Pharma 6

Question 1

GLP-1 Receptor Agonists include

Answer 1

Semaglutide

Question 2

Mechanism of action of semaglutide

Answer 2

Analogues of GLP-1; activate GLP-1 receptors

Question 3

Effect of semaglutide

Answer 3

Multi-organ Effects:
o Pancreas: Glucose-dependent Insulin secretion. Suppresses
Glucagon.
o Stomach: Slows gastric emptying (Feel full faster).
o Brain: Acts on hypothalamus to reduce appetite (Weight loss).

Question 4

Dosing fof exanatide

Answer 4

BID/ weekly

Question 5

Dosing of semaglutide

Answer 5

Injection once a week or daily oral

Question 6

GLP-1 Receptor Agonist with the highest efficacy for weight & A1c CV benefit

Answer 6

Semaglutide

Question 7

Cause and managment of GIT side effects with GLP-1 Receptor Agonists

Answer 7

Due to delayed gastric emptying
o Management: Titrate slowly. Stop eating when ful

Question 8

Contraindications of GLP-1 Receptor Agonists

Answer 8

▪ patients with personal or family history of medullary thyroid
cancer.
▪ Chronic pancreatitis

Question 9

DPP-4 inhibitors include

Answer 9

Sitagliptin

Question 10

Mechanism of action of sitaglipitin

Answer 10

Inhibit DPP-4 enzyme → ↑ endogenous GLP-1.→ increase insulin
and decrease glucagon, suppressing hepatic glucose output

Question 11

Pros of sitaglipitin

Answer 11

Oral, weight neutral, very well tolerated

Question 12

Cons of sitaglipitin

Answer 12

Modest efficacy, no major CV benefit (neutral)

Question 13

SGLT2 Inhibitors include

Answer 13

Dapagliflozin , Empagliflozin

Question 14

Mechanism of action of SGLT2 inhibitors

Answer 14

Inhibit sodium–glucose co-transporter 2 in proximal renal tubule
▪ Result: Blocks glucose reabsorption→ increased glucosuria

Question 15

Benefits of SGLT2 inhibtors

Answer 15

Weight loss and blood pressure reduction

Question 16

Administration of SGLT2 inhibitors

Answer 16

Given once daily in the morning before the first meal of the day

Question 17

An SGLT2 inhibitor approved to reduce CVS events in patients with type 2 dm

Answer 17

Empagliflozin

Question 18

Adverse effects of SGLT2 inhibitors

Answer 18

▪ Genital/urinary tract infections
▪ Dehydration
▪ Hypotension
▪ Euglycemic DKA: DKA with normal sugar (< 250). Rare

Question 19

Amyline analogues include

Answer 19

Pramlinitide

Question 20

Mechanism of action of pramlintide

Answer 20

Synthetic analog of Amylin (co-secreted with insulin)
▪ Action: Slows gastric emptying, suppresses glucagon.

Question 21

Theraputic use of pramlintide

Answer 21

Adjunct in T1 and T2 DM (Injectable)

Question 22

Side effects of pramlintide

Answer 22

Nausea,
Increased hypoglycemia risk with insulin

Question 23

Side effects of sitagliptin

Answer 23

▪ Nasopharyngitis (most common).
▪ Acute pancreatitis
▪ Disabling joint pain(arthropathy).
▪ increase the risk of heart failure hospitalizations

Question 24

ASCVD High Risk

Answer 24

GLP-1 RA or SGLT-2i (with proven benefit)

Question 25

Heart Failure

Answer 25

SGLT-2i (Preferred)

Question 26

CKD (Albuminuria)

Answer 26

SGLT-2i (Preferred) or GLP-1 RA

Question 27

Obesity

Answer 27

GLP-1 RA (Semaglutide) or SGLT-2i

Question 28

Cost Issue

Answer 28

Sulfonylurea or TZD