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metabolic drugs > type 2 diabetes > Flashcards

type 2 diabetes Flashcards

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1
Q

Metformin drug class

A

Biguanides

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2
Q

metformin target

A

AMP-kinase

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3
Q

metformin moa

A

increase the sensitivity of peripheral tissues to insulin and inhibits gluconeogenesis in the liver

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4
Q

metformin effect on senses

A

metallic taste

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5
Q

critical side effect of metformin

A

lactic acidosis

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6
Q

what condition and metformin are you worried about lactic acidosis

A

renal impairment

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7
Q

metformin dosent cause …

A

hypoglycaemia (requires endogenous insulin to work)

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8
Q

name a drug that causes taste distubance

A

amitriptyline = metallic taste

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9
Q

what enzyme does metformin inhibit

A

glycogen phosphorylase

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10
Q

gliclazide drug class

A

Sulfonylureas

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11
Q

gliclazide target

A

block ATP-sensitive K+ channels on β islet cell plasma membranes

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12
Q

what dont people like about gliclazide

A

weight gain

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13
Q

gliclazide moa

A

Reduced K+ efflux leading to β cell depolarisation, Ca2+ entry and insulin secretion

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14
Q

gliclazide side effects

A

Hypoglycaemia
Hyponatraemia
Hepatotoxicity
Hypersensitivity

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15
Q

when to with hold all diabetic drugs

A

ketoacidosis

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16
Q

name two Sulfonylureas

A

Glimepiride

gliclazide

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17
Q

glimepiride drug class

A

Sulfonylureas

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18
Q

glimepiride duration

A

long duration of action

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19
Q

overall action of glimepiride

A

stimulating the release of insulin from functioning pancreatic beta cells, and increasing sensitivity of peripheral tissues to insulin

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20
Q

what does glimepiride bind to

A

ATP-sensitive potassium channel receptors on the pancreatic cell surface

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21
Q

glimepiride moa

A

potassium blocking = depolarization of the membrane = calcium ion influx through voltage-sensitive channels = secretion of insulin

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22
Q

repaglinide drug class

A

Meglitinides

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23
Q

repaglinide target

A

sulphonylurea type-1 receptor

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24
Q

repaglinide moa

A

Antagonism of this receptor prevents potassium ions from exiting the cell when intracellular ATP levels are low. potassium ions (K+) accumulate inside beta cells = depolarisation = insulin release

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25
why are there no cardiac side effects with repaglinide
acts as an agonist at Sur-1 receptors. Thus no cardiac side effects as myocytes have Sur-2a subtype of sulphonylurea receptor
26
other good thing about repaglinide
prevention of beta cell apoptosis under heavy glucose load and prevention of fat accumulation in arteries
27
what is the sulphonylurea type-1 receptor part of
ATP-modulated potassium channel
28
where is sulphonylurea type-1 receptor found
beta cells of the pancreas
29
Glucagon-like peptide-1 analogues
Exenatide | Liraglutide
30
Liraglutide drug class
GLP-1 analogues
31
Liraglutide target
Glucagon-like peptide-1 (GLP-1) receptors
32
Liraglutide moa
GLP-1 analogues bind to and activate the receptors in the same way as the endogenous hormone and Increase synthesis and release of insulin by pancreatic β cells, suppress inappropriate glucagon secretion from pancreatic α cells
33
Liraglutide adverse effects
Severe pancreatitis Hypoglycaemia Antibody formation against exenatide
34
what to do if someone misses a dose of Liraglutide
take next one as normal
35
when not to take Liraglutide
after a meal
36
what is Liraglutide dependant on
glucose
37
Exenatide class
Glucagon-like peptide-1 receptor (GLP1R) agonists
38
where is GLP1 released from
intestinal endocrine cells
39
when is GLP1 released
after eating
40
Pioglitazone drug class
Thiazolidinediones
41
Pioglitazone target
PPARγ receptors
42
Pioglitazone moa
Causes the PPARγ-RXR complex to bind to DNA, promoting transcription of genes whose products are involved in insulin signalling e.g. lipoprotein lipase, Glut-4. This increases the sensitivity of tissues to insulin by recruiting glucose transporters to cell surface.
43
Pioglitazone are dependant on
presence of insulin
44
common side effects of Pioglitazone
weight gain | fluid retention
45
severe side effect of Pioglitazone
liver dysfunction | bone fractures in women
46
when to be careful giving Pioglitazone
people with cardiovascular probs
47
what are PPARγ receptors complexed with
retinoid X receptor
48
what are PPARγ receptors complexed with
retinoid X receptor
49
when should you stop Pioglitazone
if jaudice develops
50
why not take Pioglitazone and insulin
cardiac risks
51
why not take Pioglitazone and BB
might mask hypo
52
Sitagliptin drug class
DPP4 inhibitors
53
Sitagliptin moa
Inhibit degradation of incretin hormones GLP-1 and GIP by DPP4 enzymes. This increases levels of GLP-1 and GIP leading to increased synthesis and release of insulin by pancreatic β cells.
54
common adverse effect of Sitagliptin
Upper respiratory tract infection
55
Sitagliptin important side effect
Pancreatitis
56
caution with Sitagliptin in
heart failure
57
vildagliptin side effect
hepatotoxicity
58
Linagliptin drug class
dipeptidyl peptidase (DPP)-4 enzyme inhibitor
59
Linagliptin moa
slows the breakdown of insulinotropic hormone glucagon-like peptide (GLP)-1 and GIP
60
action of GIP and GLP
incretin hormones that increase the production and release of insulin from pancreatic beta cells
61
action of GIP and GLP
incretin hormones that increase the production and release of insulin from pancreatic beta cells
62
Acarbose drug class
alpha-glucosidase inhibitor
63
where is alpha-glucosidase found
gut
64
what is alpha-glucosidase used for
breaking down complex carbohydrates (i.e. starch) into glucose
65
Acarbose moa
kess gluclose is made in the gut so less glucose is released into the hepatic portal vein following a meal
66
Acarbose moa
kess gluclose is made in the gut so less glucose is released into the hepatic portal vein following a meal
67
name some Sodium-glucose co-transporter 2 (SGLT2) inhibitors
Canagliflozin | Dapagliflozin
68
Canagliflozin inhibits
SGLT2
69
Canagliflozin moa
reduces reabsorption of filtered glucose and lowers the renal threshold for glucose (RTG), and thereby increases urinary glucose excretion
70
what does Sodium-glucose co-transporter 2 do
reabsorption of filtered glucose from the tubular lumen
71
where is Sodium-glucose co-transporter 2 expressed
proximal renal tubule
72
where is Sodium-glucose co-transporter 2 expressed
proximal renal tubule
73
Dapagliflozin moa
blocks glucose reabsorption into the kidney, resulting in the elimination of blood glucose through the urine

metabolic drugs (14 decks)

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