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My Flashcards Year 2 > Endo- diabetes drugs > Flashcards

Endo- diabetes drugs Flashcards

(47 cards)

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1
Q

main treatment for T1DM

A

insulin

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2
Q

insulin basal-bolus regimen

A

Long-acting insulin 1-2 times a day and short-acting insulin before each meal

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3
Q

when do short acting soluble insulins reach their peak

A

2-4 hours after injection

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4
Q

short acting soluble insulins examples

A

actrapid
humulin S

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5
Q

when do short acting insulin analogues reach their peak

A

60-90 mins after injection

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6
Q

short acting insulin analogues examples

A

insulin aspart (NovoRapid)
lispro (Humalog)
glulisine (apidra)

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7
Q

what short acting insulins are preferred- soluble/analogues

A

analogues- disappear from circulation more rapidly

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8
Q

when do isophane basal insulins reach their peak

A

4-6 hours

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9
Q

when do analogue basal insulins reach their peak

A

longer duration of action with less peak activity and may be given once or twice daily

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10
Q

isophane basal insulins examples

A

insulatart
humulin

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11
Q

analogue basal insulin examples

A

Lantus (glargine)
Levemir (dertermir)

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12
Q

why should injection site be rotated when injecting insulin

A

to prevent lipohyperthrophy

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13
Q

adverse effect of insulin

A

weight gain
risk of hypoglycaemia

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14
Q

first line medication in T2DM

A

biguanide (metformin)

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15
Q

metformin has a CVS benefit true/false

A

true

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16
Q

when is metformin contraindicated

A

in renal impairment, heart failure, and hepatic failure because of the risk of lactic acidosis

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17
Q

adverse effects of metformin

A

GI- anorexia, nausea, abdominal pain, diarrhoea
lactic acidosis

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18
Q

Sulphonylureas example

A

gliclazide

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19
Q

alternative first line medication in T2DM where cost is a major issue

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A

Sulphonylureas

20
Q

mechanism of action of Sulphonylureas

Study These Flashcards
A

bind to the Sulphonylurea receptor of beta cells, which closes ATPase K+ channels, resulting in influx of Ca2+, which stimulates insulin release

21
Q

adverse effects of Sulphonylureas

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A

weight gain
hypoglycaemia

22
Q

what is the only TZDs currently available

23
Q

follow on to metformin where cost is a major issue

24
Q

avoid TZDs in which patients

Study These Flashcards
A

> 65 due to side effects

25
TZDs are particularly potent in which patients
obese women
26
adverse effects of TZDs
weight gain > risk of fracture mild anaemia
27
which diabetic drug is associated with fluid retention
TZDs
28
examples of GLP-1 receptor antagonists
liraglutide semaglutide
29
diabetic patients with atherosclerotic CVD should be given
metformin + GLP-1 receptor antagonist
30
diabetic patients with heart failure or chronic kidney disease should be given
metformin + SGLT2i
31
diabetic patients with heart failure or chronic kidney disease where SGLTi are contraindicated
metformin + GLP-1 receptor antagonist
32
non glucose effects of GLP-1 receptor antagonists
reduce appetite lower blood pressure < CVS risk
33
when are GLP-1 receptor antagonists contraindicated
in patients with a history of acute pancreatitis
34
adverse effects of GLP-1 receptor antagonists
GI- bloating, nausea, vomiting, diarrhoea small increase in incidence of gallstones
35
is there is a risk of hypo with GLP-1 receptor antagonists
no
36
examples of DPP4 inhibitors
sitagliptin alogliptin saxagliptin
37
main indications of DPP4 inhibitors
most effective in early stages of T2DM can be used as mono therapy where metformin is contraindicated, or as an add on
38
non glucose effect of DPP4 inhibitors
lowers blood pressure
39
adverse effects of DPP4 inhibitors
> risk of acute pancreatitis nausea weight neutral
40
is there a risk of hypo with DPP4 inhibitors
no
41
examples of SGLT2i
empagliflozin dapagliflozin canagliflozin
42
when should you use SGLT2i with caution
in patients already on a diuretic
43
adverse effects of SGLT2i
genital candiasis hypovolaemia and hypotension dehydration DKA slight increase in LDL and HDL cholesterol
44
which class of diabetic drugs increase the risk of UTIs
SGLT2i
45
which diabetic drug reduces hepatic gluconeogenesis
metformin
46
mechanism of action of metformin
reduces hepatic glucose production (gluconeogenesis) increased gut glucose utilisation and metabolism
47
which drug used in the treatment of T2DM works by inhibiting a brush border enzyme in the small intestine responsible for the absorption of disaccharrides
alpha-glucosidase inhibitor eg acarbose

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