Lecture 1-16

Question 1

Indications (Uses) of SGLT2 Inhibitors

Answer 1

H: Heart failure (especially HFpEF & HFrEF)
E: End-organ protection (reduces cardiovascular risk)
A: Atherosclerosis risk reduction
R: Renal protection (used in chronic kidney disease - CKD)
T: Type 2 Diabetes Mellitus (T2DM) (lowers blood glucose)
📌 Example drugs: Empagliflozin, Dapagliflozin, Canagliflozin

Question 2

Side Effects of SGLT2 Inhibitors

Answer 2

“SGLT2 PEE” (💧 think glucose in urine!)

S: Severe urinary tract infections (UTI) & genital infections (due to sugar in urine)
G: Gangrene (rare: Fournier’s gangrene – necrotizing fasciitis of perineum)
L: Low blood pressure (hypotension) (due to diuretic effect)
T: Thirst & dehydration (osmotic diuresis)
2: Two-kidney issues (worsening of acute kidney injury in some cases)
P: Polyuria (frequent urination)
E: Euglycemic ketoacidosis (rare but life-threatening)
E: Electrolyte imbalances (hyperkalemia/hyponatremia)

Question 3

SGLT 2 Contraindications

Answer 3

“DRAIN KIDNEYS”

D: DKA (Diabetic Ketoacidosis) (can cause euglycemic ketoacidosis)
R: Renal failure (Severe CKD, eGFR < 30 ml/min)
A: Acute infections (UTIs, genital infections)
I: Immunocompromised patients (risk of Fournier’s gangrene)
N: Not for Type 1 Diabetes (risk of ketoacidosis)
K: Kidney dysfunction due to dehydration (hypotension risk)

Question 4

Drug-Drug Interactions

Answer 4

“SGLT2-WARN”

S: Sulfonylureas & Insulin → Increased hypoglycemia risk
G: Glucocorticoids → Opposing effect (raises blood sugar)
L: Loop diuretics → Increased dehydration & hypotension
T: Thiazides → Further electrolyte imbalances
2: Two blood pressure meds (ACE inhibitors, ARBs) → Risk of low BP & AKI
W: Warfarin → Potential increased bleeding risk
A: Aminoglycosides → Kidney toxicity
R: Rifampin → Decreases SGLT2 drug effect (via CYP enzyme induction)
N: NSAIDs → Kidney injury risk