Hypoglycaemics

Question 1

What is Insulin? Name its drug class, indication, and mechanism of action.

Answer 1

Insulin is a hypoglycaemic used for hypoglycaemic. Its mechanism of action is reduces blood glucose levels.

Question 2

What is Glipizide? Name its drug class, indication, and mechanism of action.

Answer 2

Glipizide is a sulfonylurea (insulin secretagogue) used for T2D. Its mechanism of action is stimulates pancrease to release more insulin regardless of blood sugar levels

Question 3

What is Repaglinide? Name its drug class, indication, and mechanism of action.

Answer 3

Repaglinide is a meglitinide (insulin secretagogue) used for type 2 diabetes mellitus. Its mechanism of action is stimulates pancreas to release more insulin release

Question 4

What is Metformin? Name its drug class, indication, and mechanism of action.

Answer 4

Metformin is a biguanide used for T2D; activates AMPK (AMP-activated protein kinase)= this decreases liver gluconeogenesis= increases peripheral glucose uptake

Question 5

What is Rosiglitazone? Name its drug class, indication, and mechanism of action.

Answer 5

Rosiglitazone is a glitazone (in the thiazolidinediones class) used for type 2 diabetes mellitus. Its mechanism of action is improves insulin action (insulin sensitiser).

Question 6

Sitagliptin, saxagliptin, linagliptin, and alogliptin

Answer 6

DPP-4 inhibitors (incretin-based therapies)= inhibit DPP-4 enzyme breakdown of GLP-; increasing insulin and decreasing glucagon

Question 7

Semaglutide (ozempic), Liraglutide, Tirzepatide (Mounjaro), Exendin-4 (comes from lizard lol)

Answer 7

These are all GLP-1 agonists; mimic effects of GLP-1 to increase insulin, decrease glucagon + slow gastric emptying + increase satiety

n.b. liraglutide can cause thyroid cancer!

Question 8

Explain the MOA of glucose excretion drugs (SGLT2 inhibitors); their risks, most common SE

Answer 8

e.g. empagliflozin, ertugliflozin, canagliflozin, farxiga, invokana

class: Sodium-glucose cotransporter 2 (SGLT2) inhibitors

mechanism: blocks glucose reabsorption in kidneys, leading to glucose excretion in urine

risk: genital infections, UTIs, DKA

SE: increase urination, thirst + weight loss

Question 9

Explain the MOA of carbohydrate absorption modulators (alpha-glucosidase inhibitors); their risks, most common SE + additional info

Answer 9

e.g. miglitol, acarbose, volgibose

class: carbohydrate absorption inhibitors

MOA; competitive inhibitors of alpha-glucosidase enzyme in intestine that breaks down carbs= delaying glucose absorption

SE; GI distress, gas

n.b. taken with meals but less commonly used due to GI SEs

Question 10

Explain the MOA of bile acid sequesterants; their risks, most common SE + additional info

Answer 10

e.g. colesevelam, colestipol, cholestyramine

MOA; lowers LDL, binds to bile acids in intestine= decreases glucose production in liver + improves insulin sensitivity

SEs; (common) constipation, nausea + abdominal discomfort