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Questions and Answers
What is the primary action of insulin secretagogues in treating type 2 diabetes?
What is the primary action of insulin secretagogues in treating type 2 diabetes?
- Increase muscle mass
- Enhance glucose absorption in the intestines
- Increase insulin production from pancreatic beta cells (correct)
- Decrease hepatic production of glucose
Which class of diabetes medications is known to have a short half-life and is used as meal-time drugs?
Which class of diabetes medications is known to have a short half-life and is used as meal-time drugs?
- Sulphonylureas
- Biguanides
- Thiazolidinediones
- Non-sulphonylureas (correct)
What is one major adverse effect associated with metformin?
What is one major adverse effect associated with metformin?
- Increased insulin secretion
- Hypoglycemia
- Lactic acidosis (correct)
- Severe weight gain
Which of the following medications does NOT increase insulin secretion?
Which of the following medications does NOT increase insulin secretion?
What is the primary mechanism of action for biguanides like metformin?
What is the primary mechanism of action for biguanides like metformin?
In which part of the body do thiazolidinediones primarily improve insulin sensitivity?
In which part of the body do thiazolidinediones primarily improve insulin sensitivity?
Sitagliptin is classified as which type of diabetes medication?
Sitagliptin is classified as which type of diabetes medication?
Which class of diabetes medication is known for causing gastrointestinal disturbances like nausea and diarrhea?
Which class of diabetes medication is known for causing gastrointestinal disturbances like nausea and diarrhea?
What is the most common adverse effect associated with sulphonylureas like glyburide?
What is the most common adverse effect associated with sulphonylureas like glyburide?
Which incretin mimetic is synthesized from a protein found in the saliva of the Gila monster?
Which incretin mimetic is synthesized from a protein found in the saliva of the Gila monster?
What do DPP-4 enzyme inhibitors primarily achieve in the body?
What do DPP-4 enzyme inhibitors primarily achieve in the body?
Which of the following medications is an SGLT2 inhibitor?
Which of the following medications is an SGLT2 inhibitor?
What is the primary mechanism of action for thiazolidinediones (TZDs)?
What is the primary mechanism of action for thiazolidinediones (TZDs)?
What is a major adverse effect associated with incretin mimetics such as liraglutide?
What is a major adverse effect associated with incretin mimetics such as liraglutide?
What is the recommended action if a client experiences hypoglycemia?
What is the recommended action if a client experiences hypoglycemia?
Which drug classes must be taken with meals to prevent excessive postprandial blood glucose elevations?
Which drug classes must be taken with meals to prevent excessive postprandial blood glucose elevations?
What is a common effect of SGLT2 inhibitors on urination?
What is a common effect of SGLT2 inhibitors on urination?
Which mechanism of action do alpha-glucosidase inhibitors utilize?
Which mechanism of action do alpha-glucosidase inhibitors utilize?
What effect do biguanides like metformin NOT have on the body?
What effect do biguanides like metformin NOT have on the body?
Which class of diabetes medications acts by increasing insulin production specifically from pancreatic beta cells?
Which class of diabetes medications acts by increasing insulin production specifically from pancreatic beta cells?
What potential serious adverse effect is associated with the use of metformin?
What potential serious adverse effect is associated with the use of metformin?
Which of the following medications is categorized as a DPP-4 inhibitor?
Which of the following medications is categorized as a DPP-4 inhibitor?
What is one of the primary mechanisms of action for sulphonylureas?
What is one of the primary mechanisms of action for sulphonylureas?
Which diabetes drug class primarily targets the incretin pathway?
Which diabetes drug class primarily targets the incretin pathway?
How do thiazolidinediones (TZDs) primarily work in patients with diabetes?
How do thiazolidinediones (TZDs) primarily work in patients with diabetes?
Which of the following statements about SGLT-2 inhibitors is true?
Which of the following statements about SGLT-2 inhibitors is true?
What is the main function of DPP-4 inhibitors in diabetes management?
What is the main function of DPP-4 inhibitors in diabetes management?
Which of the following is NOT a common side effect of incretin mimetics?
