Mechanism of action and advantages of dapagliflozin for patients with cardiovascular disease

This article explains the mechanism of action of dapagliflozin and its advantages for patients with cardiovascular disease. It also discusses why more than one antidiabetic drug is often required and provides advice on managing concerns about hypoglycemia. The article includes references to relevant books, journals, and online sources.

Viva Voce Scenario 5.2 - Dapagliflozin
You are working as a registered nurse in a cardiac ward, buddied with a nursing student,
Angus. Your patient, Mr Novak Pelichowski, informs you that he is due for his dapagliflozin
[Forxiga®]. Angus asks you if you could explain the mechanism of action of dapagliflozin to
him.
Question 1: Explain to Angus the mechanism of action of this antidiabetic drug,
dapagliflozin [Forxiga®], and its effects on reducing blood glucose levels.
Answer - Dapagliflozin is an inhibitor of SGLT2. It reduces reabsorption of glucose which
is filtered and this promotes urinary glucose excretion. It reduces sodium
reabsorption and increases the delivery of sodium to the tubule which is distil.
It increases the working by removal of sugar within the kidney. It also treats
the kidney disease and heart failure (Dhillon, 2019). It increases the removal
of sodium by kidneys. By inhibiting the transporter protein in the kidneys
which is SGLT2, it reduces the glucose absorption which is renal leading to
urinary glucose excretion. This is how the blood glucose levels are reduced
and this makes the body a little exposed to this antidiabetic drug.
Mr Pelichowski says his doctor says that Forxiga® is a better antidiabetic drug for someone
like him with heart disease. Angus asks you to explain why this would be the case.
Question 2: Briefly explain to Angus two (2) advantages of dapagliflozin for
patients with cardiovascular disease. Hint: You may find this
reference useful
Verma, S., & McMurray, J. J. V. (2018). SGLT2 inhibitors and mechanisms of cardiovascular benefit: A state-of-the-art
review. Diabetologia, 61(10), 2108-2117. https://doi.org/10.1007/s00125-018-4670-7
Answer – The two advantages of dapagliflozin for patients with cardiovascular
disease are described and mentioned as follows –
a) It helps in improving the levels of visceral fat and helps in reducing the body weight and
thus ameliorates metabolic syndrome Verma & McMurray, (2018).
).b) It also helps in reducing the oxidative stress and helps in delaying the other diseases
which are in framework of how dapagliflozin for patients with
cardiovascular disease is helpful (SGLT2 inhibitors and mechanisms of
cardiovascular benefit: a state-of-the-art review, 2018).
Therefore, these are the two main advantages which are addressed for the
dapagliflozin for patients with cardiovascular disease. This also

helps in knowing that how Mr Pelichowski is creating value for
patients having the cardiovascular disease.
Angus noted that Mr Pelichowski is also taking metformin [Diabex®, Diaformin®]. He asks
why more than one antidiabetic drug is required for the management of Mr Pelichowski.
Question 3: Explain to Angus why more than one type of antidiabetic drug is
often required?
Answer – More than one type of antidiabetic drug is often required as there are some
important benefits of the other drugs as well which helps in reducing the risk of heart
diseases. Metformin lowers the rate of death due to cardiovascular diseases. More than one
type of antidiabetic drug helps in resolving the issue which is faced by Mr Pelichowski
(Brunerova, Rahelić, Ceriello and et.al., 2018). More than one type of antidiabetic drug helps
in reducing the negative impacts of the other drugs and helps in recovering the body with
having less or no risk of heart disease in an effective and healthy manner.
Mr Pelichowski is cleared for discharge. He is worried that he may have a ‘hypo’
(hypoglycaemia) at night and unable to call for help. You approach him before he leaves and
offer him some advice.
Question 4: What advice would you give Mr Pelichowski his antidiabetic drug
regimen, and his concern about having a ‘hypo’ at night?
Answer – The advice given to Mr Pelichowski for following his drug regimen
which is clinical intervention in which he should drink or eat 15 or
20 gms of fast acting carbohydrates. Reaching of blood sugar levels
is also considered as an effective process when Mr Pelichowski
might unable to call for help when required (Lawton, Blackburn and
et.al., 2019). Having a snack or meal is also helpful so that he does
not face any kind of hypo at night. This helps inn addressing the
aspects as to how the care and advice is being given to Mr
Pelichowski in an effective and significant manner at large scale.
General questions, not related to scenario
Question 5: Briefly provide a summary of what you learned from: a) your
answer to your Weekly Topic Question; b) the postings that your
read from your peers in your tutorial group.

Answer – a) During this week, I have learned that how the drug dapagliflozin [Forxiga®]
has major concern with heart diseases and failures. Further, mechanism of
action of this antidiabetic drug was being learned and gained knowledge
through. Also, clinical intervention of the drug which is dapagliflozin
[Forxiga®] was being analysed and identified with the help of information
made available to be identified based on the questions.
b) The postings from my peer helped me in making my learning more effective and I gained
knowledge by analysing the positive aspects of dealing with the problem and
issue in an effective manner.
Question 6: Choose one drug that you have learned to date in this subject.
(a) Provide the generic name of this drug and the class
(b) What is the mechanism of action that resulted in that specific
therapeutic
effect?
Answer – a) Dapagliflozin [Forxiga®] is the drug which is being taken and the generic
name of the drug is Dapagliflozin and the class of this drug is Farxiga.
b) The mechanism of action which result in specific therapeutic effect are that it helps in
reducing the glucose of the body at large scale (Batista, Forny‐Germano and
et.al., 2018). It also helps in increasing the delivery of sodium in the body.
This is how the body helps in addressing the aspects of reducing the sugar
levels in the body in an effective and significant manner. Response of the drug
in the body helps in delivering the aspects as to how the sugar levels are
reduced.

REFERENCES
Books and Journals
Batista, A.F., Forny‐Germano, L. and et.al., 2018. The diabetes drug liraglutide reverses
cognitive impairment in mice and attenuates insulin receptor and
synaptic pathology in a non‐human primate model of Alzheimer's
disease. The Journal of pathology. 245(1). pp.85-100.
Brunerova, L., Rahelić, D., Ceriello, A. and et.al., 2018. Use of oral antidiabetic drugs in the
treatment of maturity‐onset diabetes of the young: A mini
review. Diabetes/metabolism research and reviews. 34(1). p.e2940.
Dhillon, S., 2019. Dapagliflozin: a review in type 2 diabetes. Drugs. 79(10). pp.1135-1146.
Lawton, J., Blackburn, M. and et.al., 2019. Broadening the debate about post-trial access to
medical interventions: a qualitative study of participant experiences at
the end of a trial investigating a medical device to support type 1
diabetes self-management. AJOB Empirical Bioethics. 10(2). pp.100-
112.
Verma, S., & McMurray, J. J. V. (2018). SGLT2 inhibitors and mechanisms of
cardiovascular benefit: A state-of-the-art review. Diabetologia. 61(10).
2108-2117.
Online
SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the-art review, 2018.
[Online]. [Available Through]
<https://link.springer.com/article/10.1007/s00125-018-4670-7>