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Flashcards in Drugs Deck (13):
1

Effect of metformin

Decrease gluconeogenesis in liver
Decrease glucotoxicity which:
increases absorption in skeletal muscles
Increases sensitivity to insulin

2

Side effects of metformin

Weight loss
GI SE (bloating, constipation etc.)

3

Cautions for metformin

If patient has renal impairment
Or
Hepatic impairement
Increased risk of lactate acidosis

4

Contra-Indication for metformin

Ketoacidosis
General anaesthesia

5

Dosage of Metformin

500mg with breakfast for at least 1 week
Gradually increase for 10-15 days up to max 2g
Can be split BD if BM not controlled by OD.

6

Mode of action of sulfonylureas

Attached to ATP sensitive K+ channel
Upon binding of SU to the receptor there is an influx of K through the K channel and depolarisation
Results in influx of Ca
Stimulates release of insulin in vesicles

7

Examples of sulfonylureas

Glyburide (DiaBeta, Glynase)
Glipizide (Glucotrol)
Glimepiride (Amaryl)

8

Side effects of SUs

Hypoglycaemia
Weight gain

9

Contra-indication of SU

Ketoacidosis
Avoid in:
Overweight patients
Pregnancy or breast feeding (neonatal/ infant hypoglycaemia)

10

Mode of action of meglitinides

Bind to SUR1 similar to SU but with a much weaker affinity. Mechanism same as SU. Faster acting and side effects similar to SU

11

Example of meglitinide

Nateglinide

12

Dosage of meglitinide

Always use in conjunct with metformin

Nateglinide: Initially 60mg TD (max 180mg). Increase according to response. Taken 30 minutes before meals

Repaglinide. 500ug (max 4mg) Taken 30 minutes before main meals. Max 16mg a day.

13

Mode of action of DDP-4i

Inhibits dipeptidyl peptidase-4 from breaking down incretin (GLP-1, GIP)