Endocrine Flashcards
Lispro
1) Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia
2) Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Rapid-acting
Aspart
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Rapid-acting
Glulisine
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Rapid-acting
Regular
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Short-acting
NPH
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Intermediate
Glargine
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Long-acting
Detemir
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen-Muscle: increase glycogen and protien synthesis and K+ uptake-Fat: aids in TG storage3)Hypoglycemia, very rarely hypersensitivy rxns4)Long-acting
Metformin
1)First-line therapy in Type II DM, can be used in pts w/o islet function2)Biguanide/ Exact MOA unknown –> decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake (insulin sensitivity)3)GI upset, lactic acidosis (most serious)4)Contraindicated in renal failure
Tolbutamide
1)Type II DM –stimulate endogenous insulin release2)Sulfonylureas (1st generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx3)Disulfiram-like effects4)Useless in Type I DM b/c requires some islet cell function
Chlorpropamide
1)Type II DM –stimulate endogenous insulin release2)Sulfonylureas (1st generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx3)Disulfiram-like effects4)Useless in Type I DM b/c requires some islet cell function
Glyburide
1)Type II DM – stimulates endogenous insulin release2)Sulfonylureas (2nd generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx3)Hypoglycemia4)Useless in Type I DM b/c requires some islet cell funciton
Glimepiride
1)Type II DM – stimulates endogenous insulin release2)Sulfonylureas (2nd generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx3)Hypoglycemia4)Useless in Type I DM b/c requires some islet cell funciton
Glipizide
1)Type II DM – stimulates endogenous insulin release2)Sulfonylureas (2nd generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx3)Hypoglycemia4)Useless in Type I DM b/c requires some islet cell funciton
Pioglitazone
1)Monotherapy in Type II DM or in combination therapy2)Glitazone/Thiazolidinedione: Incraeses insulin sensitivity in peripheral tissue; binds PPAR-gamma nuclear transcription regulator –> incr Adiponectin expression3)Weight gain, edema, hepatoxicity, heart failure
Rosiglitazone
1)Monotherapy in Type II DM or in combination therapy2)Glitazone/Thiazolidinedione: Incraeses insulin sensitivity in peripheral tissue;, binds PPAR-gamma nuclear transcription regulator –> incr Adiponecti expression3)Weight gain, edema, hepatoxicity, heart failure
Acarbose
1)Monotherapy in Type II DM, or in combination therapy2)Alpha-glucosidase Inhibitor/ Inhibits intestinal brush-border alpha-glucosidases –> get delayed sugar hydrolysis and glucose absorption -decreases postprandial hyperglycemia3)GI disturbances
Miglitol
1)Monotherapy in Type II DM, or in combination therapy2)Alpha-glucosidase Inhibitor/ Inhibits intestinal brush-border alpha-glucosidases –> get delayed sugar hydrolysis and glucose absorption -decreases postprandial hyperglycemia3)GI disturbances
Pramlinitide
1)Type I and II DM2)Amylin Analog/ Decreases glucagon3)Hypoglycemia, nausea, diarrhea
Exenatide
1)Type II DM2)GLP-1 Analog/ Increase insulin and decrease glucagon release3)Nausea, vomiting, pancreatitis
Liraglutide
1)Type II DM2)GLP-1 Analog/ Increase insulin and decrease glucagon release3)Nausea, vomiting, pancreatitis
Linagliptin
1)Type II DM2)DPP-4 Inhibitors/ Increase insulin and decrease glucagon release3)Mild urinary or respiratory infections
Saxagliptin
1)Type II DM2)DPP-4 Inhibitors/ Increase insulin and decrease glucagon release3)Mild urinary or respiratory infections
Sitagliptin
1)Type II DM2)DPP-4 Inhibitors/ Increase insulin and decrease glucagon release3)Mild urinary or respiratory infections
Propylthiouracil
1)Hyperthyroidism2)Block peroxidase inhibiting organificatoin of iodide anda coupling of thyroid hormone synthesis -also blocks 5’-deiodinase –> decreases peripheral conversion of T4 to T53)Skin rash, agranulocytosis (rare), aplastic anemia, hepatotoxicity
Methimazole
1)Hyperthyroidism2)Block peroxidase inhibiting organificatoin of iodide anda coupling of thyroid hormone synthesis3)Skin rash, agranulocytosis (rare), aplastic anemia4)Possible teratogen
Levothyroxine
1)Hypothyroidism, myxedema2)THyroxine replacement3)Tachycardia, heat intolerance, tremors, arrhythmias
Triiodothyronine
1)Hypothyroidism, myxedema2)THyroxine replacement3)Tachycardia, heat intolerance, tremors, arrhythmias
GH
1)GH deficiency, Turner’s Syndrome
Somatostatin (octretodie)
1)Acromegaly, carcinoid, gastrinoma, glucagonoma, espohageal varices
Oxytocin
1)Stimulate labor, uterine contractions, milk let-down, controls uterine hemorrhage
ADH (Desmopressin)
1)Central DI
Demeclocycline
1)SIADH2)Tetracycline/ ADH antagonist3)Nephrogenic DI, photosensitivity, abnormalities of bone and teeth
Hydrocortisone
1)Addison’s Disease, inflammation, immune suppression, asthma2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic)4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Prednisone
1)Addison’s Disease, inflammation, immune suppression, asthma2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic)4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Triamcinolone
1)Addison’s Disease, inflammation, immune suppression, asthma2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic)4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Dexamethasone
1)Addison’s Disease, inflammation, immune suppression, asthma2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic)4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Beclomethasone
1)Addison’s Disease, inflammation, immune suppression, asthma2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic)4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
