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Endocrine Flashcards

1
Q

what insulins are rapid-acting? (3)

A
  1. lispro
  2. aspart
  3. glulisine
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2
Q

what is lispro?

A

rapid-acting insulin

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3
Q

what is aspart?

A

rapid-acting insulin

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4
Q

what is glulisine?

A

rapid-acting insulin

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5
Q

mechanism of insulins

A

bind insulin receptor (tyrosine kinase)

liver: increase glycogen
muscle: increase glycogen, protein synthesis, increase K uptake
fat: increase triglyceride

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6
Q

clinical use rapid-acting insulins

A

post-prandial control

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7
Q

side effects of insulins (2)

A
  1. hypoglycemia

2. rare hypersensitivity

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8
Q

what is a short-acting insulin?

A

regular

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9
Q

what is regular?

A

short-acting insulin

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10
Q

clinical use short-acting insulin

A

DKA, hyperkalemia (+ glucose), stress hyperglycemia

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11
Q

what is an intermediate-acting insulin?

A

NPH

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12
Q

what is NPH?

A

intermediate-acting insulin

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13
Q

what are long-acting insulins? (2)

A
  1. glargine

2. detemir

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14
Q

clinical use long-acting insulins

A

basal glucose control

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15
Q

what is a biguanide?

A

metformin

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16
Q

drug class metformin

A

biguanide

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17
Q

what does metformin do?

A

increases insulin sensitivity
decrease gluconeogenesis
increase glycolysis
increase peripheral glucose uptake

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18
Q

what drug is first line therapy in type 2 DM?

A

metformin

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19
Q

side effects metformin (2)

A
  1. GI upset

2. lactic acidosis (DO NOT use in renal failure!)

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20
Q

can you use metformin in renal failure?

A

NO!!

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21
Q

what are two first generation sulfonylureas?

A
  1. tolbutamine

2. chlorpropamide

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22
Q

what are three second generation sulfonylureas?

A
  1. glyburide
  2. glimepiride
  3. glipizide
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23
Q

what is tolbutamine?

A

1st generation sulfonylurea

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24
Q

what is chlorpropamide?

A

1st generation sulfonylurea

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25
Q

what is glyburide?

A

2nd generation sulfonylurea

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26
Q

what is glimepiride?

A

2nd generation sulfonylurea

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27
Q

what is glipizide?

A

2nd generation sulfonylurea

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28
Q

sulfonylurea mechanism

A

close K channel in beta cell –> depolarizes –> Ca influx –> insulin release

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29
Q

are sulfonylureas useful in type I diabetes?

A

NO!!

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30
Q

what type of DM are sulfonylureas useful in?

A

Type 2 (stimulates release of endogenous insulin)

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31
Q

side effects of sulfonylurea use in renal failure

A

hypoglycemia (risk increased)

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32
Q

side effects 1st generation sulfonylureas

A

disulfiram-like effects

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33
Q

side effects 2nd generation sulfonylureas

A

hypoglycemia

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34
Q

what are two glitazones/thiazolidinediones?

A
  1. pioglitazone

2. rosiglitazone

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35
Q

what is pioglitazone?

A

glitazone/thiazolidinedione

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36
Q

what is rosiglitazone?

A

glitazone/thiazolidinedione

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37
Q

mechanism glitazone/thiazolidinedione

A

increase insulin sensitivity by binding PPAR-gamma nuclear transcription regulator
PPAR-gamma regulates fatty acid storage and glucose metabolism

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38
Q

side effects glitazone/thiazolidinedione

A
  1. weight gain
  2. edema
  3. hepatotoxicity
  4. heart failure
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39
Q

what are two alpha-glucosidase inhibitors?

A
  1. acarbose

2. miglitol

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40
Q

what is acarbose?

A

alpha-glucosidase inhibitor

41
Q

what is miglitol?

A

alpha-glucosidase inhibitor

42
Q

mechanism alpha-glucosidase inhibitors

A

inhibit intestinal brush-border alpha-glucosidases

dlays sugar hydrolysis and glucose absorption –> decrease postprandial hyperglycemia

43
Q

side effect alpha-glucosidase inhibitors

A

GI disturbances

44
Q

what is an amylin analog?

A

pramlintide

45
Q

what is pramlintide?

A

amylin analog

46
Q

mechanism amylin analogs

A

decrease gastric emptying

decrease glucagon

47
Q

clinical use amylin analog

A

type 1 and 2 DM

48
Q

side effects amylin analogs (3)

A
  1. hypoglycemia
  2. nausea
  3. diarrhea
49
Q

what are two GLP-1 analogs?

A
  1. exenatide

2. liraglutide

50
Q

what is exenatide?

A

GLP-1 analog

51
Q

what is liraglutide?

