Week 6: Metabolic diseases

simvastatin

D - Statin

D - High cholesterol

MOA - Inhibits HMG CoA reductase from converting HMG CoA to Mevalonic acid, reducing cholestrol synthesis.

AE - GIT disturbances, muscle inflammation, swelling

G - Endogenous pathway (in liver), St John's wart increases metabolism

Carbimazole

D - Anti-thyroid

D - Hyperthyroidism

MOA - Reduces biosynthesis of thyroid hormone.

AE - Neutropenia and agranulocytosis (reduced WBCs), tremors, anxiety

G - First line of initial treatment, 3-4 weeks

Propylthiouracil

D - Anti-thyroid

D - Hyperthyroidism

MOA - Reduces biosynthesis of thyroid hormone, reduces de-iodination of T4 to T3

AE - Neutropenia + agranulocytosis (reduces WBCs), tremors, anxiety

G - Indicated for pregnancy and if carbimazole elicits AE

Oral Thyroxine (T4)

D - Hypothyroidism

MOA - Restores normal thyroid state Euthyroid

AE - Hyperthyroidism

Type 1 Diabetes

D - Insulin deficiency

D - Juvenile onset

MOA - Autoimmune destruction of pancreatic beta cells , insulin-dependant (IDDM)

Type 2 Diabetes

D - Insulin resistance

D - Mature onset

MOA - ?, non insulin-dependant (NIDDM)

Gestational diabetes

D - Pregnancy deficiency

MOA - Insulin resistance/impaired glucose tolerance that first develops during

Pregnancy, Usually resolves after delivery, but increases risk of T2D for both mother

and baby

Metformin

D - Oral hypoglycaemic agent (OHA)

D - Diabetes

MOA - First line OHA, not well understood, increases glucose uptake into tissues and use, improves insulin sensitivity

AE - GIT discomfort

Sitagliptin

D - Incretin enhancer; Oral hypoglycaemic agents (OHA)

D - Diabetes

MOA: inhibits DPP4, preventing breakdown of incretins, resulting in accumulation and stimulation of insulin secretion from the pancreas.

AE - Hypoglycaemia

SGLT2…

D - Sodium-linked glucose transporter (SGLT2) inhibitor; Oral hypoglycaemic agent (OHA)

D - Diabetes

MOA - Increase glucose excretion via urine

AE - dehydration