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ERM Mike Rose > Drugs Test 1 > Flashcards

Drugs Test 1 Flashcards

1
Q

Metformin

A

Class: Biguanides

MOA:

  1. )Decreases hepatic glucose production mainly by inhibiting gluconeogenesis via inhibition of enzyme activities. Reduces hepatic uptake of gluconeogenic substrates (lactate included!)
  2. ) Increases insulin sensitivity, reducing lipolysis and glucose absorbtion from the intestine. Via suppression of respiratory chain. Increased insulin TK activity. Stimulation of GLUT4.

Side effects: Diarrhea w/ high intial dose. Lactic Acidosis

Oral

No hypoglycemia; Weight neutral (loss)

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2
Q

Glimiperide

A

Class: Sulfonylureas (2nd Gen)

MOA: Insulin secretagogue. Binds SUR1 subunit of the K+ATP channel –> closes –> Ca++ entry and depol –> increased insulin release.

Must have some Beta-cell function to be effective

Oral

Side effects: Hypoglycemia and weight gain.

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3
Q

Exanitide

A

Class: Incretins

MOA: Glucagon-like Peptide 1 (GLP-1) analog. Increases cAMP levels in beta-cells –> stimulates insulin secretion and inhibitis glucagon secretion. Delays gastric emptying –> promotes satiety.

SubQ before meal

Side effect: Pancreatitis; GI problems

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4
Q

Sitagliptin

A

Class: Dipetidyl peptidase IV inhibitors

MOA: Inhibits DDP-IV which increases incretin activity (inhibits glucagon and stimulates insulin release). Delays gastric emptying –> satiety

Oral

Not associated w/ hypoglycemia and weight gain.

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5
Q

Repaglinide

A

Class: Meglitinides

MOA: Insulin secretagogues. K+ channel blocker.

Oral, take w/ meal

Hypoglycemia and weight gain.

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6
Q

Nataglinide

A

Class: Meglitinides

MOA: Insulin secretagogues. K+ channel blocker.

Oral, take w/ meal

Hypoglycemia and weight gain.

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7
Q

Acarbose

A

Class: Alpha glucosidase inhibitor

MOA: Inhibit hydrolysis of disaccharides and complex carbs to monosaccharides. Lowers postprandial glucose levels.

Side effects: GI

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8
Q

Miglitol

A

Class: Alpha glucosidase inhibitor

MOA: Inhibit hydrolysis of disaccharides and complex carbs to monosaccharides. Lowers postprandial glucose levels.

Side effects: GI

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9
Q

Pramlinitide

A

Class: Amylin Analog

MOA: Binds amylin receptors to inhibit glucagon. Delays gastric emptying.

SubQ

Can cause severe hypoglycemia in combination w/ insulin.

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10
Q

Rosaglitazone

A

Class: Thiozolidenes

MOA: PPARgamma (+/-) PPARalpha receptor agonists. Belong to steroid receptor family and affect transcription. Increase glucose uptake and utilization by increasing GLUT transporters.

Requires insulin to be present.

Oral

Side effects: Weight gain, Heart failure, URI, Hepatoxic

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11
Q

Piaglitazone

A

Class: Thiozolidenes

MOA: PPARgamma (+/-) PPARalpha receptor agonists. Belong to steroid receptor family and affect transcription. Increase glucose uptake and utilization by increasing GLUT transporters.

Requires insulin to be present.

Oral

Side effects: Weight gain, Heart failure, URI, Hepatoxic, and increased bladder cancer risk.

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12
Q

Glyburide

A

Class: Sulfonylureas (2nd Gen)

MOA: Insulin secretagogue. Binds SUR1 subunit of the K+ATP channel –> closes –> Ca++ entry and depol –> increased insulin release.

Must have some Beta-cell function to be effective

Oral

Side effects: Hypoglycemia and weight gain.

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13
Q

Glipizide

A

Class: Sulfonylureas (2nd Gen)

MOA: Insulin secretagogue. Binds SUR1 subunit of the K+ATP channel –> closes –> Ca++ entry and depol –> increased insulin release.

Must have some Beta-cell function to be effective

Oral

Side effects: Hypoglycemia and weight gain.

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14
Q

Chlorpromide

A

Class: Sulfonylureas (1st Gen)

MOA: Insulin secretagogue. Binds SUR1 subunit of the K+ATP channel –> closes –> Ca++ entry and depol –> increased insulin release.

Must have some Beta-cell function to be effective

Oral

Side effects: Hypoglycemia and weight gain. Disulfiram.

Not used anymore –> side effects (due to long half life) and less potent

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15
Q

Lispro

A

Rapid acting insulin

Onset: 15 min.

Max: 0.5-1.5hr.

Duration: 3-4hrs.

no LAG insulin (Lispro, Aspart, Glulisine)

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
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16
Q

Aspart

A

Rapid acting insulin

Onset: 15 min.

Max: 0.5-1.5hr.

Duration: 3-4hrs.

no LAG insulin (Lispro, Aspart, Glulisine)

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
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17
Q

Glulisine

A

Rapid acting insulin

Onset: 15 min.

