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Pharmacology-PROF > Drugs for Diabetes Mellitus + Endocrine + Gonadal Hormone + Thyroid > Flashcards

Drugs for Diabetes Mellitus + Endocrine + Gonadal Hormone + Thyroid Flashcards

1
Q

Parentral hypoglycemic agent/Insulin/Insulin analogues /Insulin preparation

A
  1. Rapid acting/Ultra short acting
  2. Short actng
  3. Intermediate acting
  4. Long acting/Insulin analogues

page-474

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1
Q

AntiDiabetic drugs name ?

A
  1. Parental hypoglycemic agnets -INSULIN
  2. Oral H A - CHART

PAGE-474

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2
Q

Insulin analogous name ?

A

Rapid acting/Ultra short acting
1. I LISPRO
2. I ASPART
3. Human I recombinant inhaled

Short acting insulin
1. Regular-Natural-Soluble Insulin

Intermediate acting insulin
1.Isophane insulin
2.I Zn suspension

Long acting insulin
1.Protamine Zn I suspension
2.I glargine
3.I detemir

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3
Q

Bolus Insulin ?

A

short/rapid acting insulin that is given before meal to control post meal rise of blood sugar

476

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4
Q

Basal insulin ?

A

long acting insulin that is released slowly over a period of between 8-24 hours intemded to supply the basal level of insulin during the day and particularly at night time

page-476

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5
Q

Indications of insulin ?

A
  1. type-1 dm
  2. uncontrolled dm-ii
  3. dm in = 🤰 =RTA = severe infection = post operative patient
  4. d ketoacidosis
  5. d nephropathy
  6. d neuropathy
  7. d retinopathy
  8. hyperkalemia

477

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6
Q

A/E of insulin ?

A
  1. insulin hypersensitivity
  2. insulin resresistance
  3. insulin edema
  4. hypokalemia
  5. hypoglycemia
  6. obesity
  7. alopecia
  8. inc cancer risk

page 477

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7
Q

Hypoglycemia-Clinical features ?

A
  1. tachycardia
  2. palpitations
  3. severe sweating
  4. nausea
  5. hunger
  6. convulsion
  7. coma
  8. dealth

478

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8
Q

Tx of Hypoglycemia ?

A
  1. Mild H in a patient who can swallow
    simple sugar/glucose in liquid form
    Glucose gel,honey,sweet,dextrose tablet

2.Unconscious patient
Inj Glucagon(1mg) - (S/C - IM)
Inj 3mg- intranal restore

50% glucose solution IV infusion

page-478

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9
Q

Oral hypoglycemic agents ?

A

Insulin secretagogues
1.SulfonylUreas
1st Generation
-Tolbutamide
-TolAzamide
2nd Generation
-Glipizide
-Gliclazide
-glimepiride
2.Meglitinides=Repaglinide

Insulin sensitizers
Biguanide = Metformin
ThiazolidineDiones= PIO & ROSI glitazone

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10
Q

Mechanism of SulfonylUreas?

A

=Block ATP Sensitive K channel
=dec outward K efflux
=depolarization of B cell
=opening of voltage gated Ca channel
=inc intracellular Ca
=inc secretion of Insulin

page-483

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11
Q

Indication of SulfonylUreas?

A
  1. DM-II
  2. Combination of DM-I & DM-II
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12
Q

A/E of SulfonylUreas?

A
  1. Hypoglycemia
  2. Weight gain
  3. nausea
  4. vomiting
  5. Teratogenecity
  6. Aplastic anemia
  7. Hemolytic anemia

page-484

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13
Q

Contraindiaction ??

A
  1. 🤰
  2. Lactation
  3. Renal insufficiency
  4. Hepatic insufficiency
  5. Type-1 DM
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14
Q

Metformin Mechanism ??

A

=inc Glucose——-Lactose
=inc glycolysis
=inc glucose removal

=dec plasma glucagon
=dec hepatic & renal gluconeogenesis
=dec glucose absorption

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15
Q

Metfromin indication ?

A
  1. DM-2
  2. Insulin resistance syndrome
  3. Type-2 DM in obese persons
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16
Q

A/E of Metformin ?

A
  1. Anorexia
  2. nausea
  3. vomiting;diarrhea
  4. lactic acidosis
  5. acute kidney failure
  6. dec V-B12 absorption
  7. megaloblastic anemia

486

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17
Q

ThiazoLidineDione mechanism ?

A
  1. ThiazoLidineDione binds with PPAR-GAMA in muscle fat liver
  2. express the gene involve in lipid and glucose metabolism ,insulin signal transduction
  3. promotes glucose uptakle and utilization

487

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18
Q

Dipeptidyl peptidase IV Inhibitors name ?

A

GLIPTIN
sita-saxa-lina-alo-vilda

489

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19
Q

SitaGliptin Mechanism ?