A

GLP-1 analog

52
Q

mechanism GLP-1 analogs

A

increase insulin, decrease glucagon release

53
Q

side effects GLP-1 analogs (2)

A
  1. N/V

2. pancreatitis

54
Q

what are three DPP-4 inhibitors?

A
  1. linagliptin
  2. saxagliptin
  3. sitagliptin
55
Q

what is linagliptin?

A

DPP-4 inhibitor

56
Q

what is saxagliptin?

A

DPP-4 inhibitor

57
Q

what is sitagliptin?

A

DPP-4 inhibitor

58
Q

mechanism DPP-4 inhibitors

A

increase insulin, decrease glucagon release

59
Q

side effects DPP-4 inhibitors

A

mild urinary or respiratory infections

60
Q

what diabetes drug causes weight gain?

A

glitazones / thiazolidinediones

61
Q

what diabetes drug causes hepatotoxicity?

A

glitazones / thiazolidinediones

62
Q

what diabetes drug causes heart failure?

A

glitazones / thiazolidinediones

63
Q

what diabetes drug causes lactic acidosis and shouldn’t be used in renal failure?

64
Q

what diabetes drug causes pancreatitis?

A

GLP-1 analogs

65
Q

what is propylthiouracil?

A

thyroid peroxidase inhibitor for hyperthyroidism

66
Q

what is methimazole?

A

thyroid peroxidase inhibitor for hyperthyroidism

67
Q

propylthiouracil mechanism

A

blocks thyroid peroxidase –> inhibits oxidation of iodide and organification (coupling) of iodine –> inhibits thyroid hormone synthesis
inhibits 5’-deiodinase –> decreases peripheral conversion of T4 to T3

68
Q

methimazole mechanism

A

blocks thyroid peroxidase –> inhibits oxidation of iodide and organification (coupling) of iodine –> inhibits thyroid hormone synthesis

69
Q

clinical use propylthiouracil

A

hyperthyroidism

70
Q

clinical use methimazole

A

hyperthyroidism

71
Q

which drug do you use for hyperthyroidism in pregnancy?

A

propylthiouracil (PTU)

72
Q

side effects propylthiouracil

A
  1. rash
  2. agranulocytosis / aplastic anemia
  3. hepatotoxicity
73
Q

side effects methimazole

A
  1. rash
  2. agranulocytosis / aplastic anemia
  3. teratogen (aplasia cutis)
74
Q

what is levothyroxine?

A

thyroxine replacement

75
Q

what is triiodothyronine?

A

thyroxine replacement

76
Q

clinical use levothyroxine

A

hypothyroidism, myxedema

77
Q

clinical use triiodothyronine

A

hypothyroidism, myxedema

78
Q

side effects levothyroxine (4)

A
  1. tachycardia
  2. heat intolerance
  3. tremors
  4. arrhythmias
79
Q

side effects triiodothyronine (4)

A
  1. tachycardia
  2. heat intolerance
  3. tremors
  4. arrhythmias
80
Q

clinical use GH

A

GH deficiency

Turner syndrome

81
Q

clinical use somatostatin (octreotide)

A 
acromegaly
carcinoid
gastrinoma
glucagonoma
esophageal varices
82
Q

clinical use oxytocin

A

stimulates labor
uterine contractions
milk let-down
uterine hemorrhage

83
Q

clinical use ADH (DDAVP)

A

pituitary (central) DI

84
Q

what is demeclocycline?

A

ADH antagonist

85
Q

clinical use demeclocycline

86
Q

what drug treats SIADH?

A

demeclocycline

87
Q

side effects demeclocycline

A
  1. nephrogenic DI
  2. photosensitivity
  3. bone and teeth abnormalities
88
Q

drug class hydrocortisone

A

glucocorticoid

89
Q

drug class prednisone

A

glucocorticoid

90
Q

drug class triamcinolone

A

glucocorticoid

91
Q

drug class dexamethasone

A

glucocorticoid

92
Q

drug class beclomethasone

A

glucocorticoid

93
Q

drug class fludrocortisone

A

glucocorticoid

94
Q

mechanism glucocorticoids

A

metabolic, catabolic, anti-inflammatory, and immunosuppressive
inhibits transcription factors (i.e. NF-KB)

95
Q

clinical use glucocorticoids (4)

A
  1. Addison disease
  2. inflammation
  3. immune suppression
  4. asthma
96
Q

side effects glucocorticoids (2)

A
  1. Cushing syndrome

2. adrenal insufficiency if stopped abruptly

97
Q

sx of Cushing syndrome (10)

A
  1. buffalo hump
  2. moon facies
  3. truncal obesity
  4. muscle wasting
  5. thin skin
  6. easy bruisability
  7. osteoporosis
  8. adrenocortical atrophy
  9. peptic ulcers
  10. diabetes (if chronic)
98
Q

treatment osteoporosis

A

bisphosphenates

Pharmacology (8 decks)

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