Max: 0.5-1.5hr.

Duration: 3-4hrs.

no LAG insulin (Lispro, Aspart, Glulisine)

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
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18
Q

Regular insulin

A

Short acting insulin

Onset: 30 min

Max: 2-3hrs.

Duration: 4-8hrs.

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
19
Q

NPH Insulin

A

Intermediate acting insulin

Onset: 2-4hrs

Max: 4-12 hrs.

Duration: 10-20 hrs.

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
20
Q

Glargine

A

Long Acting Insulin

Onset: 1-2 hrs.

Max: no peak

Duration 18-24hrs.

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
21
Q

Detemir Insulin

A

Long acting insulin

Onset: 1-2

Max: no peak

Duration 18-24

Side effects:

  1. )Hypoglycemia (sweating, hunger, anxiety, tremor, palpitations are early. Difficulty concentrating, weakness, drowsiness, dizziness, blurred vision, loss of consciousness are late.)
  2. ) Weight gain (loss of leaking calories)
  3. ) Allergic reactions/ Skin probs/ Insulin resistance
22
Q

Cortisol

A

Glucorticoid: 1

Mineralocorticoid: 1

23
Q

Prednisone

A

Glucorticoid: 3.5-5

Mineralocorticoid: 0.8

24
Q

Methylprednisilone

A

Glucocorticoid: 5-7.5

Mineralocorticoid: 0.5

25
Q

Dexamethasone

A

Glucocorticoid: 25-80

Mineralocorticoid: 0

26
Q

Fludrocortisone

A

Glucocorticoid: 15

Mineralocorticoid: 200

Used as aldosterone replacement

27
Q

Prednisilone

A

Glucocorticoid: 4

Mineralocorticoid: 0.8

28
Q

Betamethasone

A

Glucocorticoid: 25-30

Mineralocorticoid: 0

29
Q

Triamcinolone

A

Glucocorticoid: 5

Mineralocorticoid: 0

30
Q

Deoxycorticosterone acetate (DOCA)

A

Glucocorticoid: 0

Mineralocorticoid: 20

31
Q

Aldosterone

A

Glucocorticoid: 0.3

Mineralocorticoid: 200-1000

32
Q

ACTH

A

Distinguishes from primary and secondary adrenal insufficiency.

Anticonvulsant for infantile spasms and to prevent neurotoxicity w/ cisplatin.

33
Q

Ketoconazole

A

MOA: Inhibits side change cleavage and other CYP enzymes –> decreased steroid synthesis. Blocks glucorticoid and androgen synthesis.

Side effects: Hepatotoxic

34
Q

Metyrapone

A

Inhibits 11 beta hydroxylase in the adrenal gland with the goal of interfering with cortisol production.

May be used when waiting for a definitive dx

35
Q

Cabergoline

A

Dopamine agonist that can be used to treat pituitary adenomas.

36
Q

Mifepristone

A

Glucocorticoid receptor antagonist. Used for patients w/ inoperable ACTH secreting tumors.

37
Q

Mitotane

A

DDT class of insecticides w/ nonselective adrenal toxicity.

38
Q

Sermorelin

A

GHRH analog.

Can be used w/ arginine in co-stimulation test to find source of GH deficiency.

39
Q

Somatotropin

A

Recombinant human growth hormone

GH can be used to treat hyposecretion syndromes in children

Hypopituitarism (most commonly hormone def. is GH; 1/4000 births).

Idiopathic short stature

Turner syndrome growth deficiency

SHOX mutations

Trauma that disrupts GH release.

Goal is to give GH to maintain IGF-1 in normal range

Side effects: scoliosis, diabetogenic

Also used in muscle wasting syndrome associated w/ AIDS

Potential for abuse by body-builders

Laron-type won’t be reactive (mutated receptor)

40
Q

Mecasermine

A

Recombinant IGF-1

Stimulates growth. Not as effective as GH in kids who respond to GH.

Fewer negative side effects.

Side effects: hypoglycemia (give before a meal).

Don’t give to kids w/ cancer (growth promoter!). Don’t give if epiphyseal plates are closed.

41
Q

Bromocriptine

A

Dopamine (D2) agonist which act on Gi–> decreasing cAMP.

Used to treat pituitary adenoma secreting GH or in lack of prolactin.

42
Q

Cabergoline

A

Dopamine (D2) agonist which act on Gi–> decreasing cAMP.

Used to treat pituitary adenoma secreting GH or in lack of prolactin.

Preferred rx for prolactinoma

43
Q

Octreotide

A

Long acitng somatostatin analog that works via Gi. Used in GH secreting pituitary adenoma.

Side effects: loos stools, cramps, malabsorbtion, etc.

Also used in: Carcinoid syndrome, esophageal varices, gastric dumping syndrome, VIPoma, gastrinoma

44
Q

Pegvisomant

A

GH antagonist that block hepatic GH receptors –> prevent IGF-1 release.

Reduced IGF-1 may increase GH by negative feedback.

Side effects: Hepatoxicity

ERM Mike Rose (3 decks)

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