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Inhibitors of SGLT2 and Their Effects in Patients with Heart or Kidney Disease

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What is the onset of action for insulin detemir (Levemir)?

2 hours

How does insulin detemir (Levemir) differ from glargine in terms of peak action?

Glargine is peakless

What is the main side effect associated with 2nd Generation Sulfonylureas like glyburide (Micronase)?

Hypoglycemia

Which organ is mainly responsible for the metabolism/excretion of glyburide (Micronase)?

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

What is a rare side effect associated with sulfonylureas?

<p>Dermatological allergies</p> Signup and view all the answers

Which class of drugs should not be used in patients with renal failure due to the risk of hypoglycemia mainly in elderly patients?

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

Which medication can lower HbA1c by approximately 0.8% when used as monotherapy?

<p>Miglitol (Glyset)</p> Signup and view all the answers

Which medication prevents sucrose breakdown into glucose, making only glucose or dextrose usable during hypoglycemic episodes?

<p>Acarbose (Precose)</p> Signup and view all the answers

Which medication increases tissue insulin sensitivity, enhancing the insulin-dependent uptake of fatty acids and glucose?

<p>Rosiglitazone (Avandia)</p> Signup and view all the answers

Which medication requires regular liver function tests at baseline and at 2-3 month intervals for the first year of use?

<p>Pioglitazone (Actos)</p> Signup and view all the answers

Which medication has a slow onset of approximately 2 months for maximum effect?

<p>Thiazolidinediones (TZD’s)</p> Signup and view all the answers

Which medication is contraindicated in patients with IBS and obstruction due to its poor tolerability and side effect of flatulence?

<p>Miglitol (Glyset)</p> Signup and view all the answers

Which of the following drugs is an amylin agonist used for Type-1/Type-2 diabetics who use insulin at mealtime and have failed to achieve diabetic control?

<p>Pramlintide (Symlin)</p> Signup and view all the answers

Which of the following drugs inhibits SGLT2, a membrane protein expressed mainly in the early proximal tubule (S1 segment) of the kidney where 90% of renal glucose reabsorption occurs?

<p>Canagliflozin (Invokana)</p> Signup and view all the answers

Which of the following is a common adverse side effect of SGLT2 inhibitors?

<p>Volume depletion</p> Signup and view all the answers

Which of the following drugs is associated with an increased risk of heart failure, especially in patients who already have heart or kidney disease?

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

Which of the following drugs is not an SGLT2 inhibitor?

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

Which of the following is not a common adverse side effect of SGLT2 inhibitors?

<p>Weight gain</p> Signup and view all the answers

Which enzyme do Dipeptidyl-peptidase-4 (DPP4) inhibitors inhibit, leading to an increase in the duration of effectiveness of endogenous GLP-1 and GIP?

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

Which DPP-4 inhibitor is considered inappropriate for initial therapy and is usually used as add-on therapy for Type-2 diabetics only?

<p>Saxagliptin (Onglyza)</p> Signup and view all the answers

What common side effect is associated with DPP-4 inhibitors such as Sitagliptin and Saxagliptin?

<p>Severe joint pain</p> Signup and view all the answers

Which DPP-4 inhibitor may delay gastric emptying, impacting the absorption of other drugs that should be taken 1 hour before or 2 hours after its administration?

<p>Linagliptin (Tradjenta)</p> Signup and view all the answers

What is a potential side effect of DPP-4 inhibitors like Alogliptin that is rare but associated with their inhibitory action on substrates involved in inflammation?

<p>Acute pancreatitis</p> Signup and view all the answers

Which DPP-4 inhibitor can be used without dose adjustment in all stages of renal impairment?

<p>Linagliptin (Tradjenta)</p> Signup and view all the answers

Which medication is an amylin agonist used for Type-1/Type-2 diabetics who use insulin at mealtime and have failed to achieve diabetic control?

<p>Pramlintide (Symlin)</p> Signup and view all the answers

Which class of drugs inhibits SGLT2, a membrane protein expressed mainly in the early proximal tubule (S1 segment) of the kidney where 90% of renal glucose reabsorption occurs?

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

Which of the following is NOT a common adverse side effect of SGLT2 inhibitors?

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

Which medication should be avoided in patients with renal failure due to the risk of hypoglycemia mainly in elderly patients?

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

Which medication is contraindicated in patients with IBS and obstruction due to its poor tolerability and side effect of flatulence?

<p>Acarbose (Precose)</p> Signup and view all the answers

Which of the following drugs is not an SGLT2 inhibitor?

<p>Glyburide (Micronase)</p> Signup and view all the answers

Which medication is primarily used to lower blood glucose levels by inhibiting the reabsorption of glucose in the kidneys?

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

Which medication is an amylin analog used to improve glycemic control in patients with type 1 or type 2 diabetes?

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

Which medication is known to cause lactic acidosis, a rare but serious side effect that can be fatal in severe cases?

