Endocrine Flashcards
What are sulphonylureas used for?
Patients with type 2 diabetes mellitus, alongside diet and exercise
What are the side effects of sulphonylureas?
Hypoglycaemia, rashes, nausea, vomiting, stomach pain, indigestion, weight loss
Give examples of sulphonylureas:
Gliclazide (short-acting) and glimepiride (long-acting)
What is the mechanism of action of sulphonylureas?
Stimulates B cells of the pancreas to produce more insulin
Increases cellular glucose uptake and glycogenesis
Reduces gluconeogenesis
Who are biguanides used for?
Patients with either type 2 diabtes mellitus or PCOS (metabolic/reproductive abnormalities)
What are side effects of biguanides?
Diarrhoea, nausea, vomiting, taste changes, appetite loss, risk of lactic acidosis in patients with renal failure
Give an example of a biguanide:
Metformin
What is the mechanism of action of biguanides?
Increases activity of AMP-dependent protein kinase (AMPK) which inhibits gluconeogenesis
Reduces insulin resistance
Give examples of GLP-1 agonists:
Exanatide and liraglutide
What is the mechanism of action of GLP-1 agonists?
GLP-1 is a hormone usually released after meals to increase insulin secretion. These drugs therefore increase insulin secretion, decrease glucagon secretion and reduce hunger.
Who are GLP-1 agonists prescribed to?
Type 2 diabetics with excess weight
What are side effects of GLP-1 agonists?
Hypoglycaemia, nausea, vomiting, diarrhoea
Give an example of a synthetic thyroid hormone:
Levothyroxine
What is the mechanism of action of synthetic thyroid hormone?
Thyroxine increases the metabolic rate of all tissues in the body. It is a synthetically prepared levo-isomer of thyroxine which acts like T4 and gets converted to T3 in the liver and kidney.
It maintains brain function, food metabolism, and body temperature, among other effects.
Who would be prescribed synthetic thyroid hormone?
Patients with hypothyroidism or chronic lymphocytic thyroiditis
What are side effects of synthetic thyroid hormone?
Chest pain Coma Diarrhoea Tachycardia Itching Muscle cramps
If dosing is correct, side effects are unusual.
What are thionamides?
Thionamides are anti-thyroid drugs like carbimazole and propylthiouracil
What is the mechanism of action of thionamides?
Reduces activity of peroxidase enzyme (required for the production of thyroid hormones).
It may also reduce peripheral conversion of T4 to T3.
Carbimazole is a pro-drug.
Who are thionamides prescribed to?
Patients with hyperthyroidism, thyrotoxicosis or with upcoming thyroid surgery
What side effects do thionamides have?
Rash, agranulocytosis and sore throat
Give two examples of bisphosphates:
Alendronate (Alendronic acid)
Ibandronate
What is the mechanism of action of bisphosphates?
Inhibits osteoclast bone resorption
No effect on bone formation
What are side effects of bisphosphonates?
Abdominal pain Dyspepsia Acid regurgitation Dysphagia Headache
Who would be prescribed bisphosphonates?
Patients with Pagets disease, post menopausal osteoporosis or high risk of fractures
