stimulating AMP-activated protein kinase (AMPK)

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3
Q

What is the first line drug in T2DM normally

A

Metformin

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4
Q

What is the first line drug in T2DM if there are osmotic symptoms present

A

Sulphonylurea (Gliclazide)

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5
Q

Does Metformin prevent Micro or Macro -vascular complications

A

Macro and Micro

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6
Q

What effect does Metformin have on weight

A

Metformin causes weight loss

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7
Q

Is there a risk of hypoglycaemia with Metformin

A

No

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8
Q

What GI symptoms can Metformin cause

A

Diarrhoea, nausea, anorexia

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9
Q

Which T2DM drug can rarely cause lactic acidosis

A

Metformin

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10
Q

Is Metformin insulin dependent or independent

A

Insulin-independent

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11
Q

Which drug Increases glucose uptake and utilization by skeletal muscle

A

Metformin

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12
Q

Is Metformin safe during pregnancy

A

Yes

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13
Q

What are the contraindications to prescribing Metformin

A

If eGFR < 30 or serum creatinine > 150

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14
Q

What is a first generation sulphonylurea

A

Tolbutamide

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15
Q

What are some 2nd generation sulphonylurea’s

A

Glicazide
Glibenclamide
Glimepiride

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16
Q

How do Sulphonylureas work

A

Bind to SUR1 subunits (displacing ADP-MG) to close the KATP channel causing depolarisation -> insulin release

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17
Q

Do Sulphonylureas prevent Micro or Macro -vascular complications

A

Micro only

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18
Q

What effect doe Sulphonylureas have on weight

A

Weight Gain

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19
Q

Is there a risk of hypoglycaemia with Sulphonylureas

A

Yes

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20
Q

What are some side effects of Sulphonylureas

A 
GI symptoms
A headache
Hypersensitivity
Blood dyscrasias
Liver dysfunction
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21
Q

Are Sulphonylureas insulin dependent or independent

A

Insulin Dependent

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22
Q

What are the contraindications to prescribing Sulphonylureas

A

Avoid in severe renal or hepatic failure

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23
Q

What type of drug is Pioglitazone

A

TZD (Thiazolidinedione)

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24
Q

How do TZD’s work

Study These Flashcards
A

Exogenous agonists of nuclear receptor PPARY (largely confined to adipocytes)
Decrease insulin resistance and reduce hepatic glucose output

25
Do TZD's prevent Micro or Macro -vascular complications
Neither
26
Do TZD's cause weight gain or loss
Weight Gain
27
What are some side effects of TZD's
Fluid Retention | Hepatotoxicity
28
Is there a risk of Hypoglycaemia with TZD's
No
29
Are TZD's insulin dependent or independent
Insulin-dependent
30
What are the contraindications to prescribing TZD's
Avoid in over 65's due to bone risk | Avoid in heart failure patients due to fluid retention
31
Give an example of an SGLT2 Inhibitor
Dapagliflozin
32
How do SLGT2i's work
Selectively block reabsorption of glucose by SGLT2 in proximal tubule of kidney _> deliberately causes glucosuria
33
Is there a risk of hypoglycaemia with SGLT2i's
Yes, very low risk
34
Do SGLT2i's cause weight gain or loss
Weight loss (calorific and osmotic diuresis effect)
35
What are some side effects of SGLT2i's
Thrush | Urine Infections
36
Are SGLT2i's insulin dependent or independent
Insulin-Independent
37
Are there any contra-indications to prescribing SGLT2i's
No
38
Give examples of GLP-1 receptor agonist
Exenatide | Liraglutide
39
How do GLP-1 receptor agonists work
Binds to GPCR GLP-1 receptors that increase intracellular cAMP of the pancreatic B cell
40
Do GLP1 receptor antagonists cause weight loss or gain
Weight loss and reduces hepatic fat accumulation
41
Is there a risk of hypoglycaemia with GLP-1 agonists
Yes
42
Are GLP-1 antagonists insulin dependent or independent
Insulin-dependent
43
Give some examples of DPP-IV inhibitors
"-Gliptins" Sitagliptin Saxigliptin Vildagliptin
44
How do DPP-IV inhibitors work
Competitively inhibit DPP-4 to prolong the action of GLP-1 and GIP
45
What effect do DPP-IV inhibitors have on weight
Weight Neutral
46
Is there a risk of hypoglycaemia with DPP-IV inhibitors
Yes
47
Give some side effects of DPP-IV inhibitors
Nausea Pancreatitis Pancreatic Cancer
48
Are DPP-IV inhibitors insulin dependent
Yes
49
Give an example of an a-glucosidase inhibitor
Acarbose
50
How do a-glucosidase inhibitors work
Inhibit a-glucosidase (a brush border enzyme that breaks down starch and disaccharides to absorbable glucose)
51
Is there a risk of hypoglycaemia with a-glucosidase inhibitors
No
52
What are some side effects of a-glucosidase inhibitors
flatulence, loose stool, diarrhoea, abdo pain, bloating
53
Are a-glucosidase inhibitors insulin dependent
No, they are insulin independent
54
If a patient is suffering from hypo's when on a sulphonylurea, what type of drug can they be switched to
Glinides (meglitinides)
55
Give some examples of Glinides (meglitinides)
Repaglinide | Nateglinide
56
How do Glinides work
Bind to SUR1 (at a distinct benzamido site) to close the KATP channel causing depolarisation --> insulin release
57
Is there a risk of Hypoglycaemia with Glinides
Yes but less likely to cause hypoglycaemia than SU’s as have rapid onset/offset kinetics
58
Are Glinides insulin dependent
Yes
59
What are the side effects of GLP-1 receptor agonists
Nausea Pancreatitis Pancreatic cancer

Misc. Notes Year 2 (30 decks)

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