Oral Hypoglycemics

Question 1

What is the mechanism of action for Metformin?

Answer 1

• Increases glucose uptake and utilisation by skeletal muscle
• Reduces hepatic glucose production
• Reduces low-density lipoprotein and Very-Low density lipoproteins

Question 2

What are side effects for Metformin?

Answer 2

• GI upset: anorexia, diarrhea, nausea
• Weight loss
• Lactic Acidosis
• Impaired Vitamin B12 absorption

Question 3

What are the precautions for Metformin?

Answer 3

Renal failure, hepatic failure, shock, alcohol abuse, surgery, dehydration, mod-sev heart failure or hypoxic pulmonary disease

Question 4

What is the mechanism of action for Sulphonylureas?

Answer 4

• Stimulate insulin release from the beta cells of the pancreas by binding to the sulfonylurea receptor
• May decrease insulin resistance

Question 5

What are the side effects of Sulphonylureas?

Answer 5

• Hypoglycemia
• Weight gain

Question 6

What are the mechanisms of action of Incretin enhancers and mimetics ?

Answer 6

• Acts on GI derived peptides (incretin hormones) which are secreted following a meal
• Incretin hormones stimulate pancreatic insulin secretion and inhibit glucagon release

Question 7

What are the side effects of incretin mimetics?

Answer 7

Weight loss, nausea, vomiting, diarrhoea and hypoglycaemia

Question 8

What is the MOA of Glitazones (Rosiglitazone & Pioglitazone?)

Answer 8

• Agonists for peroxisome proliferator-activated receptor- gamma a transcription factor which activates insulin-responsive genes that regulate carbohydrate and lipid metabolism
• This improves insulin sensitivity at key sites where insulin resistance occurs

Question 9

What is the MOA of Alpha-glucosidase inhibitors (Acarbose)?

Answer 9

• Delays intestinal absorption of carbohydrates by inhibiting alpha-glucosidase enzymes in the small intestine

Question 10

What are the side effects of alpha-glucosidase inhibitors?

Answer 10

Flatulence, diarrhoea, abdominal pain and distension