Endo Pharma Flashcards
mechanism of action of thioamides (PTU, methimazole)
blocks thyroid peroxidase enzyme interfering directly with the synthesis of thyroid hormones
some advantage of methimazole over PTU in the treatment of hyperthyroidism
higher oral bioavailability and longer duration of action
serious toxicity associated with methimazole
agranulocytosis
action of saturated solution of potassium or Lugol’s solution in hyperthyroidism
inhibits thyroid hormone release
benefit of giving Lugol’s solution prior to surgery of thyroid
reduces the size and vascularity of thyroid gland
iodides cannot be used long term for the treatment of hyperthyroidism because of this effect
Jod-Basedow
when taking this drug for osteoporosis ,the patient should remain upright position for 30 min to prevent esophageal ulceration
bisphosophonates (alendronate ,etc)
the glucose lowering effect of this anti-DM drug requires functioning beta cells
sulfonylurea
anti DM drug that increases risk for bladder cancer
Pioglitazone ( a TZD)
anti DM drug with possible adverse effect of CHF
thiazolidinedione
what is the reason why DPP4 inhibitors do not cause hypoglycemia
MOA is glucose dependent stimulation of insulin secretion. kumbaga it would not function pag walang pagkain sa tiyan
Estrogen can decrease total thyroid hormone level because it can increase binding of thyroxine to thyroid binding globulin. True or false
False. It can INCREASE….
anti-thyroid DOC for pregnant women
PTU
anti-thyroid DOC for thyroid storm
PTU
in most patients, methimazole is preferred over PTU because of this adverse effect of PTU
severe hepatitis
if agranulocytosis occurs in a patient being given methimazole, it would be wise to shift to PTU. True or false
False. shift to other drug class dapat. because giving PTU might cause a cross reaction. pareho kasi silang thioamides.
around how long will the radioactive iodine take effect
6-12 weeks. implication: wag agad mag request ng thyroid function test. hintayin umepekto ang gamot
DOC for hypothyroidism
Levothyroxine
this anti-thyroid drug can be given for protection of thyroid against fallout in the event of nuclear accident
iodide (lugol’s solution)
what is the MOA of beta blockers that is useful for treating hyperthyroidism
it blocks peripheral effects of thyroid hormone and it blocks the peripheral conversion of T4 to T3
what is the MOA of prednisone that is useful for treating hyperthyroidism
blocks the peripheral conversion of T4 to T3
what is the MOA of lithium that is useful for treating hyperthyroidism
blocks the release of thyroid hormone
this is a major problem with the use of hormonal replacement tx for the prevention and tx of osteoporosis
venous thromboembolism
what agent used for osteoporosis acts as both anti-resorptive and bone forming agent
strontium ranelate
anti-osteoporotic drug associated with risk of osteosarcoma
teriparatide
anti-osteoporotic drug associated with risk of decreased renal function
bisphosphonates
anti-osteoporotic drug associated with risk of infection
denosumab
fpr patients with osteoporosis with renal insufficiency, what anti-osteoporotic agent would be best
denosumab because it does not require renal dose adjustment
anti-osteoporotic agent that promotes bone healing only (not anti resorptive)
teriparatide
anti-thyroid drug that can cause cutis aplasia (congenital malformation)
Methimazole
anti-osteoporotic drug with adverse effect of osteonecrosis of jaw and subtrochanteric fracture
denosumab and bisphosphonates
why should denosumab not be used together with bisphosphonates
both can cause osteonecrosis of jaw and subtrochanteric fracture as adverse effects
DOC for osteoporosis in general
bisphosphonates
DOC for severe hypocalcemic tetany
calcium gluconate IV
net effect of PTH vs Vitamin D vs Calcitonin on calcium and phosphate level
PTH increases calcium and decreases phosphate. VITAMIN D increases both. CALCITONIN decreases both.
