Diabetes Mellitus Drugs Overview
89 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

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?

  • Sulphonylureas
  • Biguanides
  • Thiazolidinediones
  • Non-sulphonylureas (correct)

    • 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?

    <p>Metformin</p> Signup and view all the answers

    What is the primary mechanism of action for biguanides like metformin?

    <p>Increasing insulin sensitivity</p> Signup and view all the answers

    In which part of the body do thiazolidinediones primarily improve insulin sensitivity?

    <p>Muscle, liver, and fat tissues</p> Signup and view all the answers

    Sitagliptin is classified as which type of diabetes medication?

    <p>DPP-4 inhibitor</p> Signup and view all the answers

    Which class of diabetes medication is known for causing gastrointestinal disturbances like nausea and diarrhea?

    <p>Biguanides</p> Signup and view all the answers

    What is the most common adverse effect associated with sulphonylureas like glyburide?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which incretin mimetic is synthesized from a protein found in the saliva of the Gila monster?

    <p>Exenatide</p> Signup and view all the answers

    What do DPP-4 enzyme inhibitors primarily achieve in the body?

    <p>Reduce incretin metabolism</p> Signup and view all the answers

    Which of the following medications is an SGLT2 inhibitor?

    <p>Canagliflozin</p> Signup and view all the answers

    What is the primary mechanism of action for thiazolidinediones (TZDs)?

    <p>Decrease insulin resistance</p> Signup and view all the answers

    What is a major adverse effect associated with incretin mimetics such as liraglutide?

    <p>Gastrointestinal upset</p> Signup and view all the answers

    What is the recommended action if a client experiences hypoglycemia?

    <p>Administer glucagon if required</p> Signup and view all the answers

    Which drug classes must be taken with meals to prevent excessive postprandial blood glucose elevations?

    <p>Alpha-glucosidase inhibitors</p> Signup and view all the answers

    What is a common effect of SGLT2 inhibitors on urination?

    <p>Increased urination</p> Signup and view all the answers

    Which mechanism of action do alpha-glucosidase inhibitors utilize?

    <p>Inhibit alpha-glucosidase enzyme</p> Signup and view all the answers

    What effect do biguanides like metformin NOT have on the body?

    <p>Increase insulin secretion from the pancreas</p> Signup and view all the answers

    Which class of diabetes medications acts by increasing insulin production specifically from pancreatic beta cells?

    <p>Insulin secretagogues</p> Signup and view all the answers

    What potential serious adverse effect is associated with the use of metformin?

    <p>Lactic acidosis</p> Signup and view all the answers

    Which of the following medications is categorized as a DPP-4 inhibitor?

    <p>Sitagliptin</p> Signup and view all the answers

    What is one of the primary mechanisms of action for sulphonylureas?

    <p>Stimulate insulin secretion from pancreatic beta cells</p> Signup and view all the answers

    Which diabetes drug class primarily targets the incretin pathway?

    <p>Gliptins</p> Signup and view all the answers

    How do thiazolidinediones (TZDs) primarily work in patients with diabetes?

    <p>Increase insulin sensitivity in muscle and fat tissues</p> Signup and view all the answers

    Which of the following statements about SGLT-2 inhibitors is true?

    <p>They promote urinary glucose excretion</p> Signup and view all the answers

    What is the main function of DPP-4 inhibitors in diabetes management?

    <p>They prolong the action of incretins</p> Signup and view all the answers

    Which of the following is NOT a common side effect of incretin mimetics?

    <p>Urinary tract infections</p> Signup and view all the answers

    What is a notable risk associated with the use of rosiglitazone?

    <p>Heart failure</p> Signup and view all the answers

    Which of the following best describes the administration frequency of exenatide?

    <p>Twice a day</p> Signup and view all the answers

    What mechanism do sodium-glucose transporter inhibitors utilize to lower blood glucose levels?

    <p>Block reabsorption of glucose in the kidneys</p> Signup and view all the answers

    Which drug class primarily targets insulin resistance in type 2 diabetes?