A

=inhibit DPP-IV
=dec GLP-1 GIP
=degrade GLP-1 LIKE MOLECULES
=degrade incretin

=inc GLP-1 GIP
=dec postprandial glucose excursions
=inc glucose mediated insulin secretion
=dec glucagon level

489

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20
Q

SGLT-2 Inhibitors Name ?

A

GLIFLOZIN
empa-cana-dapa-ertu

491

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21
Q

SGLT-2 INHIBITORS mechanism ?

A

=G freely filtered by renal glomeruli
=reabsorbed in PCT
=Action of SGLT-2
=Causes-Glycosuria & Lower glucose level in DM-2 patient

page-491

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22
Q

which Genration of sulfonylurease is better ?

A

2nd

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23
Q

why 2nd one better ?

A

Higher potency: They are effective at much lower doses.

Improved safety profile: Lower risk of drug interactions and side effects.

Longer duration of action: Allow for once- or twice-daily dosing, improving patient compliance.

Reduced hypoglycemia risk: Compared to first-generation agents, though still a concern.
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24
significant of MW of insulin ?
cannot pass blood placental barrier
24
molecular mechanism of insulin ? 471
I binds with the alpha-subunit of receptor autophosphorylation of Beta-subunit tyrosine kinase activity of beta subunit phosphorylation of some cytoplasmic eenzymes activation of some other enzymes = inc glycogenesis = effect on protein synthesis , lipolysis , lipogenesis
24
Gestational DM e ki diba ?
Insulin
24
molecular weight of Insulin ?
58K dalton 471
24
indication of HRT ?
reduce everyday symptoms of estrogen loss to prevent long term complications of E deficiency
25
why insulin in GDM ?
etar HIgh MW tai BPB cross kore na no teratogenicity tai GDM e Insulin
25
E & Porgesteron dose in HRT ?
E = 1-28 day of mens cycle P = 14 - 28 day of mens cycle
26
inhalation glucocorticoides ?
493
26
Gonadal hormone name ?
Estradiol estrone estriol progesterone hydroxyP medroxyP dimethisterone desogestrel
26
HRT ? 503
Post-menopausal hormone replacement therapy
27
risk of HRT ?
breast cancer endometrial cancer
28
HRT kader diba ??
Women without a uterus - continuous Estrogen women with uterus - E+ progesteron to prevent endometrial proliferatio n
29
which OHA can be given in insulin resistance ?
sulfonylurease along with insulin prof fatema mam 480
30
insulin resistance?
decline in number / affinity of receptors / defect in post-receptor mechanism
31
when A diabetic pt is called I resistance >
if need >> 200 units/day
32
immunogenic I R tx ?
by changing brand anti-histamine glucocorticoid
33
role of propranolol in insulin therapy ?
mask hypoglycemia impair recovery from low blood sugar
34
indication of glucocorticoids ? '496
adrenocortical insufficiency addison D addisonian crisis cushing syndrome congenital adrenal hyperplasia aldosterinism
35
A/E of Glucocorticoids ?
499
36
indications of POP/mini pill ?
contraception in lactating mother HTN Hepatic D Psychosis mental retardation thromboembolism
37
emergency pill combo ?
ethinyl estradiol
38
mini pill other name ?
pop
39
emergency pill dose ?
2 tabs as early as possible within 72 hrs then 2 tabs 12hr after the first dose
40
emergency pill content ?
ethinyl estradiol 2.5mg twiche daily for 5 days
41
immunosuppressive effect valo na > kharap ? fatema mam ?
valo
42
clinical features of hypoglycemia ?
tachycardia palpitation severe sweating tremulousness nausea hunger sudden unconsciousness
43
Tx of hypoglycemic Pt ?
478
44
common A/E of insulin ?
hypoglycemia
45
46
How G cause PUD ?
Glucocorticoids primarily increase the risk of PUD by compromising mucosal defense mechanisms (via prostaglandin inhibition) and impairing mucosal repair, rather than directly increasing acid production. This makes them particularly risky when used in combination with NSAIDs or in patients with pre-existing risk factors for PUD.
47
principles of withdrawal of corticosteroids?
500
48
GIT A/E of glucocorticoids ?
PUD pancreatitis
49
immunosuppressive action of corticostreoids ?
inhibit function of macrophage & APC - dec phagocytosis inhibit activation of complement imapired delayed hypersensitivity reaction dec CMI dec IL-1 IL-2
50
permissive effect ??//
small amount of G must be present for a number of metabolic reactions although G donot produce the reactions by themselves
51
IN asthma cathecolamine + corticosteroids which effect it is ?
permissive effect
52
abrupt withdrawal effect of corticosteroids?
- feedback adrenal / pituitary suppression Anorexia - N V Fever pain lethary 501
53
why Insulin is not given orally ?
Insulin is not given orally because it is a **protein that is destroyed by digestive enzymes in the gastrointestinal tract** before it can be absorbed into the bloodstream.