alendronate, ibandronate, zolendronic acid are examples of
bisphosphonates
example of selective estrogen receptor modulator (SERM)
raloxifene
only IV form of bisphosphonate
zolendronic acid or zolendronate
MOA of this anti-osteoporotic drug is preventing RANKL to bind to RaNKL receptor leading to osteoclast inhibition . This drug is also a human monoclonal antibody
Denosumab
This hormone found in pancreatic islets of langerhan modulate appetite and regulate gastric emptying
amyloid polypeptide (amylin)
glucagon is an inhibitor of insulin secretion. true or false
False. Glucagon STIMULATES insulin secretion. on the other hand, insulin INHIBITS glucagon. Ang selfish ng insulin noh
preferred route of insulin administration for patient that are hypotensive
Insulin should be administered intravenously in patient with poor blood flow / hypotensive. Usually, insulin is given subcutaneously
sulfonylurea that can cause dilutional hyponatremia
chlorpropamide (an old gen sulfonylurea)
this sulfonylurea has no active metabolite drug being excreted thru the kidneys
glipizide
thiazolidinediones have this pancreatic sparing effect and will decrease insulin requirement due to this action
improve GLUT 4 expression in muscle and adipose
main mechanism for the glucose lowering effect of metformin
decrease hepatic glucose output
examples of rapid acting insulin
lispro, aspart, glulisine (walang LAG kasi rapid)
examples of long acting insulin
detemir, degludec, glargine (think of glalalalaalalaglargine. matagal mag gargle ganun. to differentiate it from glulisine)
rapid acting insulin appearance in solution
clear
this specific insulin is in an acidic solution that when injected subcutaneously will form stable aggregates…
glargine. kaya siya long acting
true or false. insulin is used for emergency treatment of hypokalemia.
false. for hyPERkalemia dapat
insulin is composed of what 2 polypeptides
A chain (21AA) and B chain (30AA)
this glucose transporter is insulin mediated and facilitates glucose uptake from muscles and adipose tissue
GLUT 4
what is the only type of insulin that can be given intravenously
short acting insulin (regular insulin)
due to its acidic pH, this long acting insulin should not be mixed with short acting or rapid acting insulin
insulin glargine
Glibenclamide, glipizide, gliclazide, glimepiride are examples of
sulfonylureas (starts with gli-“)
which sulfonylureas are safe in px with renal problems (because they are not renally excreted)
glipizide and gliclazide
what sulfonylurea causes disulfiram like reactions and dilutional hyponatremia
chlorpropamide (old gen sulfonylurea)
repaglinide and nateglinide are examples of
rapid acting prandial insulin secretagogues
anti-diabetic agents that stimulate insulin release by closing K channels in beta cells
sulfonyureas and glinides
example of biguanide
metformin
acarbose and voglibose are examples of
alpha glucosidase inhibitor
sitagliptin, saxagliptin, vildagliptin, linagliptin are examples of
DPP4 inhibitors
pioglitazone and rosiglitazone are examples of
thiazolidinediones
coleveselam is an example of
bile acid sequestrant
canagliflozin, dapagliflozin, and empagliflozin are examples of
SGLT2 inhibitors
exenatide and liraglutide are examples of
GLP1 receptor agonist
pramlintide is an example of
amylin mimetic
anti diabetic drug class that decrease hepatic glucose output
biguanides (metformin)
anti diabetic drug class that inhibits intestinal glucosidase enzyme and delays CHO absorption
alpha glucosidase inhibitor ( -bose)
anti diabetic drug class that inhibits the enzyme that degrades GLP1
DPP4 inihibitors ( -gliptin)
anti diabetic drug class that are PPAR gamma agonist, increases number of GLUT 4 transporters in muscle and adipose tissue
thiazolidinediones (-glitazone)
anti diabetic drug class that binds bile acid in intestinal tract
bile acid sequestrant (colesevelam)
anti diabetic drug class that inhibits a specific transporter in the proximal tubule and thus there will be excretion of glucose in the urine
SGLT2 inhibitors (-gliflozin)
anti diabetic drug class that activates GLP1 receptor
GLP1 receptor agonist (-tide)
first line therapy for mild to moderate type 2 DM
metformin
anti diabetic drug that can cause lactic acidosis
metformin
preferred treatment for patient with hypoglycemia
glucose 15-20g
treatment for hypoglycemia in unconscious patients
IV glucose or glucagon IM/SC
