Flashcards in Diabetes and endocrine Deck (19):
Main 2 SE of metformin
What drug can be prescribed to aid weight loss in obese patients?
Inhibits pancreatic lipase
SE: diarrhoea, flatulence
Must show continued weight loss at 3 months to continue meds
What is carbimazole?
blocks thyroid peroxidase from coupling and iodinating the tyrosine residues on thyroglobulin → reducing thyroid hormone production and reduces peripheral conversion of T4 to T3
Adverse effects of carbimazole
Agranulocytosis (urgent FBC if signs of infection)
Dizziness and ataxia
Crosses placenta so use low dose in pregnancy
Main SE of insulin
Lipodystrophy, hypoglycaemia, weight gain
Main SE sulphonylureas + example
Hypoglycaemia, weight gain, hyponatraemia
Main SE of thiazolidenodiones and example
Weight gain, fluid retention
Main SE of DPP4-i and example
Increased risk of pancreatitis
Main SE SGLT-2i and example
Main SE GLP agonist and example
If metformin isn't enough, what can you add?
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
Most important SE of pioglitazone to be aware of
Increased risk of bladder cancer
Heart failure risk when taken with insulin
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
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
What happens when the 1st fluid bag runs out in DKA treatment?
Give 1L of NaCl 0.9% with 40mmol KCl IV over 2hrs
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)
What class of drugs can reduce awareness of hypoglycaemia?