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Pharmacology 381 > Obesity and Diabetes > Flashcards

Obesity and Diabetes Flashcards

1
Q

Risks of obesity

A
  • Type 2 diabetes
  • Cardiovascular diseases
  • Osteoarthritis
  • Hormone dependent cancers
  • Respiratory problems
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2
Q

Types of Pharmacotherapy for obesity

A
  • Appetite suppressors
  • Lipase inhibitors
  • Antidiabetic
  • Combination preparations
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3
Q

Appetite suppressor drugs

A
  • Phentermine
  • Bupropion
  • Sibutramine
  • Amphetamine
  • Lorcaserin
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4
Q

MOA of appetite suppressor drugs

A

Mostly inhibit reuptake of noradrenaline. could also target serotonin or dopamine which are important in modulation of satiety signals by stimulation of hypothalamic satiety center in the brain

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5
Q

Adverse effects of appetite suppressors

A
  • Dry mouth
  • Insomnia
  • Increased HR and BP
  • Constipation
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6
Q

Contraindication of appetite suppressors

A
  • History of hypertension
  • Cardiovascular disease
  • Arrhythmia, heart failure, stroke
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7
Q

MOA of Lorcaserin and contraindication

A
  • selective 5-HT receptor agonist decreasing appetite
  • Serotonin syndrome, renal dysfunction
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8
Q

Lipase inhibitor

A

Orlistat

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9
Q

MOA of Orlistat and adverse effects

A
  • irreversibly binds to serine residues on gastric and pancreatic lipases, Prevents breakdown of dietary fats to fatty acid and glycerol
  • Oily spotting, flatulence with discharge, increased defecation
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10
Q

comment on the effects of Orlistant

A
  • interferes with absorption of fat soluble vitamins ADEK
    and with fetal development
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11
Q

Antidiabetic drugs

A

Metformin
Liraglutide

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12
Q

MOA of metformin

A

inhibits neuropeptide Y expression, reducing food intake and decreasing body weight

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13
Q

Adverse effects and contraindications of metformin

A
  • GI disturbances, anorexia, metallic taste
  • renal/hepatic insufficiency,
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14
Q

MOA of Liraglutide

A

Long-acting glucagon-like agonist, reduces gastric emptying, slowing the rate of nutrient absorption and reducing food intake

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15
Q

Adverse effects and contraindications of Liraglutide

A
  • Hypoglycaemia, nausea, diarrhoea, constipation, headaches, kidney failure and fatigue
  • pregnancy, gall bladder disease, thyroid abnormalities
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16
Q

Combination drugs

A
  • Phentermine+ Topiramate
  • Naltrexone
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17
Q

MOA of Phentermine and topiramate

A

-Phentermine: stimulant to counteract sedative effects of topiramate, and weight loss effects
- Topiramate anticonvulsant wit weight loss effects

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18
Q

Adverse effects of Phentermine and Topiramate and their contraindications

A

Topiramate: suicidal ideation, cognitive dysfunction
Phentermine: Increases HR
- Pregnancy, Hypertension, diabetes

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19
Q

MOA of naltrexone

A

is a u receptor antagonist, results appetite suppression

20
Q

Adverse effects and contraindication of naltrexone

A
  • nausea constipation, headache, dizziness, insomnia, dry mouth
  • Epilepsy, hypertension
21
Q

Metabolic disorders leading to diabetes

A
  • Deceased carbohydrate metabolism
  • Increased protein and lipid metabolism
22
Q

DM symptoms

A
  • Exceed renal glucose threshold
  • polyuria
  • dehydration (polydipsia)
  • amyotrophy
23
Q

DM associated complications

A
  • nephropathy
  • hypertension
  • peripheral neuropathy
  • Myocardial infarction
  • sorbitol-induced cataracts
24
Q