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

Which medication is contraindicated in patients with IBS and obstruction due to its poor tolerability and side effect of flatulence?

<p>Alpha Glucosidase Inhibitors</p> Signup and view all the answers

Which medication inhibits the enzyme alpha-glucosidase in the small intestine to delay the digestion and absorption of carbohydrates?

<p>Alpha Glucosidase Inhibitors</p> Signup and view all the answers

Which medication can be used in combination with sulfonylureas, TZDs, DPP-4 inhibitors, and insulin?

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

What is the main mechanism through which metformin can indirectly activate AMPK?

<p>Inhibiting Complex I of the mitochondrial oxidative phosphorylation process</p> Signup and view all the answers

Which side effect is associated with metformin but is very rare and has a 50% fatality rate in severe cases?

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

Which organ function is crucial to consider before prescribing metformin to avoid potential complications?

<p>Kidney function</p> Signup and view all the answers

Which class of drugs delays the digestion and absorption of carbohydrates by inhibiting alpha-glucosidase in the small intestine?

<p>Alpha Glucosidase Inhibitors</p> Signup and view all the answers

Which medication class primarily focuses on enhancing tissue insulin sensitivity and improving glycemic control?

<p>Amylin agonists</p> Signup and view all the answers

What is a common side effect experienced by patients taking metformin that may include gastrointestinal disturbances?

<p>Metallic taste</p> Signup and view all the answers

Which medication is an amylin agonist used for Type-1/Type-2 diabetics who use insulin at mealtime and have failed to achieve diabetic control?

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

Which class of drugs inhibits SGLT2, a membrane protein expressed mainly in the early proximal tubule (S1 segment) of the kidney where 90% of renal glucose reabsorption occurs?

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

Which DPP-4 inhibitor is associated with an increased risk of heart failure, especially in patients who already have heart or kidney disease?

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

Which medication delays gastric emptying, impacting the absorption of other drugs that should be taken 1 hour before or 2 hours after its administration?

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

Which medication is not an SGLT2 inhibitor?

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

Which medication increases tissue insulin sensitivity, enhancing the insulin-dependent uptake of fatty acids and glucose?

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

Which medication used for diabetic control is known to increase satiety through its action on the central nervous system?

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

Which SGLT2 inhibitor is known to potentially cause volume depletion due to its diuretic effect arising from increased osmolality of the urine?

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

Which medication used for diabetic control is known to cause genital yeast infections in both men and women?

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

Which medication used for diabetic control requires dose adjustment or is contraindicated in patients with stage 3 CKD or greater?

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

Which SGLT2 inhibitor is known to potentially cause hyperkalemia as one of its adverse side effects?

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

Which medication used for diabetic control can be used in combination with sulfonylureas, TZDs, DPP-4 inhibitors, and insulin?

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

What is the mechanism of action of metformin in indirectly activating AMPK?

<p>Inhibition of Complex I of the mitochondrial oxidative phosphorylation process</p> Signup and view all the answers

Which adverse side effect is commonly associated with metformin but is very rare and has a 50% fatality rate in severe cases?

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

Which enzyme do DPP-4 inhibitors target to increase the duration of effectiveness of endogenous GLP-1 and GIP?

<p>Dipeptidyl-peptidase-4</p> Signup and view all the answers

What is a potential side effect of DPP-4 inhibitors like Alogliptin that is rare but associated with their inhibitory action on substrates involved in inflammation?

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

Which side effect is NOT commonly associated with SGLT2 inhibitors?

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

Which medication class primarily focuses on enhancing tissue insulin sensitivity and improving glycemic control?

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

Which medication used for diabetic control is known to cause weight loss due to its mechanism of action?

<p>Canagliflozin (Invokana)</p> Signup and view all the answers

Which medication is known to slow gastric emptying, which can impact the absorption of other drugs taken at the same time?

<p>Pramlintide (Symlin)</p> Signup and view all the answers

Which medication can potentially cause hypotension due to its diuretic effect?

<p>Dapagliflozin (Farxiga)</p> Signup and view all the answers

Which medication can be used in combination with sulfonylureas, TZDs, DPP-4 inhibitors, and insulin?

<p>Canagliflozin (Invokana)</p> Signup and view all the answers

Which medication is known to potentially cause lactic acidosis, a rare but serious side effect?

<p>Metformin (Glucophage)</p> Signup and view all the answers

Which medication is associated with an increased risk of heart failure, especially in patients who already have heart or kidney disease?

<p>Saxagliptin (Onglyza)</p> Signup and view all the answers

Which medication used for diabetic control can increase the risk of angioedema, urticaria, and bronchial hyperreactivity?

<p>Sitagliptin (Januvia)</p> Signup and view all the answers

Which medication used for diabetic control delays gastric emptying, thus impacting the absorption of other drugs?

