CC January 2015 DPP-4 inhibitors

echoecho's version from 2015-05-20 12:45


Question Answer
What is GLP-1?glucagon-like peptide 1
What is GIP?glucose-dependent insulinotropic hormone
The above are released from what cells of the GI tract? In response to what?L and K cells of the GI tract; response to intraluminal glucose
What does GIP (glucose-dependent insulinotropic hormone) do?stimulates insulin production
What does GLP-1 (glucagon-like peptide 1) do?stimulates insulin production and inhibits glucagon production
Which of the 2 hormones (GLP-1 glucagon-like peptide 1 vs. GIP glucose-dependent insulinotropic hormone) is associated with satiety?GLP-1 glucagon like peptide 1
Satiety is mediated by what?a decrease in gastric emptying time
Comment on the levels of GLP-1 glucagon-like peptide 1 in type 2 DM patient?reduced levels (but able to respond to it) of GLP-1 glucagon like peptide 1
Given that GLP-1 glucagon like peptide 1 is decreased in type 2 DM, what attempt was made to improve gllycemic control?increase endogenous levels of GLP-1 glucagon like peptide 1
Give the above question and answer, as a result, what medication class was developed?DPP-4 inhibitors
What is DPP-4?enzyme dipeptidyl peptidase-4
What is the function of DPP-4?dipeptidyl peptidase 4 rapidly degrades GLP-1 (glucagon like peptide 1)
What do inhibitors of DPP-4 do?they prolong the activity of GLP-1 (glucagon like peptide 1)
List the current approved 4 oral DPP-4 inhibitors?1) sitagliptin (Januvia) 2. saxagliptin (Onglyza) 3. linagliptin (Tradjenta) 4. alogliptin (Niesina)
A mean reduction in HgbA1c of _____% (100 dose) at 24 weeks of using Sitagliptin?0.79%
Monotherapy with DPP-4 inhibitors result in ______ (larger vs. smaller) HgbA1c reduction compared to metformin?smaller
Which combination (metformin plus sulfonylurea vs. metformin plus DDP-4 inhibitors) lowers HgbA1c more? which has higher incidence of hypoglycemia? which is less expensive?1) metformin plus sulfonylurea 2) metformin plus sulfonylurea 3) metformin plus sulfonylurea
DPP-4 inhibitors are generally well-tolerated oral agents, true or false?true
What are the most common side effects?nasopharyngitis, upper respiratory tract infection, headache
DPP-4 inhibitors are excreted ______ (hepatic vs. renally)?renally
Reduced doses of DPP-4 inhibitors are recommended when creatinine clearance < ______ mL/minute
Question Answer
*** In the 2014 Standards of Medical Care in Diabetes, the ADA states, "if non-insulin monotherapy at maximal tolerated dose does not achieve or maintain the A1c target over 3-6 months, add a second oral agent which would be?a glucagon-like peptide (GLP-1) receptor agonist or insulin
*** What is the initial therapy recommended?metformin
The American Assoc. of Clinical Endocrinologists recommends what as second-line therapy?a GLP-1 receptor agonist or a DPP-4 inhibitor
A recent study further affirmed the benefit in hgbA1c reduction and low incidence of what?adverse effects
In addition, the study suggested what other benefits with use of DPP-4 inhibitor therapy?1) improvement in BP 2) improvement in lipid profile 3) improvement of quality of life