PHA 4TH - Anti Diabetic drugs

What is the MOA of regular insulin?

Facilitates glucose uptake into cells;

Indications of insulin therapy?

Type 1 DM gestational DM some Type 2 DM and DKA;

Major adverse effect of insulin?

Hypoglycemia;

Which insulin is used IV in emergencies like DKA?

Regular insulin;

What is the MOA of NPH insulin?

Intermediate acting insulin with protamine delaying absorption;

Main risk of NPH insulin?

Nocturnal hypoglycemia;

What is the MOA of insulin lispro?

Rapid acting insulin analog with amino acid substitution preventing aggregation;

Advantage of rapid acting insulin analogs?

Reduced postprandial hyperglycemia;

Fastest acting insulin?

Insulin lispro;

What is the MOA of insulin glargine?

Long acting insulin forming precipitate for slow release;

Key feature of insulin glargine?

Peakless basal insulin;

Longest acting insulin?

Insulin degludec;

What is basal bolus insulin therapy?

Combination of long acting basal and rapid acting prandial insulin;

MOA of sulfonylureas?

Close ATP sensitive potassium channels leading to insulin release;

Indication of sulfonylureas?

Type 2 diabetes mellitus;

Major adverse effects of sulfonylureas?

Hypoglycemia and weight gain;

Contraindication of sulfonylureas?

Renal and hepatic impairment;

MOA of meglitinides?

Close potassium channels causing rapid insulin release;

Indication of meglitinides?

Postprandial hyperglycemia;

Main adverse effect of meglitinides?

Hypoglycemia if meals are skipped;

Which meglitinide is preferred in renal impairment?

Repaglinide;

MOA of metformin?

Activates AMPK decreasing gluconeogenesis and increasing insulin sensitivity;

First line drug for Type 2 DM?

Metformin;

Major adverse effect of metformin?

Lactic acidosis;

Common side effects of metformin?

Nausea diarrhea metallic taste;

Contraindication of metformin?

Renal impairment and hypoxic states;

MOA of alpha glucosidase inhibitors?

Delay carbohydrate absorption in intestine;

Indication of alpha glucosidase inhibitors?

Postprandial hyperglycemia;

Main adverse effects of alpha glucosidase inhibitors?

Flatulence and diarrhea;

Contraindication of alpha glucosidase inhibitors?

Inflammatory bowel disease;

MOA of thiazolidinediones?

Activate PPAR gamma increasing insulin sensitivity;

Main effect of TZDs?

Increase glucose uptake in muscle and adipose tissue;

Major adverse effects of TZDs?

Weight gain edema heart failure;

Contraindication of TZDs?

Heart failure and liver disease;

MOA of pioglitazone?

PPAR gamma agonist improving insulin sensitivity;

Unique adverse effect of pioglitazone?

Bladder cancer risk;

MOA of rosiglitazone?

PPAR gamma agonist;

Major adverse effect of rosiglitazone?

Cardiovascular risk;

MOA of GLP1 receptor agonists?

Enhance glucose dependent insulin secretion and decrease glucagon;

Additional effect of GLP1 agonists?

Delay gastric emptying and promote satiety;

Indication of GLP1 agonists?

Type 2 DM and obesity;

Common adverse effects of GLP1 agonists?

Nausea vomiting diarrhea;

Serious adverse effect of GLP1 agonists?

Pancreatitis;

MOA of exenatide?

GLP1 receptor agonist resistant to DPP4 degradation;

Contraindication of exenatide?

Severe renal impairment;

MOA of liraglutide?

GLP1 analog with prolonged half life via albumin binding;

Benefit of liraglutide?

Weight loss;

MOA of semaglutide?

Long acting GLP1 receptor agonist;

Unique feature of semaglutide?

Available oral formulation;

MOA of DPP4 inhibitors?

Prevent degradation of GLP1 and GIP;

Effect of DPP4 inhibitors?

Increase insulin and decrease glucagon;

Weight effect of DPP4 inhibitors?

Weight neutral;

Prototype DPP4 inhibitor?

Sitagliptin;

MOA of SGLT2 inhibitors?

Block glucose reabsorption in proximal tubule;

Effect of SGLT2 inhibitors?

Increase urinary glucose excretion;

Indications of SGLT2 inhibitors?

Type 2 DM heart failure diabetic nephropathy;

Most common adverse effect of SGLT2 inhibitors?

Genital infections;

Serious adverse effect of SGLT2 inhibitors?

Euglycemic diabetic ketoacidosis;

MOA of glucagon?

Stimulates glycogenolysis and gluconeogenesis;

Indication of glucagon?

Severe hypoglycemia;

Common adverse effects of glucagon?

Nausea and vomiting;

MOA of diazoxide?

Opens potassium channels inhibiting insulin release;

Indication of diazoxide?

Insulinoma;

Adverse effects of diazoxide?

Hyperglycemia hyperuricemia edema;

MOA of octreotide?

Somatostatin analog inhibiting hormone release;

Indication of octreotide?

Endocrine tumors like insulinoma;

MOA of pramlintide?

Amylin analog decreasing glucagon and delaying gastric emptying;

Indication of pramlintide?

Adjunct to insulin therapy;

Major adverse effect of pramlintide?

Hypoglycemia with insulin;

MOA of colesevelam?

Bile acid sequestrant improving glucose metabolism;

Adverse effects of colesevelam?

Constipation and hypertriglyceridemia;

MOA of bromocriptine?

D2 receptor agonist with unclear glucose lowering mechanism;

Indication of bromocriptine?

Type 2 DM and hyperprolactinemia;