Endo drugs

Question 1

Insulin (rapid acting)

Answer 1

Aspart, Lispro, Glulisine

MOA: Binds insulin receptor
Use: T1DM, T2DM, GDM

SE: Hypoglycemia, hypersensitivity

Question 2

Insulin (short acting)

Answer 2

Regular

Use: T1DM, T2DM, GDM, DKA, hyperkalemia, stress hyperglycemia
Give IV insulin in acute DKA

Question 3

Insulin (intermediate)

Insulin (long acting)

Answer 3

NPH - intermediate
Long acting - Deltemir, Glargine

Use: T1DM, T2DM, GDM

Question 4

Oral Hypoglycemics

Answer 4

Sulfonylureas, Biguanides (metformin), Glitazones, SGLT2 inhibitors (Canaglifozin)

Question 5

Sulfonylureas

Answer 5

Chlorpropamide, Tolbutamide - first generation
Glimepiride, Glipizide, Glyburide - second generation

MOA: Close K channel in B cell membrane -> cell depolarizes -> Ca influx -> insulin release

Use: T2DM. NOT T1DM

SE: hypoglycemia - 2nd gen; 1st gen: disulfirum like effects

Question 6

Glitazones

Answer 6

Pioglitazone, Rosiglitazone

MOA: Increase insulin sensitivity in peripheral tissue; Bind PPAR-y nuclear transcription regulator

Use: T2DM
SE: Weight gain, edema, hepatotoxicity, HF, increased risk fractures

Question 7

SGLT2 inhibitors

Answer 7

Canaglifozin
MOA: Block glucose reabsorption in PCT
USE: T2DM
SE: Glucosuria, UTI, vaginal yeast infections

Question 8

DPP 4 inhibitors

Answer 8

-“gliptons”
MOA: increase insulin, decrease glucagon release
Use: T2DM
SE: urinary or respiratory infections

Question 9

GLP1 analogs

Answer 9

Exanitide, Liraglutide
MOA: increase insulin, decrease glucagon release
Use: T2DM
SE: N/V, Pancreatitis

Question 10

Amylin analog (Pramlinitide)

Answer 10

MOA: decrease gastric emptying, decrease glucagon release
Use: T1DM, T2DM
SE: Hypoglycemia, nausea, diarrhea

Question 11

PTU, methimazole

Answer 11

Moa: Blocks thyroid peroxidase, inhibits oxidation of iodide, organification (coupling) of iodine -> inhibits thyroid hormone synthesis
PTU blocks 5’deiodinase -> decreased peripheral T4->T3 conversion

Use: Hyperthyroidism, PTU in pregnancy
SE: Skin rash, agranulocytosis, aplastic anemia, Hepatoxicity - PTU
Methimazole - teratogen (aplastic cutis); CI in pregnancy;

Question 12

Levothyroxine (T4), triiodothyronine (T3)

Answer 12

MOA: TH replacement
Use: Hypothryroidism, myxedema, weight loss (off label)
SE: Tachycardia, heat intolerance, tremors, arrhythmias

Question 13

Conivaptan, Tolvaptan

Answer 13

ADH antagonists

Use: SIADH, block ADH action at V2 receptor

Question 14

Desmopressin acetate

Answer 14

Use: Central (not nephrogenic) DI

Question 15

Growth Hormone

Answer 15

Use: Turner syndrome, GH deficiency

Question 16

Oxytocin

Answer 16

Stimulate labor, uterine contraction, milk letdown; control uterine hemorrhage

Question 17

Somatostatin (octreotide)

Answer 17

Use: Acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices

Question 18

Demeclocycline

Answer 18

ADH antagonist
Use: SIADH
SE: Nephrogenic DI, photosensitivity, bone and teeth abnl

Question 19

Glucocorticoids

Answer 19

Beclomethasone, Dexamethasone, fludrocortisone, hydrocortisone, methylprednisone, prednisone

Moa: Metabolic, catabolic, anti-inflammatory, immunosuppressive by GC response elements; inhibits Phospholipase A2; and inihbits trxn factors: NF-kB

Use: Addison disease, immunossuppression, asthma

SE: Iatrogenic Cushing syndrome, adrenal insufficiency when abruptly stopped drug, adrenocortical atrophy, steroid diabetes

Question 20

Cinacalcet

Answer 20

Moa: sensitizes Ca sensing receptor in PTH glands to circulating Ca -> decreased PTH release

Use: Hypercalcemia due to 1 or 2 HyperPTH

SE: Hypocalcemia