ENDOCRINE Flashcards
Which 2 drugs block thyroid peroxidase and therefore organification?
Propylthiouracil and Methimazole
What is unique about propylthiouracil vs. methimazole?
Propylthiouracil also blocks the peripheral conversion of T4 to T3 by blocking 5’ deiodinase
What drug can cause nephrogenic DI and tooth abnormalities?
Demeclocycline it is a member of tetracycline family
What are the short acting insulins?
Regular insulin
What drug is a biguanide?
metformin
What is the MOA of the glitazones/thiazolidinediones?
They increase peripheral insulin sensitivity by binding trascription factor PPAR-gamma
What kind of drugs are pioglitazone and rosiglitazone?
Glitazones/Thizolidinediones
Which thyroid peroxidase inhibitor is a potential teratogen? Which can cause hepatotoxicity?
Teratogen = methimazole; Hepatotoxcity = propylthiouracil
What kind of drug is metformin?
Biguanide
What is demclocycline used to Tx? What can it cause?
Tx SIADH can cause nephrogenic DI
What kind of drugs are glargine and detemir?
long-acting insulins
Name 3 second generation sulfonylureas
Glyburide, Glimepiride, and Glipizide
MOA of methimazole
Thyroid peroxidase inhibitor
What kind of drugs are chlorpropamide and tolbutamide?
first generation sulfonylureas
What kind of drugs are exanatide and liraglutide? MOA?
GLP-1 analogs; act as incretins to increase insulin release and decrease glucagon
What treats central diabetes insipidus? What treats nephrogenic?
DDAVP (desmopressin); Thiazide diuretics
What diabetes drug can also treat life-threatening hyperkalemia?
any of the insulins (insulin pulls K back into cells)
What are the 3 rapid-acting insulins?
Lispro, Aspart, and Glulisine
2 indications for adminstration of growth hormone
GH deficiency and Turner syndrome
What can be caused by chronic use of glucocorticoids? What about chronic use with abrupt stoppage?
Iatrogenic Cushing’s; Adrenocortical insufficiency
What blood disorder can be treated with the same drug that treats central diabetes insipidus?
Von Willebrand Disease (DDAVP causes release of vWF from Weibel Palade bodies in endothelium)
What kind of drugs are glulisine, lispro, and aspart?
Rapid acting insulins
Which diabetes drugs are likely to cause weight gain?
Pioglitazone and Rosiglitazone (glitazones/thiazolidinediones)
What 2 drugs are used to replace thyroxine?
Levothyroxine (T4) and Triiodiothyronine (T3)
What kind of drugs are glyburide, glimepiride, and glipizide?
second generation sulfonylureas
Which diabetic medication can cause pancreatitis?
Exanatide and Liraglutide (GLP-1 analogs)
What are the 2 long actin insulins?
Glargine and Detemir
Why is metforin contraindicated in renal failure?
Because it causes a metabolic acidosis that the kidneys would not be able to handle
What is the intermediate acting insulin?
NPH insulin
What kind of drug is triamcinolone?
Glucocorticoid
Compare the AE of first generation sulfonylureas to second generation sulfonylureas
First generation = disulfiram like reaction; second generation = hypoglycemia
What kind of drug is miglitol?
alpha-glucosidase inhibitor
which drugs decrease post-prandial hyperglycemia?
acarbose and miglitol
What are the AE of the glitazones/thiazolidinediones? (4)
Weight gain, Hepatotoxicity, Heart failure, Edema
What are the AE of insulin drugs?
Hypoglycemia (rarely = hypersensitivity)
Name 2 first generation Sulfonylureas
Tolbutamide and Chlorpropamide
What is the AE of chlorpropamide and tolbutamide?
First generation sulfonylureas = disulfiram like rxn
What kind of drug is pramlintide?
An amylin analog (decreases glucagon)
What are the AE of metformin?
GI upset, more seriously = lactic acidosis
Name 2 alpha-glucosidae inhibitors
acarbose and miglitol
Name 3 DPP-4 inhibitors
linagliptin, saxagliptin, sitagliptin
AE of GLP-1 analogs?
PANCREATITIS, N/V
What is the MOA of sulfonylureas?
Close the K channel on Beta cells of pancreas leading to depolarization of the cell and release of ENDOGENOUS insulin; thus, they require some islet fxn to work
Which thyroid drug can cause hepatotoxicity?
propylthiouracil (thyroid peroxidase inhibitor)
What 2 drugs increase insulin sensitivity by binding to PPAR-gamma?
Pioglitazone and Rosiglitazone
Name 2 glitazones/thiazolidinediones
Pioglitazone and Rosiglitazone
What kind of drug is NPH insulin?
Intermediate acting insulin
Which drug is DOC for type II DM?
Metformin (a biguanide)
What are the AE of levothyroxine and triiodothyronine?
Tremors, Heat intolerance, tachycardia, arrhythmias (upregulate B1 receptors on heart)
Which endocrine drugs have a disulfiram like reaction?
first generation sulfonylureas– chlorpropamide and tolbutamide
What is the MOA of acarbose and miglitol?
Inhibit alpha-glucosidase on intestinal brushborder to SLOW sugar absorption
What is the AE of glyburide, glimipiride, and glipizide?
second generation sulfonylureas = hypoglycemia
Which thryoid peroxidase inhibitor does NOT decrease peripheral converision of T4 to T3?
Methimazole
Which 2 drugs are GLP-1 analogs?
Exanatide and Liraglutide (GLP-1 is an incretin)
MOA of propylthiouracil
Thyroid peroxidase inhibitor
What kind of drugs end in gliptin?
DPP-4 inhibitors
Which adrenocortical disease can glucocorticoids be used to treat?
Addison’s disease
What are 5 clinical uses of octreotide?
Acute bleeding of esophageal varices, Acromegaly, Insulinoma, Glucagonoma, Gastrinoma, and Carcinoid
What kind of drug is regular insulin?
A short acting insulin
What kind of genes are regulated by PPAR-gamma? What drugs affect this nuclear regulator?
insulin and fatty acid storage (adiponectin); the glitazones/thiazolidinediones (pioglitazone and rosiglitazone)
