Oral Hypoglycaemics — Selected Classes

Current · V5 (2025) → L2.iii Historical · V4 (2023) → U2.iii 1 exam appearance

2024B Q10

Exam question

Outline the mechanisms of action and adverse effects of the following: (a) Biguanides (35% of marks). (b) Sodium-Glucose cotransporter – 2 (SGLT-2) inhibitors (SGLT-2) (35% of marks). (c) Sulfonylureas (30% of marks).

CICMWrecks answer

Master answer

Canonical sourceFocused Pharmacopeia comparison

Open in Pharmacopeia

Canonical comparison

Master Compare

Compare candidate-facing canonical Pharmacopeia fields side by side. Isolated AI-draft proposals are never included.

3selected

Field	METFORMIN Endocrine · Endocrine · Level 3	SGLT2 Inhibitors Endocrine · Endocrine · Level 3	SULFONYLUREAS Endocrine · Endocrine · Level 3
Mechanism of action	- Enhance peripheral action of insulin - ↑ rate of anaerobic glycolysis and ↓ rate of gluconeogenesis - Inhibit intestinal absorption and ↓ peripheral utilization of glucose	Binding and blocking SGLT2 (Sodium-Glucose Co-Transporter 2) protein in proximal tubule of kidney. Results in: - Reduced Renal glucose reabsorption - Increased glucose excretion in urine	- Liberates insulin from pancreatic beta-cells (prolong depolarization in membrane → ↓ permeability to K+ → open Ca++ channel → Ca++ influx → Insulin release)
Adverse Effects Toxicity	- Does not cause hypoglycaemia when used on its own - GI disturbances - Lactic acidosis (rare)	- Polyuria, UTIs, Dehydration - Potential risk of AKI - Ketoacidosis - Toxicity (rare): excessive fluid loss and electrolyte imbalances	- Hypoglycaemia - GI disturbances - Cholestatic jaundice - LFT derangement - Leucopenia, thrombocytopenia - some Potentially teratogenic

Past papers

Exam appearances

1 appearance

Exam	Exact exam wording	Candidate success
2024B Q10	Outline the mechanisms of action and adverse effects of the following: (a) Biguanides (35% of marks). (b) Sodium-Glucose cotransporter – 2 (SGLT-2) inhibitors (SGLT-2) (35% of marks). (c) Sulfonylureas (30% of marks).	52%