Insulin types

A

porcine
bovine

25
Q

Insulin plasma half-life

A

10 mins

26
Q

What is inulin combined with to aid glucose absorption and how does it help

A
  • pramlintide
  • slows down gastric emptying
27
Q

Short acting insulin types

A

-Insulin lispro
-Insulin aspart
- Insulin glulisine

28
Q

Intermediate acting insulin types

A
  • crystalline insulin zinc
  • Insulin isophane
29
Q

Long acting insulin

A
  • Insulin glargine
  • Insulin detemir
30
Q

Oral hypoglycaemics

A
  • Biguanides
  • Thiazolidinediones
  • sulfonylureas
  • alpha- glucosidase inhibitors
  • GLP-1 agonist
31
Q

Drug in biguanide class and its MOA

A
  • Metformin
  • Reduces hepatic glucose production, increases glucose uptake and utilization in skeletal muscle. Reducing LDL and VLDL. Prevents hyperglycaemia
32
Q

what do biguanides do and what are the adverse effects

A
  • Sensitizers: increase peripheral glucose uptake
  • anorexia, metallic taste
33
Q

Drug in class thiazolidinedione and its MOA

A
  • Pioglitazone
  • bind PPARG, leading to improved insulin sensitivity and beta cell function. Enhance fatty acid and glucose uptake
34
Q

Function of thiazolidinediones and their adverse effects

A
  • sensitizers: Increase peripheral glucose uptake
  • peripheral oedema, increased subcutaneous fat, water retention
35
Q

which thiazolidinediones were withdrawn and why

A
  • Troglitazone and Rosiglitazone
  • due to toxicity
36
Q

Drugs in class sulfonylureas and their MOA

A
  • Tolbutamide, tolazamide, chlorpropamide, acetohexamide
  • Bind to sulfonylurea receptor(Katp) on beta cell mem. Blocking Katp depolarizes cell mem, causing Ca2+ influx and insulin release. Maintaining high insulin, enhancing glucose uptake and reducing hepatic glucose production
37
Q

Function of sulfonylureas and their Adverse effects

A
  • Secretagogues: increase insulin secretion
  • Hypoglycaemia, weight gain, GI disturbances, jaundice, nausea
38
Q

Drugs in class meglitinides and their MOA

A
  • Repaglinide, nateglinide
  • short acting secretagogues acting on Katp channels. Taken before meals, increase Ca2+ influx increase insulin release. Maintaining high insulin levels and enhancing glucose uptake. But are less effective than sulfonylureas
39
Q

Adverse effects of meglitinides

A

Hypoglycaemia and weight gain

40
Q

Drugs in class alpha-glucosidase inhibitors and their MOA

A
  • Acarbose
  • Reversibly inhibits intestinal alpha-glucosidase, which is responsible for hydrolysis of oligosaccharides to glucose. This results in the delayed digestion of carbohydrates and starch in the small intestines
41
Q

Function and adverse effects of alpha-glucosidase inhibitors

A
  • delay carbohydrate digestion
  • fermentation of starch, leading to flatulence, diarrhoea
42
Q

Drugs in class SGLT2 and their MOA

A
  • Empagliflozin, Dapagliflozin
  • block re-uptake of glucose and sodium that has been filtered through the kidneys, Results in excess glucose and sodium excretion. good for hypertension
43
Q

Adverse effects of SGLT2

A
  • Urinary and genital infections
44
Q

Drug names in class Dipeptidyl peptidase inhibitors(DPP-IV) and their MOA

A
  • Sitagliptin, saxagliptin
  • inhibit DPP-IV. DPP-IV inactivated incretin hormones. Increased incretin inhibit glucagon and increase insulin decreasing gastric emptying and blood glucose
45
Q

Function and adverse effects of DPP-IV inhibitors

A
  • incretin mimetics
  • headache
  • contraindicated in pancreatic cancer, severe liver disease and heart disease
46
Q

Drugs in class glucagon-like peptide-1 and their MOA

A
  • Exenatide, Liraglutide
  • If glucose levels are elevated it increases insulin secretion and inhibits glucose release
47
Q

Function and adverse effects of GLP-1

A
  • Incretin mimetics
  • GI disturbances, diarrhoae, constipation, headache, dizziness

Pharmacology 381 (7 decks)

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