SGLT2 Inhibitors - Pharmacology Summary Mechanisms of Action: Inhibits SGLT2 (sodium/glucose cotransporter 2) in the proximal tubule, blocking reabsorption of filtered glucose (leading to osmotic diuresis) Examples (_gliflozin): • Empagliflozin (Jardiance) - Best risk/benefit ratio of the three • Dapagliflozin (Forxiga) • Canagliflozin (Invokana) Major Advantages: • Weight loss (~2-3kg) • Empagliflozin and canagliflozin ↓ CV mortality in high risk patients with T2D + atherosclerotic heart disease • All 3 heart failure hospitalizations and progression of nephropathy Contraindications: eGFR < 30 mL/minute/1.73 m2 (for first initiation of use) Common Side Effects and Toxicities: • AKI (likely from hypovolemia) • GU infections (e.g. UT Is, vulvovaginal candidiasis) • Euglycemic diabetic ketoacidosis (DKA) • Canagliflozin ↑ risk of lower limb amputation and bone fractures - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedi #SGLT2 #Inhibitors #Pharmacology #Summary #DM2 #diabetes #endocrinology
