Pharmacology

Question 1

Example of a biguanide

Answer 1

Metformin

Question 2

Metformin - weight effects

Answer 2

Weight neutral

Question 3

Does Metformin cause hypos?

Answer 3

No hypos

Question 4

Side effects of Metformin

Answer 4

Lactic acidosis, GI disturbance

Question 5

Example of a SU

Answer 5

Glipizide, Glibenclamide

Question 6

Mechanism of action of SU

Answer 6

Blocks KATP channel = depol = Ca entry = insulin release

Question 7

Does SU cause hypos?

Answer 7

Yes

Question 8

SU - weight effects

Answer 8

Weight gain

Question 9

Side effects of SU

Answer 9

GI upset, cardio problems

Question 10

Example of a TZD

Answer 10

Pioglitazone

Question 11

Mechanism of action of TZD

Answer 11

Binds PPARgamma = binds DNA = transcription of insulin genes = increased insulin sensitivity

Question 12

Can TZDs cause hypos?

Answer 12

No

Question 13

TZD - weight effect

Answer 13

Weight gain (Na retention)

Question 14

Side effects of TZD

Answer 14

Worsens heart failure, liver problems, osteoporotic fractures, bladder cancer

Question 15

Example of a-glucosidase inhibitor

Answer 15

Acarbose

Question 16

Mechanism of action of acarbose

Answer 16

Delays carbs absorption (a-glucosidase is a brush border enzyme) = decreased postprandial glucose

Question 17

Does acarbose cause hypos?

Answer 17

No

Question 18

Acarbose - weight effects

Answer 18

Weight neutral

Question 19

Side effects of acarbose

Answer 19

Flatulence, diarrhoea, abdominal pain

Question 20

Example of DPP4 inhibitor

Answer 20

Sitagliptin, Linagliptin

Question 21

Mechanism of action of DPP4 inhibitor

Answer 21

Block DPP4 = upregulates GLP-1 and GIP = insulin release

Question 22

Do DPP4 inhibitors cause hypos?

Answer 22

No

Question 23

DPP4 - weight effects

Answer 23

Weight neutral

Question 24

Side effects of DPP4

Answer 24

Pancreatitis, pancreatic cancer, worsens HF

Question 25

Incretin/GLP-1 mimetic examples

Answer 25

Exenatide

Question 26

Mechanism of action of exenatide

Answer 26

Mimics GLP-1 = insulin release, decrease glucagon release, slows gastric emptying

Question 27

Can exenatide cause hypos?

Answer 27

Yes

Question 28

Exenatide - weight effects

Answer 28

Weight loss

Question 29

Side effects of exenatide

Answer 29

Pancreatitis, nausea

Question 30

Example of SGLT2 inhibitor

Answer 30

Dapagliflozin

Question 31

Mechanism of action of SGLT2 inhibitor

Answer 31

Binds SGLT2 in PCT = glucose in urine

Question 32

SGLT2 inhibitor side effects

Answer 32

Thrush, UTI

Question 33

ATP binds to what subunit?

Answer 33

Kir6.2 = closes K channel

Question 34

SU binds to what subunit?

Answer 34

SUR1 = opens K channel

Question 35

What binds SUR1 subunit?

Answer 35

SU and ADP/Mg

Question 36

What do GLP-1 and GIP do?

Answer 36

Released after eating, enhance insulin release, decrease glucagon release

Question 37

Hypos in SGLT2 inhibitors?

Answer 37

No

Question 38

SGLT2 inhibitor - weight effect

Answer 38

weight loss