Which of the following is NOT a common side effect of incretin mimetics?
What is a notable risk associated with the use of rosiglitazone?
What is a notable risk associated with the use of rosiglitazone?
Which of the following best describes the administration frequency of exenatide?
Which of the following best describes the administration frequency of exenatide?
What mechanism do sodium-glucose transporter inhibitors utilize to lower blood glucose levels?
What mechanism do sodium-glucose transporter inhibitors utilize to lower blood glucose levels?
Which drug class primarily targets insulin resistance in type 2 diabetes?
Which drug class primarily targets insulin resistance in type 2 diabetes?
How does amylin contribute to diabetes management?
How does amylin contribute to diabetes management?
What is the primary adverse effect of SGLT2 inhibitors?
What is the primary adverse effect of SGLT2 inhibitors?
Which medication would be taken on a daily basis to manage type 2 diabetes?
Which medication would be taken on a daily basis to manage type 2 diabetes?
Which of the following medications must be taken with meals to prevent excessive postprandial blood glucose elevations?
Which of the following medications must be taken with meals to prevent excessive postprandial blood glucose elevations?
What is the primary effect of sulphonylureas in diabetes management?
What is the primary effect of sulphonylureas in diabetes management?
What is a key characteristic of DPP-4 inhibitors like sitagliptin?
What is a key characteristic of DPP-4 inhibitors like sitagliptin?
Which of the following medications is categorized as a thiazolidinedione (TZD)?
Which of the following medications is categorized as a thiazolidinedione (TZD)?
What is a significant concern when administering metformin, particularly in certain patients?
What is a significant concern when administering metformin, particularly in certain patients?
Which class of diabetes medications targets the incretin pathway?
Which class of diabetes medications targets the incretin pathway?
What distinguishes non-sulphonylureas from sulphonylureas?
What distinguishes non-sulphonylureas from sulphonylureas?
Which type of drug is primarily associated with gastrointestinal disturbances like nausea and diarrhea?
Which type of drug is primarily associated with gastrointestinal disturbances like nausea and diarrhea?
What is a common effect of SGLT-2 inhibitors on renal function?
What is a common effect of SGLT-2 inhibitors on renal function?
What is the primary effect of incretin mimetics like exenatide?
What is the primary effect of incretin mimetics like exenatide?
Which of the following adverse effects is most commonly associated with sulphonylureas?
Which of the following adverse effects is most commonly associated with sulphonylureas?
How do DPP-4 inhibitors affect incretin levels in the body?
How do DPP-4 inhibitors affect incretin levels in the body?
What is a notable action of SGLT2 inhibitors in the treatment of type 2 diabetes?
What is a notable action of SGLT2 inhibitors in the treatment of type 2 diabetes?
What is the main mechanism of action for thiazolidinediones like rosiglitazone?
What is the main mechanism of action for thiazolidinediones like rosiglitazone?
Which statement is true regarding the administration of liraglutide?
Which statement is true regarding the administration of liraglutide?
What common gastrointestinal side effect can occur with incretin mimetics like liraglutide?
What common gastrointestinal side effect can occur with incretin mimetics like liraglutide?
What should be considered when using glucocorticoids in patients on hypoglycemic medication?
What should be considered when using glucocorticoids in patients on hypoglycemic medication?
What is the purpose of administering pramlintide in diabetes management?
What is the purpose of administering pramlintide in diabetes management?
What characteristic is shared by all sodium-glucose transporter inhibitors like canagliflozin?
What characteristic is shared by all sodium-glucose transporter inhibitors like canagliflozin?
What effect does metformin have on hepatic glucose production?
What effect does metformin have on hepatic glucose production?
Which drug class is primarily responsible for increasing insulin sensitivity in peripheral tissues?
Which drug class is primarily responsible for increasing insulin sensitivity in peripheral tissues?
Which of the following agents is classified as an insulin secretagogue?
Which of the following agents is classified as an insulin secretagogue?
What is a primary contraindication for the use of metformin?
What is a primary contraindication for the use of metformin?
What unique characteristic distinguishes non-sulphonylureas from sulphonylureas?
