Diabetic Drugs

Question 1

Name 3 drugs which increase insulin secretion.

Answer 1

SUs
GLP-1 agonists
DPP-4i

Question 2

Name 2 drugs which increase insulin sensitivity.

Answer 2

Metformin

Pioglitazone

Question 3

Name a drug which blocks glucose resorption in the kidneys.

Answer 3

SGLTi

Question 4

What is the first line treatment of T2DM + drug class?

Answer 4

Metformin

Biguanide

Question 5

Name 2 actions of metformin + proposed molecule it stimulates.

Answer 5

Increases insulin sensitivity
Decreases gluconeogenesis
AMPK

Question 6

What is the effect on metformin on weight, vascular complications, lipids and risk of hypoglycaemia?

Answer 6

Weight loss
Reduces vascular complications
Lowers lipids
No hypoglycaemic risk

Question 7

Name 3 side effects of metformin + CIs.

Answer 7

GI disturbance
Lactic acidosis
Rash
CI in hepatic/renal disease

Question 8

Name 3 SUs.

Answer 8

Tolbutamide
Gliclazide
Glipizide

Question 9

Which SU reduced microvascular complications?

Answer 9

Glipizide

Question 10

SUs are quicker to resolve hyperglycemia than metformin. True or False?

Answer 10

True

Question 11

How is insulin released then stopped from release from the pancreatic beta cells?

Answer 11

ATP binds to Kir6.1 subunit of KATP channel
Depolarisation causing Ca channel opening
Vesicles bind to cell membrane and release insulin
ADP-MG2+ binds SUR1 subunit of KATP channel to cause closure

Question 12

How do SUs work?

Answer 12

Displace ADP-Mg2+ from SUR1 to close KATP

Question 13

What is the effect of SUs on weight, vascular complications and risk of hypoglycaemia?

Answer 13

Weight gain
No vascular complication reduction
Hypoglycaemia

Question 14

Name 3 groups in which SUs should not be given and why?

Answer 14

Hepatic/renal disease
Elderly
Pregnant
Hypoglycaemia risk

Question 15

Name 2 side effects of SUs.

Answer 15

Hypoglycaemia

SIADH

Question 16

Name a DPP-4i and explain how it works.

Answer 16

Alogliptin

Blocks DPP-4 enzyme which inhibits incretins from stimulating insulin release

Question 17

What is the effect of DPP-4i on weight?

Answer 17

Weight neutral

Question 18

Give 2 examples of incretins + relevance to BG?

Answer 18

GLP-1 and GIP
Increase insulin production
Reduce gluconeogenesis

Question 19

Name a GLP-1 agonists and explain how it works.

Answer 19

Liraglutide

Mimics GLP-1 by decreasing glucagon release and resists DPP-4 breakdown

Question 20

What are 2 benefits of GLP-1 agonists?

Answer 20

Weight loss

Reduced CVD risk

Question 21

Name a rare side effect of GLP-1 agonists?

Answer 21

Pancreatitis

Question 22

What is the only thiazolidinedione used in T2DM treatment and how does it work?

Answer 22

Pioglitazone

Forms a PPARgamma-RXR TF for insulin signalling to increase sensitvity

Question 23

Name 3 side effects of pioglitazone and 3 conditions it can’t be used in.

Answer 23

Weight gain
Fluid retention
Fractures
Oedema, HF and osteoporosis

Question 24

Name a SGLT2i and explain how it works + effect.

Answer 24

Dapagliflozin
Blocks SGLT2 glucose resorption channel in kidney
Glucosuria

Question 25

What is the effect of SGLTi on weight, hypoglycaemia risk and CVD risk?

Answer 25

Weight loss
Hypoglycaemia
Reduced CVD risk

Question 26

Name 2 side effects of SGLTI?

Answer 26

Hypoglycaemia

UTI

Question 27

Which SGLTi is best for renal disease?

Answer 27

Empagliflozin

Question 28

Name 2 examples of rapid insulin.

Answer 28

NovoRapid (aspart)

Humalog (lispro)

Question 29

Name 2 examples of long-acting insulin.

Answer 29

Lantus (glargine)

Levemir (determir)

Question 30

Name an example of a short soluble insulin.

Answer 30

Humulin S

Question 32

Name an intermediate acting SC insulin.

Answer 32

Humulin I

Question 32

Name 2 rapid mix and 1 short mix insulin.

Answer 32

Humalog Mix and Novomix

Humulin M3