Pharmocology

Question 1

Explain the mechanism of action of metformin.

Answer 1

Decreases gluconeogenesis
Decreases absorption of glucose in the blood
Up-regulates insulin receptors, more glucose into the muscles

Question 2

What are the side effects of metformin?

Answer 2

Nausea
Diarrhea
Abdominal discomfort
Headache
Lactic acidosis (rare)

Question 3

What are the mechanisms of sulfonylureas?

Answer 3

Sulfonylureas work by binding to a specific receptor on the beta cells in the pancreas, which triggers the release of insulin. This increased insulin production helps to lower blood sugar levels in people with type 2 diabetes.

In addition to stimulating insulin release, sulfonylureas also reduce the amount of glucose produced by the liver, which further helps to lower blood sugar levels.

Question 4

What are the sides effects of sulfonylureas?

Answer 4

Hypoglycemia (low blood sugar)
Weight gain
Upset stomach
Skin rash or itching
Photosensitivity

Question 5

Why are they both (metformin and sulfonylureas) hazardous in renal failure?

Answer 5

Both are eliminated via the kidney
Renal failure leads to build-up and increases toxicity.

M- leads to lactic acidosis
S- hypoglycemia that triggers the kidneys to respond to low glucose levels

Question 6

Identify three classes of drugs that may worsen blood glucose control.

Answer 6

Glucocorticoids: They can increase blood glucose levels by promoting gluconeogenesis and reducing glucose uptake in peripheral tissues.

Beta-blockers: They can mask the symptoms of hypoglycemia (low blood sugar) by inhibiting the release of glucagon, a hormone that raises blood glucose levels. They can also impair insulin sensitivity and decrease glucose uptake in peripheral tissues.

Thiazide diuretics: They can increase blood glucose levels by reducing insulin sensitivity and impairing glucose tolerance.

Question 7

Outline the mechanism by which antibiotics increase the risk of candidiasis.

Answer 7

Antibiotics kill beneficial bacteria and Suppressed immune system
Imbalance of microorganisms
Candida overgrowth

Question 8

Outline the management of candidiasis in diabetes mellitus.

Answer 8

Control blood glucose levels: High blood sugar levels create a favorable environment for Candida growth.
Antifungal therapy: Topical or oral antifungal medication is typically prescribed to treat candidiasis. Examples of antifungal medications include fluconazole, ketoconazole, and nystatin.

Question 9

Briefly outline (2 sentences) the mechanism of action of the antifungal azoles.

Answer 9

Azoles inhibit the synthesis of ergosterol, a critical component of fungal cell membranes, by targeting the enzyme lanosterol 14-alpha-demethylase. This disrupts the integrity of the fungal cell membrane, leading to cell death.