What unique characteristic distinguishes non-sulphonylureas from sulphonylureas?
Which mechanism of action is utilized by SGLT-2 inhibitors to manage diabetes?
Which mechanism of action is utilized by SGLT-2 inhibitors to manage diabetes?
Glyburide is primarily indicated for which purpose in diabetes treatment?
Glyburide is primarily indicated for which purpose in diabetes treatment?
What is a significant concern associated with the use of DPP-4 inhibitors like sitagliptin?
What is a significant concern associated with the use of DPP-4 inhibitors like sitagliptin?
Which of the following medications acts as a DPP-4 inhibitor?
Which of the following medications acts as a DPP-4 inhibitor?
What is a common adverse effect of SGLT2 inhibitors like canagliflozin?
What is a common adverse effect of SGLT2 inhibitors like canagliflozin?
Which class of diabetes medications primarily acts by delaying carbohydrate absorption?
Which class of diabetes medications primarily acts by delaying carbohydrate absorption?
Which medication is recognized for causing gastrointestinal upset as a major adverse effect?
Which medication is recognized for causing gastrointestinal upset as a major adverse effect?
What distinguishes sitagliptin from sulphonylureas in terms of insulin secretion modulation?
What distinguishes sitagliptin from sulphonylureas in terms of insulin secretion modulation?
How often is liraglutide generally administered to patients?
How often is liraglutide generally administered to patients?
Which of the following agents would most likely reduce postprandial glucose levels due to its mechanism of action?
Which of the following agents would most likely reduce postprandial glucose levels due to its mechanism of action?
What is the mechanism by which thiazolidinediones like rosiglitazone enhance insulin sensitivity?
What is the mechanism by which thiazolidinediones like rosiglitazone enhance insulin sensitivity?
In which scenario are glucagon medications typically used?
In which scenario are glucagon medications typically used?
What is a characteristic of the action of biguanides like metformin?
What is a characteristic of the action of biguanides like metformin?
Which class of diabetes drugs is formed to act specifically on meals due to their short half-life?
Which class of diabetes drugs is formed to act specifically on meals due to their short half-life?
What type of adverse effect is mainly associated with metformin?
What type of adverse effect is mainly associated with metformin?
What defines the main function of insulin secretagogues?
What defines the main function of insulin secretagogues?
Which mechanism differentiates thiazolidinediones from other diabetes medications?
Which mechanism differentiates thiazolidinediones from other diabetes medications?
What condition is a serious potential risk associated with the use of metformin?
What condition is a serious potential risk associated with the use of metformin?
What effect do SGLT-2 inhibitors have on urine output?
What effect do SGLT-2 inhibitors have on urine output?
What is the role of DPP-4 inhibitors in diabetes management?
What is the role of DPP-4 inhibitors in diabetes management?
What is a significant characteristic of incretin mimetics like exenatide?
What is a significant characteristic of incretin mimetics like exenatide?
Which medication uniquely mimics a protein found in the saliva of a Gila monster?
Which medication uniquely mimics a protein found in the saliva of a Gila monster?
Which class of diabetes medications lowers blood glucose by promoting glucose loss via urine?
Which class of diabetes medications lowers blood glucose by promoting glucose loss via urine?
What is a common adverse effect associated with SGLT2 inhibitors?
What is a common adverse effect associated with SGLT2 inhibitors?
What effect do DPP-4 inhibitors have on incretin levels?
What effect do DPP-4 inhibitors have on incretin levels?
What is the primary action of alpha-glucosidase inhibitors in the management of diabetes?
What is the primary action of alpha-glucosidase inhibitors in the management of diabetes?
Which of the following incretin medications is taken once a week?
Which of the following incretin medications is taken once a week?
Which adverse effect is NOT commonly associated with thiazolidinediones?
Which adverse effect is NOT commonly associated with thiazolidinediones?
Which drug class is primarily focused on decreasing insulin resistance?
Which drug class is primarily focused on decreasing insulin resistance?
Which of the following medications is a DPP-4 inhibitor?
Which of the following medications is a DPP-4 inhibitor?
