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Pharmacology final > Diabetes and Hormones > Flashcards

Diabetes and Hormones Flashcards

1
Q

2 major thyroid hormones

A

T3
T4

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2
Q

normal effects of thyroid hormones

A

increase basal metabolic rate
accelerate the rate of utilization of foods for energy
accelerate the growth rate of young people
excite mental process
increase the activity of most endocrine glands
more and bigger mitochondria

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3
Q

2 disorders of thyroid gland

A

hyperthyroidism
hypothyroidism

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4
Q

hyperthyroidism

A

high state of excitability
intolerance to heat
increased sweating
mild to extreme weight loss
muscle weakness
nervousness
extreme fatigue
inability to sleep
tremor of hands

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5
Q

hypothyroidism

A

fatigue
extreme somnolence
extreme muscular sluggishness
slow heart rate
decreased BV and CO
increased weight
mental sluggishness
depressed growth of hair

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6
Q

cause for thyroid disorder - auto immunity

A

destruction of the thyroid gland can cause hypo
errant stimulation of the thyroid receptors causes hyper

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7
Q

cause for thyroid disorder - cancer

A

tumor of the thyroid gland can cause hyper

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8
Q

cause for thyroid disorder - diet

A

lack of iodine in the diet can cause hypo

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9
Q

cause for thyroid disorder - genetics

A

lacking enzymes involved in making thyroid hormones causes hypo

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10
Q

goiters

A

large protrusions on the neck due to enlarged thyroid gland

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11
Q

why do you get goiters

A

result of thyroid stimulating hormones receptor activity

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12
Q

when can you see goiters

A

severe hypo and sometimes hyper

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13
Q

hypo

A

low thyroid hormones so body over produces thyroid stimulating hormone in pituitary gland
grows bigger and bigger

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14
Q

hyper

A

elevated levels of anti-TSH antibodies over stim thyroid gland
gets bigger and bigger

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15
Q

what can decrease t4 absorption

A

excessive clacium or aluminum antacids

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16
Q

treatment for hypo

A

drugs

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17
Q

treatment for hyper

A

removal of part or all of the gland
inhibit thyroid hormone synthesis

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18
Q

what can inhibit thyroid hormone synthesis

A

thioamide

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19
Q

estrogen and progestogen use as drugs

A

contraception
fertility treatments
menopause
rare diseases

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20
Q

combined oral contraceptive

A

combination of estrogen and progestogen
preventative
taken regular

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21
Q

high dose progestin

A

morning after pill

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22
Q

major side effects of estrogen and progestogen

A

breast fullness
depression
fluid retention
headache
nausea
vomitting

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23
Q

minor side effects of estrogen and progestogen

A

cv disease
carcinogenicity
metabolic effects like abnormal glocose tolerance
weight gain

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24
Q

possible benefecial effect of estrogen

A

good effect on cholesterol levels

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25
Q

other reasons to take estrogen and progestogen

A

menopause
post menopause
premature menopause
transgender
estrogen deficiency due to removal of ovaries
inadequate functioning of ovaries

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26
Q

drugs can block effects of hormone also

A

tamoxifen: used to treat estrogen-dependent breast cancer

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27
Q

what can be agonist and antigonist

A

selective estrogen-receptor modulators

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28
Q

androgens

A

anabolic steroids that have a masculinizing effect

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29
Q

where are androgens produced

A

testis
ovary to lesser extent

30
Q

androgens from testes are

A

testosterone DHT and DHEA

31
Q

androgens use

A

by males with hypogonadism
prevent body deterioration due to HIV, severe burns, surgery

32
Q

adverse effects of using androgens

A

increased aggression
reduced testicle size
impotence

33
Q

regulation of glucose in healthy person

A
  1. beta islets cells of pancreas sense high levels of glucose in the blood
  2. insulin is released
  3. insulin goes throughout the body
    interacts with insulin receptors on the tissues
  4. insulin receptors cause glucose transporters to become active
  5. glucose is transported to the tissues
34
Q

other metabolic effects of insulin on healthy people

A

regulates metabolism of glucose, fatty acids and amino acids inside the cell
causes formation of glycogen in the liver
storage of triglycerides in the adipose tissue
maintain blood glucose at <100mg/dl fasting and <120mg/dl post meal

