Endocrine Flashcards
Alpha cells?
glucagon
Beta cells?
insulin
Delta cells?
somatostatin
Regular insulin?
short-acting insulin
Humulin is made using…?
recombinant DNA to produce the hormone in bacteria or yeast
Novolin is made by…?
switing the aa that is different in pork insulin
What is an analogue of Humulin in which the normal proline B28 and lysine B29 are switched?
insulin lispro (Humalog)
What is a recombinant human insulin analog for use as an injection (once a day)? (shifted isoelectric point insulins)
insulin glargine
Insulin glargine differs from human insulin in Asparagine 21 is replaced by …. and two … are added to the C-terminus of the B-chain.
glycine
arginines
the 1st human inhaled insulin powder?
exubera
Condition caused by LOW INSULIN?
ketoacidosis
Condition caused by INSULIN OVERDOSE?
hypoglycemic coma
Normal glycosylation of HbA1c is…?
<7%
Class of oral hypoglycemics developed from an antibiotic having hypoglycemic properties?
sulfonylureas
What enhances hypoglycemic action of sulfonylureas?
NSAIDs
Two second generation sulfonylureas?
glyburide and glipizide
Class of oral hypoglycemics that are benzoic acid derivatives?
meglitinides
Class of oral hypoglycemics that does not effect insulin secretion but decreases hepatic glucose production?
biguanides
A biguanide that inhibits ANP kinase?
metformin
Class of oral hypoglycemics that bind to PPAR-gamma and increase insulin sensitivity?
thiazolidinediones
A thiazolidinedione?
pioglitazone
Class of oral hypoglycemics that reduces intestinal absorption of starch, disaccharides by inhibiting brush border alpha-glucosidase?
alpha-glucosidase inhibitors
2 apha-glucosidase inhibitors?
acarbose and miglitol
2 main incretins in humans are?
GIP and GLP-1
What increases glucose-dependent insulin secretion and is a new target for antidiabetic drugs?
GLP-1
2 types of incretin drugs (hypoglycemic drugs for type 2 diabetes)
- peptides
2. dipeptidyl peptidase-4 inhibitors
an incretin peptide that binds to GLP-1 receptors and improves glycemic control?
exenatide
the newest incretin peptides?
liraglutide and taspoglutide
an incretin DPP-4 inhibitor that inhibits inactivation of GLP-1?
sitagliptin
which incretin peptides are resistant to hydrolysis by DPP-4?
exenatide and liraglutide
What is an analogue of amylin?
pramlintide
an antihypertensive antidiuretic that has potent hyperglycemic actions?
diazoxide
chronic adrenocortical insufficiency?
Addison’s disease
increased adrenocortical secretion?
Cushing’s syndrome
synthetic ACTH used to test HPA axis?
cosyntropin
the main mineralocorticoid?
aldosterone
the main glucocorticoid?
hydrocortisone (cortisol)
glucocorticoids inhibit release of arachidonic acid and its metabolites through decreased expression of…?
phospholipase-A2
Short half life corticosteroid therapeutic agents?
cortisol/hydrocortisone, cortisone acetate
Intermediate half life corticosteroid therapeutic agents?
prednisone, prednisolone, methylprednisolone
Long half life corticosteroid therapeutic agents?
dexamethasone, betamethasone, triamcinolone
Suppression of what is a major side effect of glucocorticoid therapy?
ACTH and TSH
Inhibitors of synthesis and action of adrenocorticol steroids?
aminoglutethimide and ketoconazole
Synthetic estrogens have … which greatly decrease hepatic metabolism?
ethinyl groups
synthetic estrogens?
ethinyl estradiol and mestranol
Intramuscular injection of sulfate esters of estrone used to treat symptoms of menopause in women after hysterectomy?
Premarin
Drugs whose estrogenic activities are tissue selective?
SERMS (selective estrogen receptor modulators)
Example of SERMS?
tamoxifen
a true anitestrogen?
clomiphene
synthetic progestin component in birth control?
norethindrone
2 FDA approved morning after pills (postcoital contraception)?
Plan B and Preven
An approved antiprogestin for contragestation (abortion pill)?
mifepristone
Inhibitors of 5a-reductase inhibit production of…?
DHT
a non steroidal antiandrogen used in treatment of prostate cancer?
flutamide
an inhibitor of 5a-reductase that treats benign prostatic hyperplasia and also male pattern baldness?
finasteride
an aldosterone antagonist that also competes for testosterone receptor and treats hirsutism?
spironolactone
an antifungal that also inhibits cytochrome P-450 enzymes leading to inhibition of testosterone synthesis?
ketoconazole
major carrier of thyroid hormones?
thyroxine binding globulin
protein carriers of thyroid hormones?
thyroxine binding globulin (major carrier), transthyretin, albumin
3 inhibitors of TRH production?
somatostain, dopamine, glucocorticoids
preferred method for preventing iodine deficiency?
iodized salt
increased fatty acid synthesis and fatty acid oxidation, increased bile acid synthesis, decreased cholesterol, elevated glycolysis and gluconeogenesis
hyperthyroidism
decreased fatty acid synthesis and oxidation, increased cholesterol
hypothyroidism
myxedema?
hypothyroidism
cretinism?
hypothyroidism- infant
first synthetic thyroid hormone and treatment of hypothyroidism?
levothyroxine
Graves disease?
hyperthyroidism
toxic nodular goiter (carcinoma)?
hyperthyroidism
antithyroid drugs that inhibit iodine organification?
thioureylenes
2 thioureylenes?
propylthiouracil (PTU) and methimazole
inhibits conversion of T4 to T3?
PTU
antithyroid that crosses placenta and gets concentrated in fetal thyroid?
methimazole
the active form of Vit D?
calcitriol
plasma Ca is tightly regulated at…
2.5 mM
3 major sites of of action for blood calcium regulation?
bone, GI tract, kidney
PTH functions to … plasma Ca
increase
what stop osteoclasts from breaking down bone?
bisphophonates
What allows both PTH and Calcitonin secreting cells to respond to extracellular calcium?
calcium sensing receptor
functions to decrease plasma Ca and is synthesized by parafollicular cells of thyroid?
calcitonin
functions to increase plasma Ca and is synthesized in skin and blood?
calcitriol (active form of Vit D)
Primary function of calcitriol?
increase Ca uptake from GI
at pharmacologic doses, calcitriol…
increase reabsorption from kidneys and bone resorption
Increased PTH causes
increased Ca reabsorption from kidney, increased bone resorption and increased synthesis of calcitriol
PTH mechanism of action works through increasing …
cAMP which activates protein kinases
in the mechanism of action, calcitonin decreases the … on osteoclasts
ruffled border surface area
very effective for short term treatment of hypercalcemia?
calcitonin
calcitriol induces synthesis of … which allows the uptake and binding of more Ca?
calbindin
treatment of metabolic rickets?
calcitriol
bisphosphonates used in Pagets disease?
alendronate, etidronate, risedronate
bisphosphonate used for osteoporosis?
alendronate
true or false: bisphosphonates must be taken after an overnight fast with a full glass of water with no food for 30 min?
true
first generation bisphosphonate?
etidronate
serious complication of bisphosphonates therapy?
osteonecrosis of the jaw
surgical correction improves osteonecrosis lesions: T or F
F
osteonecrosis of jaw much more common with … generation
3rd
excess fluoride causes…
fluorosis