Flashcards
What are Insulin Secretagogues?
What are Insulin Secretagogues?
Drugs that increase insulin production in Type 2 Diabetes. They act on the beta cells of the pancreas.
What are the two classes of Insulin Secretagogues?
What are the two classes of Insulin Secretagogues?
- Sulphonylureas: Examples include glyburide, chlorpropamide, tolbutamide, glimepiride, and glipizide.
- Non-sulphonylureas (meal-time drugs): Examples include repaglinide and nateglinide.
What is Metformin?
What is Metformin?
Metformin is a biguanide that works by decreasing hepatic glucose production and increasing tissue sensitivity to insulin.
How does Metformin affect the pancreas?
How does Metformin affect the pancreas?
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What are some side effects of Metformin?
What are some side effects of Metformin?
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How do Sulphonylureas work?
How do Sulphonylureas work?
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What is the main requirement for Sulphonylureas to be effective?
What is the main requirement for Sulphonylureas to be effective?
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What is the main action of Sulphonylureas?
What is the main action of Sulphonylureas?
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Sulphonylureas
Sulphonylureas
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Incretins
Incretins
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DPP-4
DPP-4
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Incretin Mimetics
Incretin Mimetics
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DPP-4 Inhibitors
DPP-4 Inhibitors
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SGLT2
SGLT2
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SGLT2 Inhibitors
SGLT2 Inhibitors
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Thiazolidinediones (TZDs)
Thiazolidinediones (TZDs)
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Alpha-glucosidase Inhibitors
Alpha-glucosidase Inhibitors
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Amylin Mimetic
Amylin Mimetic
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Insulin Secretagogues
Insulin Secretagogues
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Biguanides
Biguanides
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Metformin: Side Effects
Metformin: Side Effects
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Metformin
Metformin
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Gliptins (DPP-4 Inhibitors)
Gliptins (DPP-4 Inhibitors)
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Non-sulphonylureas
Non-sulphonylureas
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GLP-1 Mimetics
GLP-1 Mimetics
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Hypoglycemia: What to do?
Hypoglycemia: What to do?
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Hypoglycemia
Hypoglycemia
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How to Treat Hypoglycemia?
How to Treat Hypoglycemia?
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Study Notes
Drugs for Diabetes Mellitus
- Drugs lower blood glucose levels in patients with type 2 diabetes
- Used alone or in combination with other agents
- In addition to diet and lifestyle changes
Diabetes Drugs - Target Pancreas
- Insulin secretagogues increase insulin production in Type 2 DM
- Act on beta cells of the pancreas
- Two classes of insulin secretagogues: Sulphonylureas and Non-sulphonylureas (meal-time drugs)
Sulphonylureas
- Glyburide
- Chlorpropamide, tolbutamide
- Glimepiride
- Glipizide (Glucotrol)
Non-sulphonylureas (meal-time drugs)
- Repaglinide, nateglinide
- Short half-life
- Same drug target but different duration of action
Biguanides
- Metformin
- Decreases hepatic production of glucose
- Increases tissue sensitivity to insulin, increasing glucose uptake
- Does not increase insulin secretion from the pancreas
- Does not cause hypoglycemia
- Net weight loss
- GI disturbances (nausea, diarrhea, decreased appetite); taken 2-3/day with meals to reduce disturbances
- Lactic acidosis (rare but 50% mortality concern in renal insufficiency)
Thiazolidinediones (TZDs)
- Rosiglitazone
- Pioglitazone
- Glitazones or TZDs
- Decrease insulin resistance ("insulin sensitizing agents")
- Increase glucose uptake and use in skeletal muscle
- Inhibit glucose and triglyceride production in the liver
- Rosiglitazone (Avandia) has a boxed warning for increased risk of angina, myocardial infarction (MI), and heart failure, due to plasma volume increase.