35
Q

% population in us affected by diabetes

A

> 10%

36
Q

3rd type of diabetes

A

gestational diabetes
may lead to type 2 diabetes

37
Q

other rare types of diabetes

A

congenital diabetes
cystic fibrosis-related diabetes
steroid diabetes induced by high doses of glucocorticoids
monogenic diabetes

38
Q

type 1 diabetes

A

10% of diabetics
onset in the 20’s

39
Q

type 1 diabetes pathophysiology

A

B islets of pancreas get damaged and destroyed by auto immune disease
insulin cannot be produced

40
Q

when blood glucose rises acts as a

A

diuretic

41
Q

consequence of high blood glucose

A

loss of calories in urine causes weight loss and increased appetite
tissues use fat as energy and produce ketone bodies
toxic effect

42
Q

issue with low insulin

A

increase in formation of new glucose
release of FFA to make ketoacids that make the blood acidic

43
Q

type 2 diabetes

A

non-insulin dependent
90% of diabetes
onset older

44
Q

type 2 diabetes pathophysiology

A

insulin receptors don not work properly
pancreas makes extra insulin
insulin resistant

45
Q

overtime pancreas becomes __ in type 2

A

burned out and stops working
then resembles type 1 and requires insulin injections

46
Q

symptoms of uncontrolled diabetes

A

polyuria
polyphagia
polydipsia
unexplained weight loss
fatigue
blurred vision
irritable
neuropathy: damage to feet
ketosis (type 1 only)

47
Q

4 tests for diagnosing diabetes

A

glycosylated hemoglobin HbA1c <7% is the goal
fasting plasma glucose levels
glucose tolerance test : drink glucose
symptoms of hyperglycemia

48
Q

defining difference btw type 1 and 2

A

insulin level following a glucose tolerance test

49
Q

primary methods for non-drug control of diabetes

A

diet and exercise (2>1)

50
Q

diet strategy for diabetes

A

control protein intake
lower saturated fat intake
modulate the types of fat
reduce cholesterol
reduce carbs
modify vitamins and minerals

51
Q

exercise strategy for diabetes

A

improve uptake of glucose by muscles
reduce risk of CV complications
improve glycemic control

52
Q

problem with exercise and diabetes

A

autonomic neuropathy
retinopathy
peripheral neuropathy

53
Q

recommendation of exercise for diabetes

A

150 min/wk of moderate exercise
resistance training for enhaced glycemic control

54
Q

exercise can have effects that last

A

24-48 hours

55
Q

drug treatment for type 1

A

rapid acting short acting
intermediate acting/extended long acting

56
Q

rapid short acting

A

subcutaneous injection (post meal)
injected before meal
bolus injection (loading dose)

57
Q

long acting

A

subcutaneous injection
released slower
injected after meal
basal injection (maintenance dose)

58
Q

can different types of insulin medication be injected with the same syringe

A

no unless sold that way

59
Q

should you change the site of injection

A

yes for consistent results
not all same rate of absorption

60
Q

what format of injection more used now

A

insulin pens and pumps

61
Q

major adverse event of insulin injection

A

hypoglycemia

62
Q

if hypoglycemia occurs

A

need immediate dose of sugar

63
Q

if unconscious

A

need to go to hospital for a glucagon injection or parenteral glucose

64
Q

other complications of insulin

A

weight gain
allergy to medecin
lipohypertrophy

65
Q

drug treatment for type 2

A

insulin scretagogues
biguanides
insulin sensitizers
a glucosidase inhibitors
insulin

66
Q

insulin secretagogues

A

sulfonylureas (slower) and non sulfonylureas
cause pancreas to secrete more insulin

67
Q

biguanides

A

reduces release of glucose from the liver

68
Q

insulin sensitizers

A

make tissues more able to use glucose
doesn’t cause hypoglycemia

69
Q

a-glucosidase inhibitors

A

prandase
may contribute to hypoglycemia, dextrose tablets would be required

70
Q

insulin (type 2 tx)

A

used if needed with pills to help reach blood glucose goals

71
Q

treatment approach before medication

A

exercise
lower blood glucose levels
lower BP
healthy diet that reduces bad cholesterol (LDL)

(try 3 months)

72
Q

diabetes can get worse overtime

A

not pt at fault

Pharmacology final (2 decks)

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