Created at 3:28 a.m. Apr, 30, 2026
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buttalli
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Name an enzyme that Metformin inhibits and one that it activates
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(1) Inhibits: mGPD
(2) Activates: AMP Kinase
(mGPD = Inhibits mitochondrial enzyme glycerophosphate dehydrogenase)
(AMPK ↓ Gluconeogenesis and ↑ Insulin sensitivity)
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Other than affecting gluconeogenesis, what is the mechanism of Metformin?
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↑ Insulin sensitivity
(Other aspects include ↓ intestinal absorption of glucose)
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Adverse Effects (2) : Metformin
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(1) Lactic acidosis
(2) GI Issues
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How is Metformin excreted?
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Renal
(Unaltered and in active form)
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Name a diabetes drug which may cause weight loss
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Metformin
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Suffix: Thiazolidinediones
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"-glitazone"
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MOA: Glitazones
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PPAR-γ ligand
(∴ ↑ Insulin sensitivity and fatty acid oxidation)
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How do glitazones ↓ serum triglyceride levels?
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(1) ↑ Fatty acid oxidation
(2) ↑ Differentiation of adipocytes
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Name 2 proteins that glitazones upregulate
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(1) Adiponectin
(2) GLUT4
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Adverse Effects (4) : Glitazones
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(1) Weight gain
(2) Peripheral edema(3) ⇒ Heart failure
(4) ↓ Bone mineral density
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What are the physiologic effects of Amylin?
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(1) ↓ Gastric emptying
(2) ↓ Glucagon
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What drug can be used to treat T1DM and T2DM but is not an insulin analog?
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Amylin
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Adverse Effects (2) : Amylin
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(1) Hypoglycemia
(2) GI upset
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Name 2 α-glucosidase inhibitors
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(1) Acarbose
(2) Miglitol
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What is the mechanism of α-glucosidase inhibitors in treating diabetes?
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↓ Intestinal glucose absorption
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Why are α-glucosidase inhibitors infrequently prescribed?
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Severe abdominal side effects
(Undigested GI sugars ∝ Symptoms of lactose intolerance)
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Suffix: SGLT2 inhibitors
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"-flozin"
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MOA: "-flozin" drugs
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Inhibit SGLT2
(In proximal convoluted tubule ∵ that's where everything is reabsorbed)
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Adverse Effects (3) : SGLT2 inhibitors
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(1) ↑ Frequency of urination
(2) UTIs
(3) ↑ Risk of vaginal candidiasis
(↑ Urination ⇒ Hypotension)
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Contraindication: SGLT2 inhibitors
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2.2 - Metformin, thiazolidinediones, pramlintide, SGLT2 inhibitors 
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