Diabetic Medications Flashcards
(24 cards)
What is the mechanism of action of SGLT-2 inhibitors?
They block sodium-glucose cotransporter-2 in the proximal renal tubule, reducing glucose and sodium reabsorption and promoting glucosuria.
What are common adverse effects of SGLT-2 inhibitors?
Genital candidiasis, urinary tract infections, and polyuria due to osmotic diuresis.
What is a contraindication for DPP-4 inhibitors and GLP-1 receptor agonists in diabetic patients?
They should not be used in patients with diabetes and pancreatitis.
What hypersensitivity reactions are associated with DPP-4 inhibitors and GLP-1 receptor agonists?
Angioedema and other hypersensitivity reactions.
What is the mechanism of action of metformin?
Inhibits mitochondrial glycerol-3-phosphate dehydrogenase, reducing hepatic gluconeogenesis and increasing insulin sensitivity.
What serious metabolic complication is associated with metformin?
Lactic acidosis, especially in patients with renal impairment or conditions reducing lactate clearance.
What are adverse effects of metformin?
GI upset, lactic acidosis (especially in renal insufficiency), vitamin B12 deficiency, and weight loss.
What GI side effects are commonly associated with metformin?
Flatulence and diarrhea.
Which diabetic medications are associated with the incretin effect?
GLP-1 receptor agonists.
What is the mechanism of action of pioglitazone?
Activates PPAR-γ, increasing insulin sensitivity and adiponectin levels, and regulating glucose metabolism and fat storage.
What are the adverse effects of pioglitazone?
Weight gain, edema, heart failure, increased risk of fractures, and delayed onset of action.
What is the mechanism of action of sulfonylureas?
Close potassium channels in pancreatic beta cells, causing depolarization and calcium influx, which increases insulin release.
What are the adverse effects of sulfonylureas?
Hypoglycemia (especially in renal insufficiency), weight gain, and disulfiram-like reaction with first-generation agents.
What is the mechanism of action of meglitinides (e.g. nateglinide, repaglinide)?
Stimulate insulin release by binding to a different site than sulfonylureas on the beta-cell potassium channels.
What are the adverse effects of meglitinides?
Hypoglycemia and weight gain.
What is the mechanism of action of GLP-1 analogs?
Decrease glucagon release, decrease gastric emptying, and increase glucose-dependent insulin release.
What are adverse effects of GLP-1 analogs?
Nausea, vomiting, pancreatitis, and weight loss.
What is the mechanism of action of DPP-4 inhibitors?
Inhibit the DPP-4 enzyme that inactivates GLP-1, increasing glucose-dependent insulin release and decreasing glucagon and gastric emptying.
What are adverse effects of DPP-4 inhibitors?
Respiratory and urinary infections, and they are weight neutral.
What is the mechanism of action of α-glucosidase inhibitors?
Inhibit intestinal brush-border α-glucosidases, delaying carbohydrate hydrolysis and glucose absorption.
What are adverse effects of α-glucosidase inhibitors?
GI upset and bloating. Not recommended in renal insufficiency.
What is the mechanism of action of amylin analogs like pramlintide?
Decrease glucagon release and gastric emptying.
What are the adverse effects of amylin analogs?
Hypoglycemia, nausea, and increased satiety.