    <p>Thiazolidinediones</p> Signup and view all the answers

    How does amylin contribute to diabetes management?

    <p>Delays gastric emptying</p> Signup and view all the answers

    What is the primary adverse effect of SGLT2 inhibitors?

    <p>Increased urination</p> Signup and view all the answers

    Which medication would be taken on a daily basis to manage type 2 diabetes?

    <p>Sitagliptin</p> Signup and view all the answers

    Which of the following medications must be taken with meals to prevent excessive postprandial blood glucose elevations?

    <p>Acarbose</p> Signup and view all the answers

    What is the primary effect of sulphonylureas in diabetes management?

    <p>Increase insulin production from pancreatic beta cells</p> Signup and view all the answers

    What is a key characteristic of DPP-4 inhibitors like sitagliptin?

    <p>They do not affect insulin levels directly</p> Signup and view all the answers

    Which of the following medications is categorized as a thiazolidinedione (TZD)?

    <p>Pioglitazone</p> Signup and view all the answers

    What is a significant concern when administering metformin, particularly in certain patients?

    <p>Possibility of lactic acidosis</p> Signup and view all the answers

    Which class of diabetes medications targets the incretin pathway?

    <p>Gliptins</p> Signup and view all the answers

    What distinguishes non-sulphonylureas from sulphonylureas?

    <p>Non-sulphonylureas stimulate insulin secretion at mealtime</p> Signup and view all the answers

    Which type of drug is primarily associated with gastrointestinal disturbances like nausea and diarrhea?

    <p>Biguanides</p> Signup and view all the answers

    What is a common effect of SGLT-2 inhibitors on renal function?

    <p>Increased urination due to glucose excretion</p> Signup and view all the answers

    What is the primary effect of incretin mimetics like exenatide?

    <p>Enhance insulin release</p> Signup and view all the answers

    Which of the following adverse effects is most commonly associated with sulphonylureas?

    <p>Hypoglycemia</p> Signup and view all the answers

    How do DPP-4 inhibitors affect incretin levels in the body?

    <p>They reduce incretin metabolism</p> Signup and view all the answers

    What is a notable action of SGLT2 inhibitors in the treatment of type 2 diabetes?

    <p>Promote glucose excretion in urine</p> Signup and view all the answers

    What is the main mechanism of action for thiazolidinediones like rosiglitazone?

    <p>Decrease insulin resistance</p> Signup and view all the answers

    Which statement is true regarding the administration of liraglutide?

    <p>Injected once a day</p> Signup and view all the answers

    What common gastrointestinal side effect can occur with incretin mimetics like liraglutide?

    <p>Nausea</p> Signup and view all the answers

    What should be considered when using glucocorticoids in patients on hypoglycemic medication?

    <p>They decrease the effectiveness of hypoglycemic medications</p> Signup and view all the answers

    What is the purpose of administering pramlintide in diabetes management?

    <p>To delay gastric emptying</p> Signup and view all the answers

    What characteristic is shared by all sodium-glucose transporter inhibitors like canagliflozin?

    <p>They promote glucose loss in urine</p> Signup and view all the answers

    What effect does metformin have on hepatic glucose production?

    <p>Decreases hepatic glucose production</p> Signup and view all the answers

    Which drug class is primarily responsible for increasing insulin sensitivity in peripheral tissues?

    <p>Thiazolidinediones</p> Signup and view all the answers

    Which of the following agents is classified as an insulin secretagogue?

    <p>Glyburide</p> Signup and view all the answers

    What is a primary contraindication for the use of metformin?

    <p>Severe renal insufficiency</p> Signup and view all the answers

    What unique characteristic distinguishes non-sulphonylureas from sulphonylureas?

    <p>They stimulate insulin secretion at mealtime</p> Signup and view all the answers

    Which mechanism of action is utilized by SGLT-2 inhibitors to manage diabetes?

    <p>Decrease glucose reabsorption in the kidneys</p> Signup and view all the answers

    Glyburide is primarily indicated for which purpose in diabetes treatment?