54
long term A/E of OCP ?
MI venous thromboembolism cerebrovascular D cholecystitis depression cholagitias
55
insulin [preparation ?
474
56
short acting I ?
regular ' natural solub le
57
rapid acting I >
lispro aspart
58
which long acting Insulin use frequently ?
Long-acting insulins frequently used include **insulin glargine**, **insulin detemir**, and **insulin degludec**.
59
intermediate acting I ?
I Zn suspension 474
60
hormonal contraceptives name ?
combined pill oral pill OCP POP post coital once a month male pill Depot
61
long term adverse effect of estrogen ?
Long-term adverse effects of estrogen therapy include: 1. **Increased risk of thromboembolism** (e.g., deep vein thrombosis, pulmonary embolism). 2. **Increased risk of stroke**. 3. **Elevated risk of breast cancer** with prolonged use. 4. **Endometrial hyperplasia and cancer** (if unopposed by progesterone in women with a uterus). 5. **Gallbladder disease**. (Source: Katzung & Trevor's Pharmacology)
62
which glucocorticoides has less mineralocorticoid activity ?
dexamethasone
63
estrogen deficiency te aged wwomen der ki ki prblem hoy ??
1. **Osteoporosis** 2. **Vasomotor symptoms (hot flashes)** 3. **Vaginal atrophy** 4. **Increased cardiovascular risk** 5. **Cognitive decline**
64
insulin indication ?
477
65
what is mineralocorticoid activity ?
Mineralocorticoid activity refers to the regulation of electrolyte and water balance, primarily by promoting sodium retention and potassium excretion in the kidneys, mediated by hormones like aldosterone.
66
insulin kokhon dei ?
khawar 30 min age
67
which beta blocker in thyrotoxicosis < 520
propranolol atenolol metoprolol
68
anti-thyroid drugs name ? 520
carbimazole methimazole propylthiouracil lithium salt iodide amiodarone
69
OPC er severe A/E >?
Depression sukanto sir
70
Hydrocotisone & dexamethasone er modde kontar anti-inflmmatory effect valo ?
**Dexamethasone** has better anti-inflammatory function compared to hydrocortisone due to its higher glucocorticoid potency and longer duration of action.
71
precautions of streoid therpay <
500
72
which streoid in Head injury >?
dexamethasone
73
heart effect of steroid ?
HTN
74
eye effect of steroid ?
cataract glaucoma
75
Which enzyme is inhibited in anti-inflammatory action <
TAX2
76
Contraceptive fucntion of OCP ?
Contraception
77
non-contraceptive function of OCP ?
endometriosis irregular mens holy hajj to prevent mens DUB Functional ovarian cyst
78
what advice is given to prevent lipodystrophy ?
To prevent **lipodystrophy**, the following advice is given: 1. **Rotate injection sites** regularly to avoid repeated trauma to the same area. 2. **Use proper injection techniques** to ensure even distribution of medication. 3. **Avoid reusing needles** to reduce tissue irritation. 4. **Monitor injection sites** for early signs of lipodystrophy. (Source: Katzung & Trevor's Pharmacology)
79
non-diabetic use of Insulin ?
Non-diabetic uses of insulin include: 1. **Hyperkalemia management** (to shift potassium into cells). 2. **Total parenteral nutrition (TPN)** in critically ill patients. 3. **High-dose insulin therapy** for beta-blocker or calcium channel blocker overdose. 4. **Anabolic purposes** (misuse in bodybuilding for muscle growth). (Source: Katzung & Trevor's Pharmacology)
80
immunosppressive effect of steroid example ?
organ transplantation
81
which transporter in insulin mechanism ?
glucose GLUT4 471
82
Amino acid no in insulin ?
51 A chain 21 B chain 30
83
Route of administration of insulin >
476
84
C peptide function ?
its level provides an index of B cell function in Pt receiving exogenous insulin 471
85
non-diabetic use of metformin ?
PCOS Weight management
86
Graft rejection e steroid er kon effect >
immunosuppressive
87
which drug used with misoprostol >
mifepristone
88
why Misoprostol + Mifeprostone ?
medical termination of pregnancy
89
indication of progesterone ?
HRT DUB Contraception endometriosis premature labour 507
90
A/E OF progesterone /
headache mood change dec HDL inc LDL dec bone density weight gain
91
contraindications of steroids ?
500
92
blood glucose kotor niche namle Hypoglycemia ?
< 70 mg/dl
93
when ergotamine contraindicated ?
during labour and before 3rd stage of labor
94
when oxytocin is used ?
active management of 3rd stage labor
94
long acting steroids >
betamethasone dexamethasone
95
why PG are commonly used in therapeutic aborton >
much more effective than oxytocin termination of pg - midterm abortion
96
short acting steroid <
cortisone hydrocortisone prednisone prednisolone methylP
97
intermediate acting steroid ?
triamcinolone paramethasone 13-2-2025 12.30AM

Pharmacology-PROF (38 decks)

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