Mechanisms of T2 DM drugs Flashcards Preview

Endocrine Week 2 2017/18 > Mechanisms of T2 DM drugs > Flashcards

Flashcards in Mechanisms of T2 DM drugs Deck (18)
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1

How does metformin work?

Reduces hepatic gluconeogenesis

Increases peripheral uptake of glucose

Decreases carbohydrate absorption

Increases fatty acid oxidation

2

Sulphonylureas are known as insulin ___.

secretagogues

3

What effect do sulphonylureas have?

Insulin secretion by beta cells

4

How do sulphonylureas cause insulin secretion by beta cells?

Displace ADP-Mg2from SUR1 subunit of KATP channel, causing it to close

Depolarisation

Opening of Ca2+ channels and influx of Ca2+

Insulin secretion

5

Sulphonylurea action is (dependent on / independent of) glucose concentration.

independent of glucose concentration

This is why they can cause hypoglycaemia

6

What do TZDs cause?

Increased fatty acid uptake by adipocytes

Reduced hepatic gluconeogenesis (similar to metformin)

7

How do TZDs work?

Binds to PPAR-γ​ nuclear receptor in adipocytes / hepatocytes

Affecting gene expression for fatty acid uptake and gluconeogenesis

8

GLP-1 agonists imitate what general type of hormone?

Incretins

9

Where is GLP-1 normally secreted from?

L cells in the ileum

10

What effects do incretins normally cause?

Increased insulin secretion by beta cells

Decreased glucagon secretion by alpha cells

Reduced gastric emptying

Reduced appetite

11

What effects do GLP-1 agonists cause?

Increased insulin secretion by beta cells

Decreased glucagon secretion by alpha cells

Reduced gastric emptying

Reduced appetite

12

What is DPP-4?

Enzyme which breaks down incretins

13

How do DPP-4 antagonists work?

Competitively inhibit DPP-4, allowing incretins to act for longer, producing:

Increased insulin secretion by beta cells

Decreased glucagon secretion by alpha cells

Reduced gastric emptying

Reduced appetite

14

What is SGLT2?

Where is it found?

Sodium-glucose linked transporter 2

Proximal tubules of kidney

15

What are the differences between SGLT1 and SGLT2?

SGLT1 found in GI tract, SGLT2 found in proximal tubules

16

How does SGLT2 work?

Actively transports 3 Naout

Then uses that energy to transport the 3 Naand one glucose molecule in (causing glucose reabsorption)

17

How do SGLT2 inhibitors work?

What renal sign do they produce?

Block SGLT2 transporter, decrease glucose reabsorption

Glycosuria

18

How does insulin work?

Increases uptake of glucose into cells

Liver and skeletal muscle cells - glycogen

Adipocytes - triglycerides