Diabetes Drugs - Incretin Pathway and Others
- Gliptins (DPP-4 inhibitors) and incretin mimetics
- Sitagliptin (Januvia) - DPP-4 inhibitor
- Exenatide - Incretin mimetic
- SGLT-2 inhibitors
Other Drugs (not covered)
- Amylin mimetic
- Alpha-glucosidase inhibitors
Medication sites of action
- Biguanides act on the liver
- Thiazolidinediones act on the muscle and fat cells
- DPP-4 inhibitors, Glinides, Sulfonylureas and Some injectable hormones act on the pancreas
- Alpha-glucosidase inhibitors and Some injectable hormones act on the intestine
Oral Drugs - Target Pancreas
- Sulphonylureas (e.g., glyburide): Stimulate insulin secretion from pancreatic beta cells (Beta cell function must be present)
- Sulphonylureas (e.g., glyburide): Improve sensitivity to insulin in muscles, liver, and fat
- Sulphonylureas (e.g., glyburide): Liver by decreasing the rate of insulin metabolism and breakdown
- Sulphonylureas (e.g., glyburide): Hypoglycemia is the most common adverse effect (usually mild but can be severe)
- Sulphonylureas (e.g., glyburide): Taken with breakfast (usually one/day)
Incretins
- Intestinal contents release incretins (GLP-1 and GIP)
- Stimulates insulin release
- Incretins broken down by enzyme DPP-4
- GLP-1 mimetics (e.g., Exenatide (Byetta))
- Synthetic saliva protein of the Gila monster
- Synthetic GLP-1 mimetic
- SC administration
- Liraglutide, semaglutide, dulaglutide; daily or weekly administration
- Decreases appetite, useful in obesity-linked diabetes, weight loss drug (without diabetes)
- Major adverse effect: GI upset
- Tirzepatide (GIP & GLP-1 agonist), new incretin mimetic,
Incretin Preparations - FYI
- SC Injection: Dulaglutide: Once a week; Exenatide: Twice a day; Exenatide extended-release: Once a week; Liraglutide: Once a day; Lixisenatide; Once a day; Semaglutide: Once a week; Tirzepatide: Once a week
- Semaglutide po tablets: daily
Incretins
- DPP-4 enzyme inhibitors reduce incretin metabolism; result in higher plasma incretin level, reduced glucose
- DPP-4 enzyme inhibitors: Sitagliptin, saxagliptin, linagliptin
- DPP-4 enzyme inhibitors used alone or in combination with metformin for type 2 diabetes only
- Oral once daily with or without food
Na-Glucose Transporter Inhibitors
- Newest group of Type 2 DM drugs
- Inhibit glucose transporter in nephron (PT) sodium-glucose transporter subtype 2 (SGLT2)
- Loss of glucose in urine (plus water)
- Canagliflozin, dapagliflozin, empagliflozin
- Approved in Canada May 2014
- Increased urination (possible hypotension/dizziness)
- UTIs (not surprising)
Other Injectable Drugs
- Amylin Mimetic: Amylin co-released with insulin, delays gastric emptying and inhibits glucagon secretion, reduces postprandial glucose
- Pramlintide: Acts as amylin, supplement to insulins (DM Type I & II), SC injection
Oral Drugs
- Alpha-glucosidase inhibitors: Reversibly inhibit the enzyme alpha-glucosidase in the brush border of the small intestine; Acarbose, miglitol; Inhibits digestion of oligo- and disaccharides; Delayed absorption of glucose
- Must be taken with meals to prevent excessive postprandial glucose elevations
Medication Interactions
- Glucocorticoids: Decrease the effect of hypoglycemic medication; Cortisol-like drugs increase blood glucose
Antihyperglycemic Agents: Client Care Implications
- Assess for signs of hypoglycemia
- If hypoglycemia occurs: give glucagon if required; Have the alert client eat 120–200 mL clear fruit juice; glucose tablets or gel, teaspoon of corn syrup or honey; or non-diet soft drink
- After liquid snack give a small snack with carbohydrates and protein; Monitor blood glucose levels
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Description
This quiz explores various drugs used to manage diabetes mellitus, particularly focusing on medications for type 2 diabetes. You will learn about insulin secretagogues, biguanides, and incretin pathway drugs, including their classifications and examples. Test your knowledge about the mechanisms and applications of these essential treatments.
