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Flashcards in Diabetes and endocrine Deck (19):
1

Main 2 SE of metformin

GI upset
Lactic acidosis

2

What drug can be prescribed to aid weight loss in obese patients?

Orlistat
Inhibits pancreatic lipase
SE: diarrhoea, flatulence
Must show continued weight loss at 3 months to continue meds

3

What is carbimazole?

Anti-thyroid
blocks thyroid peroxidase from coupling and iodinating the tyrosine residues on thyroglobulin → reducing thyroid hormone production and reduces peripheral conversion of T4 to T3

4

Adverse effects of carbimazole

Agranulocytosis (urgent FBC if signs of infection)
Dizziness and ataxia
Drowsiness
SIADH
P450 inducer
Crosses placenta so use low dose in pregnancy

5

Main SE of insulin

Lipodystrophy, hypoglycaemia, weight gain

6

Main SE sulphonylureas + example

Hypoglycaemia, weight gain, hyponatraemia
Gliclazide

7

Main SE of thiazolidenodiones and example

Pioglitazone
Weight gain, fluid retention

8

Main SE of DPP4-i and example

Increased risk of pancreatitis
Sitagliptin

9

Main SE SGLT-2i and example

UTIs
Dapagliflozin

10

Main SE GLP agonist and example

N&V, pancreatitis
Liraglutide

11

If metformin isn't enough, what can you add?

Gliptin/sulphonylurea/pioglitazone/SGLT-2i

12

In DKA, describe the insulin regime

Should try to stick with pt's own long acting insulin
Use insulin infusion on top (5units/hr)
Glucose 10% infusion should be started when BM<14

13

Most important SE of pioglitazone to be aware of

Increased risk of bladder cancer
Heart failure risk when taken with insulin
Liver toxicity

14

Advice with bisphosphonate prescribing

Regular dental check up, good oral hygiene (osteonecrosis of jaw)
Avoid taking iron tablets until 2-3hrs after as they reduce bisphosphonate absorption
Swallow tablet whole, plenty of water, sitting or standing 30m before breakfast or another oral medication

15

1st line management of adult with DKA

500ml fluid bolus NaCl 0.9% if BP<90, over 15mins
Then NaCl 0.9% 1L over 1 hr
With sodium chloride 0.9% insulin IV infusion to a concentration of 1 unit/mL; infuse at a fixed rate of 0.1 units/kg/hour

16

What happens when the 1st fluid bag runs out in DKA treatment?

Give 1L of NaCl 0.9% with 40mmol KCl IV over 2hrs

17

When do you convert to a SC insuin regimen in DKA?

When pt feels ready to eat
When ketoacidosis is resolved (ketones<0.3mml.L and pH>7.3)

18

What class of drugs can reduce awareness of hypoglycaemia?

Beta blockers

19

Name 3 SE of thyroxine treatment

Osteoporosis
AF
Angina