Endocrine Flashcards
Insulin Rapid Acting
name
mechanism
use
ude
Lispro
Aspart
Glulisine
- Binds insulin receptor fast and increases glucose stored as glycogen
- all diabetes
- hypoglycemia
long acting insulin
name
use
Detemir
Glargine
type 1 DM, type 2 and GDM
METFORMIN
mechanism
use
ude
- decreases gluconeogenesis and increase glycolysis (inc. insulin sensitivity)
- oral, first line for type 2, can cause weight loss
- lactic acidosis and disulfiram like reaction
Sulfonylureas
name
mechanism
use
ude
First gen:
Chlorprpamide
Tolbutamide
2nd gen:
Glimepiride
Glipizide
Glyburide
- closes potassium channel in cell membrane so insulin can work
- releases endogenous insulin for type 2 people
- disulfiram reaction
Thiazolidinediones
name
mechanism
use
ude
Pioglitazone
Rosiglitazone
- increase insulin sensitivity in peripheral tissue
- for type 2 (safe to use in renal impairment)
- causes weight gain and hepatotoxic
Meglitinides name mechanism use ude
Nateglinide
Repaglinide
- simulates postprandial insulin release by blocking K channels
- type 2DM
- hypoglycemia
GLP-1 Analogs (incretins)
name
mechanism
use
ude
Exenatide
Liraglutide (sc injection)
- increase glucose dependent insulin release and decreases glucagon
- Type 2 DM
- pancreatitis and modest weight loss
DPP-4 Inhibitors
name
mechanism
use
ude
Linagliptin
Saxagliptin
Sitagliptin
- Block DPP 4 enzyme that deactivates GLP 1
- Type 2 DM
- urinary infection
Amylin Analogs
name
mechanism
use
ude
Pramlintide (sc injection)
- decrease gastric emptying and glucagon
- Type 1 and 2
- hypoglycemia
Sodium-Glucose Co transporter 2 (SGLT 2) Inhibitors
name
mechanism
use
ude
Canagliflozin
Dapagliflozin
Empagliflozin
- blocks reabsorption of glucose in PCT
- type 2
- glycosuria and UTI
Alpha Glucoside Inhibitors
name
mechanism
use
ude
Acarbose
Miglitol
- inhibits intestinal brush border alpha glucosidases and delay post parandyal hyperglycemia
- type 2 dm
- GI problems
Thionamides name mechanism use ude
Propylthyiouracil
Methimazole
- inhibit thyroid hormone synthesis and blocks the conversion of t4-t3
- hyperthyroidism
- skin rash, methimazole is teratogenic
PTU blocks what enzyme causing what?
5 deiodinase, blocking t4-t3
Levothyroxine (T$) and Triiodothyronine (T3)
name
mechanism
use
ude
- thyroid hormone replacement
- hypothyroidism and for weight loss
- tachy
ADH antagonist
use
Conivaptan
Tolvaptan
SIADH
Desmopressin Acetate
use
central DI
Ocreotide
use
somatostatin analogue
treated acromegaly, carcinoid syndrome, gastronome, glucagonoma and esophageal varicies
demeclocycline
mechanism
use
ude
- ADH antagonist (part of tetracycline family)
- SIADH
- Nephrogenic DI and teeth abnormalities
Glucocorticoids
name
mechanism
use
ude
Beclomethasone dexamethasone hydrocortisone methylprednisolone prednisone triamcinolone
- anti inflammation
immunosuppression
inhibition of phospholipase A2
inhibition of NF-kB - adrenal insufficiency, inflammation and asthma
3.Cushing syndrome and weight gain
adrenal insufficieny if stopped too fast
Fludrocortisone
mechanism
use
ude
- aldosterone analogue
- mineralocorticoid replacement in primary adrenal insufficiency
- hyper pigmentation
Cinacalcet
mechanism
use
ude
- sensitizes calcium sensing receptor (CaSR) in parathyroid so it decreases PTH
- primary and secondary hyperthyroidism
- hypocalcemia