OHGs 1

Question 1

Metformin

Answer 1

Class: biguanide
MOA: decrease gluconeogenesis from liver
Indications: T2DM, PCOS
Contraindications: eGFR <30, CLD
AEs: GI, rash, lactic acidosis

Question 2

Gliptins

Answer 2

Class: DPP-4
MOA: decrease inactivation GLP-1 -> stimulates beta cell insulin release
Indications: T2DM
Contraindications: pancreatitis, HF 2’ to saxagliptin
AEs: nasopharyngitis (resolve 10-14d), rash, pancreatitis, GI

Question 3

Flozins

Answer 3

Class: SGLT-2 inhibitors
MOA: inhibit Na-glucose transporter, induce urinary glucose excretion
Indications: T2DM, HF, CKD
Contraindications: eGFR <45 (or <25 for alternative effects)
AEs: dehydration, dizziness, UTIs, ketoacidosis, weight loss

Question 4

Glutides

Answer 4

Class: GLP-1 receptor agnoists
MOA: stimulates beta cells in pancreas + slows gastric emptying
Indications: diabetes, obesity
Contraindications:
AEs: diabetic retinopathy, GI, pancreatitis, cholecystitis

Question 5

Glitazones

Answer 5

Class: thiazolidinediones
MOA: increases insulin sensitivity - transcription factor proxisome proliferator-activated receptor gamma agonist
Indications: T2DM
Contraindications: T1DM (A), ketoacidosis (A), sulfonylurea/insulin (R) (increased risk hypo + HF), osteoporosis (R), bladder ca (R), HF (R) (NYHA II-IV), CLD (R), pregnancy, breastfeeding
AEs: fluid overload, weight gain, headaches/mylagias, DILI