Pharmacology - Treatment of Diabetes 3 Flashcards
-gliflozin
SGLT2 inhibitors
inhibit glucose absorption by bocking sglt2 sodium glucose cotransporter
where is SGLT2 highly expressed
a.PCT
b.DCT
c.loop of henle
a.PCT
what effect do sglt 2 inhibitors have on the renal threshold for glucose
a. increase
b.decrease
a. increase
promote excretion of glucose in the urine
what line are sglt2 inhibitors in diabtetes treatment
a. 1
b.2
c.3
b.2
add on therapy
loss of calories and weight loss associated so good for cvd
what type of infection has increased risk when taking sglt2 inhibitors
a.chest infection
b. uti
c. sepsis
b. uti
due to polyuria
which of these drugs does sglt2 inhibitors NOT interact with
a. ACEi
b.ARBs
c.NSAIDS
d. B blockers
d. B blockers
what should patients be advised to do when starting an sglt2 inhibitor
ketoacidosis
advice patient of symptoms to check ketones and to stop if significant illness/ major surgery
when initiating insulin tretament it should be done as..
a.monotherapy
b.add on therapy
b.add on therapy
add onto metformin in particular as reduces weight gain and offers CV protection
patient has significant hyperglycaemia despite maximal doses of oral agents what should be done next
a.insulin therapy
b.insulin bolus
c.intermediate acting insulin bedtime / 2x daily
c.intermediate acting insulin bedtime / 2x daily - human NPH insulin
first line
2nd = long acting insulin analaogue eg insulin glargine 1x daily
eg if unable to self inject, lifestyle makes frequent injection innapropriate , target hba2 not reached because of hypoglycaemia or hypo with human nph insulin
what is hyperosmolar hyperglycaemic syndrome triggered by
a.acute illness, poor dietary and drug adherance
b.chronic illness, poor dietary and drug adherance
c. lack of excercise, poor dietary and drug adherance
a.acute illness, poor dietary and drug adherance
affects patients with type 2 diabetes
similar symptoms to DKA but still have some insulin so metabolism doesnt switch to fats and no acidosis
which of these are signs of HHS
a.v high blood glucose, low serum smolarity
b.low blood glucose, high serum osmolarity
c.v high blood glucose, high serum osmolarity
c.v high blood glucose, high serum osmolarity
what is the treatment for HHS
IV fluids, electrolytes and insulin
give LMWHeparin as high VTE risk state
which drug familiy are known as insulin resistance reducers
a.thiazolidinediones
b.sglt2 inhibitors
c.insulin
d.glp 1 analogue
a.thiazolidinediones
impact fatty acid metabolism
bind to PPARy receptors in adipose tissue , skeletal muscle and liver (insulin target tissues)
ligand activated transcription factors
target genes - enzymes involved in lipid metabolism so decreased FFAs
what is the mechanism of action of thiazolidinediones
impact fatty acid metabolism
bind to PPARy receptors in adipose tissue , skeletal muscle and liver (insulin target tissues)
ligand activated transcription factors
target genes - enzymes involved in lipid metabolism so decreased FFAs and glut 4 receptors so snesitivity to insulin incrased
thiazolidinediones are only effective in the prescence of which other substance ?
a.glucagon
b.insulin
c.LMWH
d.anticoagulants
b.insulin