<p>Linagliptin (Tradjenta)</p> Signup and view all the answers

Which medication used for diabetic control requires careful consideration before prescribing to patients with chronic kidney disease (CKD)?

<p>Ertugliflozin (Steglatro)</p> Signup and view all the answers

Which medication used for diabetic control is contraindicated in patients with IBS and obstruction due to its poor tolerability and side effect of flatulence?

<p>Acarbose (Precose)</p> Signup and view all the answers

Which medication used for diabetic control can cause genital yeast infections in both men and women?

<p>Canagliflozin (Invokana)</p> Signup and view all the answers

Which medication used for diabetic control is an amylin analog that helps improve glycemic control in patients with type 1 or type 2 diabetes?

<p>Pramlintide (Symlin)</p> Signup and view all the answers

Which adverse side effect is NOT commonly associated with Amylin agonist Pramlintide?

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

Which of the following is a potential adverse side effect of SGLT2 inhibitors that may arise from increased osmolality of the urine?

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

Which common adverse side effect is associated with both Dapagliflozin and Empagliflozin among the SGLT2 inhibitors?

<p>Genital yeast infections</p> Signup and view all the answers

Which of the following adverse side effects is NOT commonly seen with SGLT2 inhibitors like Canagliflozin?

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

What is a less common adverse side effect associated with SGLT2 inhibitors like Bexagliflozin in addition to weight loss and genital yeast infections?

<p>Orthostatic hypotension</p> Signup and view all the answers

Which of the following is a potential adverse drug interaction risk when combining Dapagliflozin with medications that have diuretic effects or affect electrolyte balance?

<p>Increased risk of hyperkalemia</p> Signup and view all the answers

Which medication used for diabetic control is an amylin analog that helps improve glycemic control in patients with type 1 or type 2 diabetes?

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

Which class of drugs primarily focuses on enhancing tissue insulin sensitivity and improving glycemic control?

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

Which medication used for diabetic control inhibits the enzyme alpha-glucosidase in the small intestine to delay the digestion and absorption of carbohydrates?

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

Which medication should be avoided in patients with renal failure due to the risk of hypoglycemia mainly in elderly patients?

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

Which SGLT2 inhibitor is known to potentially cause hyperkalemia as one of its adverse side effects?

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

Which DPP-4 inhibitor is considered inappropriate for initial therapy and is usually used as add-on therapy for Type-2 diabetics only?

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

Which medication used for diabetic control is an amylin analog that helps improve glycemic control in patients with type 1 or type 2 diabetes?

<p>Pramlintide (Symlin)</p> Signup and view all the answers

Which drug class is known to potentially cause volume depletion due to its diuretic effect arising from increased osmolality of the urine?

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

Which medication used for diabetic control delays gastric emptying, thus impacting the absorption of other drugs?

<p>Linagliptin (Tradjenta)</p> Signup and view all the answers

Which medication used for diabetic control is associated with an increased risk of angioedema, urticaria, and bronchial hyperreactivity?

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

Which medication used for diabetic control is known to potentially cause lactic acidosis, a rare but serious side effect?

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

Which medication used for diabetic control can lower HbA1c by approximately 0.8% when used as monotherapy?

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

Amylin agonist Pramlintide is primarily used in patients with type 1 diabetes.

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

Amylin agonist Pramlintide can cause weight gain as one of its adverse side effects.

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

All SGLT2 inhibitors are associated with the adverse side effect of bone fractures.

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

Genital yeast infections are a common adverse side effect of all DPP-4 inhibitors.

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

SGLT2 inhibitors primarily work by inhibiting the enzyme alpha-glucosidase in the small intestine.

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

All SGLT2 inhibitors carry a significant risk of lactic acidosis as an adverse side effect.

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

Metformin primarily stimulates insulin secretion in the pancreas.

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

Amylin agonist Pramlintide is commonly associated with weight gain as a side effect.

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

SGLT2 inhibitors primarily work by inhibiting alpha-glucosidase in the small intestine.

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

One of the common side effects associated with DPP-4 inhibitors is angioedema.

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

Drug interactions with metformin are mainly due to its effect on increasing intestinal glucose absorption.

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

Amylin agonist Pramlintide can cause hypoglycemia as an adverse side effect.

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

Saxagliptin is considered appropriate for initial therapy in Type-2 diabetics.

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

Linagliptin delays gastric emptying, impacting the rate and extent of absorption of other drugs.

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

DPP-4 inhibitors like Sitagliptin increase the duration of effectiveness of endogenous GLP-1 and GIP by inhibiting their breakdown.

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

Alogliptin, a DPP-4 inhibitor, is widely distributed throughout the body on endothelial cells and circulating form.

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

SGLT2 inhibitors are known to potentially cause lactic acidosis as a rare but serious side effect.

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

Pramlintide, an amylin agonist, can be used in combination with insulin for diabetic control.

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

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