Endo

Question 1

Bromocriptine =

- used for

Answer 1

DA agonist

- trt prolacintoma (inhib PRL)

Question 2

Propylthiouracil

- mech, clin use, tox

Answer 2

• blocks TPO -> no organification of I- (to make MIT/DIT), and no T3/T4 syn; also blocks 5’deiodinase (no T4->T3)
• hyperthyroidism
• skin rash, agranulocytosis (rare), aplastic anemia, hepatotox

Question 3

Methimazole

- mech, clin use, tox

Answer 3

• blocks TPO -> no organification of I- (to make MIT/DIT), and no T3/T4 syn
• hyperthyroidism
• skin rash, agranulocytosis (rare), aplastic anemia, possible teratogen

Question 4

Cabergoline =

- use for

Answer 4

DA agonist

- trt prolactinoma (inhib PRL)

Question 5

Demeclocycline

- mech, clin use, tox

Answer 5

• ADH antag (in tetracycline family)
• SIADH
• nephrogenic DI, photosensitivity, abnl’ities of bone/teeth

Question 6

Desmopressin =

- used for

Answer 6

ADH analog

- DI (distinguishes central DI from nephrogenic DI bc works in central DI, but not in nephrogenic)

Question 7

How do you treat nephrogenic DI?

Answer 7

Hydrochlorothiazide (makes gradient more conc’d so urine will be more conc’d), indomethacin, amiloride

Question 8

Conivaptan, tolvaptan =

- used for?

Answer 8

ADH R antag

- SIADH

Question 9

Lispro =

Answer 9

rapid-acting insulin

Question 10

Detemir =

Answer 10

long-acting insulin

Question 11

Aspart =

Answer 11

rapid-acting insulin

Question 12

Glargine =

Answer 12

long-acting insulin

Question 13

Glulisine =

Answer 13

rapid-acting insulin

Question 14

NPH =

Answer 14

intermediate insulin

Question 15

Regular insulin =

Answer 15

short-acting insulin

Question 16

Metformin =

• can be used in pt’s w/ no islet cells?
• SE?
• C/I’d in?

Answer 16

biguanide
decr's gluconeogenesis and incr's glycolysis, incr's periph glc uptake (insulin sensitivity)
- yes
- GI upset, lactic acidosis
- renal failure

Question 17

Sulfonylureas =

• mech
• use in T1DM?
• SEs of 1st gen? 2nd gen?

Answer 17

1st gen: Tolbutamide, Chlorpropamide
2nd gen: Glyburide, Glimepiride, Glipizide
- close K ch in b-cell mem -> depol -> Ca in and insulin release
- no bc need some islet cell func
- 1st gen: disulfiram-like effects; 2nd gen: hypoGlc

Question 18

Tolbutamide =

SE?

Answer 18

1st gen sulfonylurea

- disulfiram-like effects

Question 19

Chlorpropamide =

SE?

Answer 19

1st gen sulfonylurea

- disulfiram-like effects

Question 20

Glyburide =

SE?

Answer 20

2nd gen sulfonylurea

- hypoGlc

Question 21

Glimepiride =

SE?

Answer 21

2nd gen sulfonylurea

- hypoGlc

Question 22

Glipizide =

SE?

Answer 22

2nd gen sulfonylurea

- hypoGlc

Question 23

Glitazones/thiazolidinediones (TZDs) =

- mech, SEs

Answer 23

Pioglitazone, Rosiglitazone

• bind PPARg nuc trxn regulator -> incr’d insulin sensitivity and incr’d adiponectin
• wt gain, edema, hepatotox, HF

Question 24

a-glucosidase inhibitors =

- mech, SEs?

Answer 24

Acarbose, Miglitol

• inhib intestinal BB a-glucosidase -> delayed sugar hydrolysis and glc ab’n -> decr’d postprandial hyperGlc
• GI disturbances

Question 25

Acarbose = | SE?

Answer 25

a-glucosidase inhib | - GI disturbances

Question 26

Miglitol = | SE?

Answer 26

a-glucosidase inhib | - GI disturbances

Question 27

Pramlintide = - mech, SEs - use in?

Answer 27

amylin analog - decr glucagon - hypoGlc, N, D - T1 or T2 DM

Question 28

GLP-1 analogs = | - mech, SE

Answer 28

Exenatide, Liraglutide - incr insulin and decr glucagon release - N,V, pancreatitis

Question 29

Exenatide = | SE?

Answer 29

GLP-1 analog | - N, V, pancreatitis

Question 30

Liraglutide = | SE?

Answer 30

GLP-1 analog | - N, V, pancreatitis

Question 31

DPP-4 inhib's = | - mech, SEs?

Answer 31

"-gliptin" (linagliptin, saxagliptin, sitagliptin) - incr insulin, decr glucagon release - mild urinary or resp infec's

Question 32

Linagliptin = | SE?

Answer 32

DPP-4 inhib | - mild urinary or resp infec's

Question 33

Saxagliptin = | SE?

Answer 33

DPP-4 inhib | - mild urinary or resp infec's

Question 34

Sitagliptin = | SE?

Answer 34

DPP-4 inhib | - mild urinary or resp infec's

Question 35

Levothyroxine, triiodothyronine | - mech, clin use, tox

Answer 35

- T4 replacement - hypothyroidism, myxedema - tachy, heat intol, tremors, arrhythmias

Question 36

To control uterine hemorrhage, give?

Answer 36

oxytocin (contractions)

Question 37

Glucocorticoids = | - mech, clin use, tox

Answer 37

Hydrocortisone, prednisone, triamcinolone, dexamethasone, beclomethasone - decr'd prod of leukotrienes and PGEs by inhib'ing phospholipase A2 and exp'n of COX-2 - Addison's dz, inflamm, imm supp'n, asthma - iatrogenic Cushing's synd, ad insuff when quickly stopped after chronic use