Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPT > Insulin and diabetes drugs > Flashcards

Insulin and diabetes drugs Flashcards

1
Q

insulin MoA

A

lowers blood glucose by stimulating peripheral glucose uptake primarily by skeletal muscle cells and fat, and by inhibiting glucose production and release by the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

insulin adverse effects

A

hypoglycemia

lipodystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

insulin contradictions

A

renal impairment

patients at risk of hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

insulin drug interactions

A
  • Dose needs increasing with systemic steroids

- Caution with other hypoglycaemic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

name a biguinide

A

metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

biguinide MOA

A

↓hepatic glucose production by inhibiting gluconeogenesis; some gluconeogenic activity remains so hypoglycaemia risk reduced

Supress appetite so limit weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

biguinide adverse effects

A

GI upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

biguinide contradictions

A
  • Excreted unchanged by kidneys so stop if eGFR < 30 mL/min

- Alcohol intoxication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

biguinide drug interactions

A
  • ACEi, diuretics, NSAIDs (drugs that may impair renal function)
  • Loop and thiazide like diuretics ↑glucose so can reduce metformin action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

name a sulfonylurea

A

gliclazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

sulfonylurea MoA

A

Stimulate β-cell pancreatic insulin secretion blocking ATP-dependant K+ channels

Need residual pancreatic function to work; weight gain through anabolic effects of insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

sulfonylurea adverse effects

A
  • Mild GI upset – nausea, vomiting, diarrhoea

- Hypoglycaemia (works at low [glucose])

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

sulfonylurea contradictions

A
  • Renal and hepatic disease

- Caution for people at risk of hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

sulfonylurea drug interactions

A
  • Other hypoglycaemic agents

- Loop and thiazide like diuretics ↑glucose so can reduce SU action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

name 2 thiazolidinedione (glitazones)

A

Pioglitazone, rosiglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Glitazone MoA

A

Insulin sensitisation in muscle and adipose, ↓hepatic glucose output by activation of PPAR-γ

t1/2 not related to duration of action – 6-8 weeks for benefit; used much less frequently than other agents

Weight gain because of fat cell differentiation

17
Q

glitazone adverse effects

A
  • GI upset, fluid retention
  • Fracture risk
  • Bladder cancer
18
Q

glitazone contradictions

A

Heart failure due to fluid retention

19
Q

glitazone drug interactions

A

other hypoglycaemic drugs

20
Q

name 2 SGLT-2 inhibitors (gliflozins)

A

Dapagliflozin, canagliflozin

21
Q

gliflozin MoA

A

↓↓glucose absorption from tubular filtrate, ↑urinary glucose excretion

Competitive reversible inhibition of SGLT-2 in PCT

Modest weight loss, hypoglycaemic risk is low; used in TIIDM as add on therapy

22
Q

gliflozin adverse effects

A
  • UTI and genital infections

- Thirst and polyuria

23
Q

gliflozin contradictions

A

Hypovolaemia - possibly hypotension

24
Q

gliflozin drug interactions

A
  • Antihypertensive

- other hypoglycaemic agents

25
Q

name 2 DPP-4 inhibitors (gliptins)

A

Sitagliptin, saxagliptin

26
Q

gliptin MoA

A

Prevent incretin degradation - ↑[incretin] levels

Glucose dependant so postprandial action; doesn’t stimulate insulin secretion at normal blood glucose – lower hypoglycaemic risk

Supress appetite

27
Q

gliptin adverse effects

A
  • GI upset

- small pancreatitis risk

28
Q

gliptin contradictions

A
  • Avoid in pregnancy

- History of pancreatitis

29
Q

gliptin drug interactions

A
  • other hypoglycaemic agents

- drugs ↑glucose can oppose gliptin action – thiazide like and loop diuretics

30
Q

name 2 GLP-1 receptor agonists (incretin mimics)

A

Exenatide

liraglutide

31
Q

GLP-1 receptor agonists MoA

A

↑glucose dependant synthesis of insulin secretion from β-cells; activate GLP-1 receptor – resistant to degradation by DPP-4

Given by subcutaneous injection; promotes satiety

NICE suggest add-on if triple therapy ineffective

32
Q

GLP-1 receptor agonists adverse effects

A

GI upset, decreased appetite with weight loss

33
Q

GLP-1 receptor agonists contradictions

A

Renal impairment

34
Q

GLP-1 receptor agonists drug interactions

A

other hypoglycaemic agents

CPT (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions