Block 2 endocrine Flashcards
what is the first line pharmacological management of type 2 diabetes
metformin
what group of oral anti diabetic is metofmrin and how does it work
metformin is a biguanide that reduces insulin resistance by reducing the amount of sugar your liver releases into the blood
give 2 examples of antidaiabetics that work to reduce insulin resistance
metformin and pioglitazone
how does pioglitazone work
helps insulin work better in muscle and fat. It lowers the amount of sugar the liver releases and makes fat cells more sensitive to insulin effects
how does sulphonylurea work (gliclazide, glipizide, glibenclamide)
it is an insulin secretagogue which means they work by causing the body to secrete insulin
how does glisten work
it is a DPP4 inhibitor - stops GLP1 being broken down so fast so prolongs the effects of GLP-1
GLP-1 is produced by the upper GI tract immediately after a meal, stimulates insulin secretion from beta cells and suppresses glucagon secretion from alpha cells
how do incretins work
they are GLP-1 agonists
how do SGLT-2 inhibitors work
they enhance glucose secretions by preventing glucose from being reabsorbed and so is excreted in urine
How does acarbose and amylin work
acarbose stops starch being absorbed
amylin influences gastric emptying
Write out the main groups of anti diabetics
- reduce insulin resistance (metformin and pioglitazone)
- increased beta cell activity (sulphonylurea)
- increased GLP-1 activity ( gliptin, a DPP4 inhibitor) and incretins
- enhance glucose excretions (SGLT-2 inhibitor)
- slow glucose absorption (acarbose and amylin)
what are the main side effects of metformin
think it reduces insulin resistance
therefore GI symptoms, weight loss and lactic acidosis
what are the main side effects of pioglitazone
osteoporosis, wieght gain, fluid retention
what are the main side effects of sulphonylurea
think they increase beta cell activity
so will cause weight gain and hypoglycaemia
what are the main side effects of gliptin (DPP4 inhibitor)
- think it increases GLP-1 activity therefore GI symptoms (possibly pancreatitis)
what are the main side effects of incretins
GLP-1 agonist so weight loss, GI tract upset.
what are the main side effects of SGLT-2 inhibitors -flozin
enhance glucose excretion therefore
weight loss
UTI
glucoseuria
Rapid acting insulins
a) when do they start working
b) how long do they last
a) around 10 mins
b) around 4 hours
give an example of rapid acting insulin
novorapid
Humalog
apidra
short acting insulins
a) when do they start working
b) how long do they last
a) around 30 mins
b) 8 hours
give an example of short acting insulin
act rapid
humulin S
inhuman rapid
intermediate acting insulins
a) when do they start working
b) how long do they last
a) around an hour
b) around 16 hours
give an example of an intermediate acting insulin
insulatard
humulin I
Insuman basal
long acting insulins
a) when do they start working
b) how long do they last
a) around an hour
b) around 24 hours
give an example of a long acting insulin
Lantus
Levemir
degludec (lasts over 40 hours)
give an example of some combination insulins
rapid: intermediate ratios
Humalog 25
Humalog 50
novomix 30
name the hormones that are produced by the anterior pituitary
ACTH TSH LH FSH prolactin GH
name the hormones that are produced by the posterior pituitary
ADH
oxytocin
what is the function of ACTH
stimulates adrenal gland to produce cortisol
what is the function of TSH
stimulates thyroid gland to secrete thyroxine
mnemonic for anterior pituitary hormones (FLATPEG)
F - FSH
L- LH
A- ACTH
T- TSH
P- prolactin
E- endorphins
G- growth hormone