    <p>Stimulating insulin secretion</p> Signup and view all the answers

    What is a significant concern associated with the use of DPP-4 inhibitors like sitagliptin?

    <p>Pancreatitis</p> Signup and view all the answers

    Which of the following medications acts as a DPP-4 inhibitor?

    <p>Sitagliptin</p> Signup and view all the answers

    What is a common adverse effect of SGLT2 inhibitors like canagliflozin?

    <p>Increased urination</p> Signup and view all the answers

    Which class of diabetes medications primarily acts by delaying carbohydrate absorption?

    <p>Alpha-glucosidase inhibitors</p> Signup and view all the answers

    Which medication is recognized for causing gastrointestinal upset as a major adverse effect?

    <p>Exenatide</p> Signup and view all the answers

    What distinguishes sitagliptin from sulphonylureas in terms of insulin secretion modulation?

    <p>Inhibits incretin metabolism</p> Signup and view all the answers

    How often is liraglutide generally administered to patients?

    <p>Once a day</p> Signup and view all the answers

    Which of the following agents would most likely reduce postprandial glucose levels due to its mechanism of action?

    <p>Pramlintide</p> Signup and view all the answers

    What is the mechanism by which thiazolidinediones like rosiglitazone enhance insulin sensitivity?

    <p>Increasing glucose uptake in skeletal muscle</p> Signup and view all the answers

    In which scenario are glucagon medications typically used?

    <p>To treat severe hypoglycemia</p> Signup and view all the answers

    What is a characteristic of the action of biguanides like metformin?

    <p>They decrease hepatic production of glucose.</p> Signup and view all the answers

    Which class of diabetes drugs is formed to act specifically on meals due to their short half-life?

    <p>Non-sulphonylureas</p> Signup and view all the answers

    What type of adverse effect is mainly associated with metformin?

    <p>Nausea and diarrhea</p> Signup and view all the answers

    What defines the main function of insulin secretagogues?

    <p>They increase insulin secretion from pancreas.</p> Signup and view all the answers

    Which mechanism differentiates thiazolidinediones from other diabetes medications?

    <p>They improve insulin sensitivity primarily in muscle and adipose tissues.</p> Signup and view all the answers

    What condition is a serious potential risk associated with the use of metformin?

    <p>Lactic acidosis</p> Signup and view all the answers

    What effect do SGLT-2 inhibitors have on urine output?

    <p>They lead to more frequent urination.</p> Signup and view all the answers

    What is the role of DPP-4 inhibitors in diabetes management?

    <p>They inhibit the breakdown of incretin hormones.</p> Signup and view all the answers

    What is a significant characteristic of incretin mimetics like exenatide?

    <p>They are administered as SC injections.</p> Signup and view all the answers

    Which medication uniquely mimics a protein found in the saliva of a Gila monster?

    <p>Exenatide</p> Signup and view all the answers

    Which class of diabetes medications lowers blood glucose by promoting glucose loss via urine?

    <p>SGLT2 inhibitors</p> Signup and view all the answers

    What is a common adverse effect associated with SGLT2 inhibitors?

    <p>Increased urination</p> Signup and view all the answers

    What effect do DPP-4 inhibitors have on incretin levels?

    <p>They reduce incretin metabolism.</p> Signup and view all the answers

    What is the primary action of alpha-glucosidase inhibitors in the management of diabetes?

    <p>Delay glucose absorption in the intestine</p> Signup and view all the answers

    Which of the following incretin medications is taken once a week?

    <p>Dulaglutide</p> Signup and view all the answers

    Which adverse effect is NOT commonly associated with thiazolidinediones?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which drug class is primarily focused on decreasing insulin resistance?

    <p>Thiazolidinediones</p> Signup and view all the answers

    Which of the following medications is a DPP-4 inhibitor?

    <p>Sitagliptin</p> Signup and view all the answers

    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

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Diabetes Mellitus Class PDF

    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.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser