Endocrine

Question 1

Rapid acting insulin

Answer 1

• Lispro, aspart, glulisine
• onset: 10-15 min
• peak: 30 -90 min
• Duration: 3-5 hours
• monitor for low K

Question 2

Short acting insulin (regular)

Answer 2

• name: regular
• onset: 30-60 min
• Peak: 2-4 hours
• Duration: 5-7 hours
• monitor low K
• Mixing with NPH: clear before cloudy
• Inject air into cloudy, inject air into clear, withdraw clear, withdraw cloudy

Question 3

Intermediate acting insulin (NPH)

Answer 3

• name: NPH
• onset: 1-2 hours
• peak: 4-12 hours
• duration: 12-18 hours

Question 4

Long-acting insulin

Answer 4

• glargine, detemir, degludec
• onset: 1-2 hours
• peak: none (lowest risk for hypoglycemia)
• duration: 24 + hours
• monitor for low K

Question 5

Metformin

Answer 5

• oral hypoglycemic
• metallic taste
• lactic acidosis
• stop before using contrast dye (24-48 hours)
• PO (stop if NPO)

Question 6

Thiazolidinediones (TZD)

Answer 6

• Oral hypoglycemic
• Suffix: -glitazone
• SE: fluid overload, increased LDL, hepatotoxicity
• Can worsen HF and increase risk of MI so no if HF or FVO

Question 7

Sulfonylureas

Answer 7

• Manages hyperglycemia
• Glyburide, glipizide, glimepiride
• SE: hypoglycemia, wt gain, GI upset
• Photosensitivity
• No alcohol
• 30 min before a meal

Question 8

Levothyroxine

Answer 8

• Synthetic hormone
• Tx hypothyroidism
• safe during pregnancy
• wks to work
• monitor for hyperthyroidism
• take at same time daily, before breakfast on empty stomach

Question 9

Methimazole

Answer 9

First line antithyroid

• Tx hyperthyroidism
• Risk: agranulocytosis (increased risk infection) or drug induced hepatitis
• Taper for risk of thyroid storm
• takes a few wks for results

Question 10

Propylthiouracil (PTU)

Answer 10

• First-line antithyroid

- Risk: agranulocytosis and drug-induced hepatitis

Question 11

Radioactive Iodine (RAI)

Answer 11

• Radiation therapy
• Tx: hyperthyroidism or thyroid cancer
• Single dose of ingesting radioactive iodine
• pt is radioactive so use precautions
• Risk: Radiation sickness, BM suppression, Hypothyroidism
• Teratogenic
• May take 3 months for maximum effect

Question 12

Strong Iodine Solution

Answer 12

Antithyroid agent

• Tx: hyperthyroidism and preparation for thyroidectomy
• Inhibits thyroid production d/t high levels iodine
• AE: Iodism (metallic taste, stomatitis, sore-throat and gums)
• Fluids!
• Avoid foods high iniodine
• taste bad, dilute in water or fruit juice

Question 13

Desmopressin

Answer 13

• Posterior pituitary hormones
• Tx: DI (not enough ADH) , nocturnal enuresis, clotting disorders
• mimics ADH
• monitor for low Na
• Fluid restriction potentially
• can be given intranasal

Question 14

Corticosteroids

Answer 14

• Steroids
• Tx: Addison disease, chronic asthma, eczema, insect bites, etc
• Suffix: asone
• Risk for high BS, osteoporosis, decreased immunity depression, HTN, decreased libido, weight gain, risk for cataracts (increase Ca)
• Stres can cause decrease cortisol, may need higher dose at that time