Diabetes drugs tutorial Flashcards

(47 cards)

1
Q

what is an acceptable eGFR

A

60 and above

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2
Q

when should diabetics (T2) go on statins

A

when 40 (or younger if have cardiovascular problems)

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3
Q

how should dosage of metformin be adjusted as renal function decreases

A

should also be decreased

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4
Q

what level of eGFR should metformin be stopped

A

30

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5
Q

what does monocular vision cause

A

loss of vision depth

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6
Q

what must vision be to drive

A

better than 6/12 in one eye

must have 120 degrees of arc vision

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7
Q

I’ve woken up in the morning vomiting – I can’t keep anything down. Should I stop my insulin? I’m on Novomix30, 26 units, twice daily. Concern is DKA

A

Keep going with insulin, insulin requirement increases when your unwell

try and take carbs

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8
Q

what is the advice for T1DM and alcohol

A

Can drink just need to be careful, avoid drinks with high sugar content. Risk is hypoglycaemia , often later in the night as alcohol blocks the release of sugar from the liver.

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9
Q

can SUs cause hypos

A

yes

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10
Q

how do SUs affect weight

A

cause gain via appetite increase

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11
Q

do SUs need functioning B cells to work

A

yes

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12
Q

name the only biguanide

A

metformin

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13
Q

what are the roles of metformin

A

reduces hepatic gluconeogenesis
increases glucose uptake in skeletal muscle
reduces carb absorption
increases fatty acid oxidation

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14
Q

does metformin cause hypos

A

no

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15
Q

what are the most common SEs of metformin

A

anorexia, diarrhoea, nausea

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16
Q

why should metformin not be given to patients with renal or hepatic disease

A

as might cause lactic acidosis

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17
Q

what can metformin be combined with

A

SUs, insulin, glitazones

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18
Q

what are glitazones

A

thiazolidinediones (TZDs)

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19
Q

what do TZDs bind to and where

A

PPARgamma

in liver, adipose tissue and skeletal muscle

20
Q

what is the role of TZDs

A

increase lipogenesis,

enhanced uptake of fatty acids and glucose

21
Q

what are the most common side effects of TZDs

A

weight gain and fluid retention

22
Q

why are TZDs contraindicated in patients with heart problems

A

as SE of fluid retention can exacerbate heart failure

23
Q

what do TZDs double the risk of

24
Q

what releases GLP1

A

L cells throughout ileum and colon

25
what does GLP1 do
when released stimulates insulin
26
what is exenatie
GLP1 receptor agonist
27
what is the action of GLP1 RAs
increase insulin secretion suppresses glucagon secretion slows gastric emptying
28
how do GLP1 RAs affect weight
causes loss
29
can GLP1 RAs cause hypos
yes
30
how are GLP1 RAs administered
injected before first and last meals of the day
31
what releases GIP
K cells in duodenum and proximal jejnum
32
what does DPP4 do
inhibits GIP and GLP1 - stops the release of insulin
33
what do DPP4 inhibitors do
competitively inhibit DDP4 = lowing blood sugar
34
how do DPP4 inhibitors affect weight
are weight neutral
35
how does metformin affect weight
causes weight loss
36
how much do oral agents lower HbA1c
by 1-2%
37
how does insulin affect weight
causes gain
38
when would you use a GLP1 analogue
if patients are very overweight
39
what drug is being used less and less
TZDs, should be low on the list when prescribing
40
what is the max metformin dose
3g in 24 hrs
41
should you give GLP1s in pregnancy
no
42
should you give TZDs in pregnancy
no
43
is metformin okay in pregnancy
yes
44
can you give SUs in pregnancy
no
45
should you give DPP4 agonists in pregnancy
no
46
is insulin okay in pregnancy
yes
47
what should expecting mothers with poor glycaemic control on metformin switch to
insulin therapy