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Pharmacology - Clinical Sciences > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Drug x replaces endogenous insulin in diabetes, i.e. it promotes cellular uptake of glucose, fatty acids, and amino acids and their conversion to glycogen, triglycerides, and proteins.

Glyburide
Insulin
Levothyroxine
Propylthiouracil

A

Insulin

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2
Q

Drug x closes ATP-sensitive K+ channels, preventing K+ efflux and depolarizing pancreatic B cells, causing influx of Ca2+ and releasing insulin; increases amount of insulin secreted

Metformin
Insulin
Propylthiouracil
Glyburide

A

Glyburide

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3
Q

Drug x is converted to T3 in peripheral tissues which binds thyroid nuclear receptors and incr gene transcription, thereby increasing metabolic rate, protein synthesis, gluconeogenesis, cell growth, and differentiation, and CNS development.

Propylthiouracil
Glyburide
Levothyroxine
Metformin

A

Levothyroxine

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4
Q

Drug x increases the number and affinity of insulin receptors in peripheral tissues; decreases hepatic output; decr glucose absorption from the gut; incr glucose uptake and utilization in skeletal muscle and adipose tissue; does not usually cause hypoglycemia.

Metformin
Insulin
Glyburide
Propylthiouracil

A

Metformin

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5
Q

Drug x binds to thyroid peroxidase and thereby inhibits the conversion of iodide to iodine. Normally thyroglobulin is degraded to produce T4 and T3 which are the main hormones produced by the thyroid gland. Therefore, drug x effectively inhibits the production of new thyroid hormones.

Levothyroxine
Glyburide
Propylthiouracil

A

Propylthiouracil

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6
Q

Clinical use: hyperthyroidism

Levothyroxine
Propylthiouracil
Glyburide
Iodine

A

Propylthiouracil

PROPerLY quench the burning THYROID with URINE

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7
Q

Clinical use: hypothyroidism

Glyburide
Levothyroxine
Propylthiouracil

A

Levothyroxine

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8
Q

Clinical use: type 2 diabetes mellitus

Metformin
Glyburide
Metformin, glyburide, insulin
Insulin

A

Metformin, glyburide, insulin

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9
Q

Clinical use: type 1 and type 2 diabetes mellitus

Glyburide
Insulin
Metformin
Propylthiouracil

A

Insulin

Usually a long acting insulin plus pre-meal and pre-snack injections of a rapid-acting insulin in type 1 DM

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10
Q

Adverse effects: Agranulocytosis, Alopecia, Arthralgia, Skin rash esp maculopapular rash, Hepatitis and cholestatic jaundice

Levothyroxine
Propylthiouracil
Glyburide
Metformin

A

Propylthiouracil

Mnemonic: Only ASH is left after burning (PROPerLY quench the burning THYROID with URINE)

Agranulocytosis-severe and dangerous leukopenia (lowered WBC count)

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11
Q

Adverse effects:
Lactic acidosis ( esp. in pts with hypoxia, renal and hepatic dysfunctions whom this drug is CI),
Agitated GI tract (diarrhea, cramps, nausea, vomiting, increased flatulence),
Blood glucose levels stable (no hypoglycemia unlike insulin and sulfonylureas),
B12 deficiency seen in higher doses and long-term users

Glyburide
Insulin
Metformin
Propylthiouracil

A

Metformin

*LAB

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12
Q

Adverse effects: hypoglycemia only and also contraindicated during episodes of hypoglycemia

Metformin
Glyburide
Insulin
Levothyroxine

A

Insulin

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13
Q

Adverse effects: Insomnia; irritability; tachycardia and anxiety; weight loss, decreased appetite; hyperthyroid symptoms

Levothyroxine
Propylthiouracil
Glyburide
Metformin

A

Levothyroxine

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14
Q

Adverse effects: hypoglycemia; photosensitivity reactions; can cause weight gain

Metformin
Insulin
Glyburide
Propylthiouracil

A

Glyburide

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15
Q

What drugs can mask signs of hypoglycemia and prolong recovery from hypoglycemia, thus interacting with insulin?

Beta-blockers
Thiazides
ACEi
CCBs

A

Beta-blockers

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16
Q

Which drug has these interactions: bile acid sequestrants decrease absorption; estrogens can increase thyroid requirement. Warfarin’s anticoagulant effect is increased when combined with this drug.

Glyburide
Metformin
Levothyroxine
Propylthiouracil

A

Levothyroxine

17
Q

Which drug has these interactions: potentiated by alcohol, anti-inflammatory drugs, salicylates, and sulfonamides increase risk of hypoglycemia; effects decreased by diuretics, steroids, thyroid and phenytoin.

Metformin
Glyburide
Levothyroxine
Insulin

A

Glyburide

18
Q

Contraindications: Type 1 DM, hypoglycemia, diabetic ketoacidosis, allergy to sulfonamide drugs

Metformin
Glyburide
Insulin
Propylthiouracil

A

Glyburide

19
Q

Drug x Interactions: thiazides and steroids incr drug x requirements; alcohol, most nonsteroidal anti-inflammatory drugs, sulfonylureas, and warfarin can decrease drug x requirements. Psyllium may delay absorption of glucose from meals, leading to less postprandial hyperglycemia, which may allow for a reduced dosage of drug x.

Metformin
Glyburide
Insulin
Levothyroxine

A

Insulin

20
Q

Contraindicated in pts with untreated subclinical (suppressed serum TSH level with normal T3 and T4 levels) or overt thyrotoxicosis of any etiology and in patients with acute myocardial infarction. CI in pts with uncorrected adrenal insufficiency bc drug x may precipitate an acute adrenal crisis by increasing metabolic clearance of glucocorticoids. Should not be used to treat obesity or weight loss.

Glyburide
Propylthiouracil
Levothyroxine
Metformin

A

Levothyroxine

21
Q

Contraindications: renal failure, metabolic acidosis, type 1 diabetes

Insuline
Metformin
Glyburide
Levothyroxine

A

Metformin

22
Q

Interaction: may increase the effect of oral blood thinners, eg warfarin. Warfarin dose changes and monitoring for the effects of warfarin on blood clotting are necessary.

Glyburide
Metformin
Propylthiouracil
Levothyroxine

A

Propylthiouracil

23
Q

Contraindicated in hypothyroidism, pregnancy (crosses placenta and may cause harm to fetus), if need to use in pregnancy, should be used at lowest effective dose.

Glyburide
Metformin
Propylthiouracil
Levothyroxine

A

Propylthiouracil

24
Q

Interactions: alcohol increases risk of lactic acidosis; cimetidine and furosemide compete for proximal renal tubule secretion that reduces clearance leading to increased effects. Beta blockers can alter glucose metabolism and increase risk of hypoglycemia. Psyllium may delay absorption of glucose from meals, leading to less postprandial hyperglycemia and may allow for a reduced dosage of drug x.

Metformin
Insulin
Glyburide
Levothyroxine

A

Metformin

Pharmacology - Clinical Sciences (3 decks)

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