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Year 3 - Drug Profiles > Endocrine > Flashcards

Endocrine Flashcards

1
Q

how does insulin work?

A

stimulates glucose uptake from the circulation into tissues, including skeletal muscle and fat, and increases use of glucose as an energy source.

stimulates glycogen, lipid and protein synthesis and inhibits gluconeogenesis and ketogenesis.

For the treatment of hyperkalaemia, insulin drives K+ into cells, reducing serum K+ concentrations.

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2
Q

what are the indications to take insulin?

A

diabetes, hyperkalaemia

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3
Q

what are the contraindications to taking insulin?

A

renal impairment

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4
Q

what are the side effects of insulin?

A

Hypoglycaemia, lipohypertrophy in site of SC injection

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5
Q

what are the interactions with insulin?

A

other hypoglycaemic agents increases the risk of hypoglycaemia

systemic corticosteroids increases insulin requirements.

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6
Q

what class of drug is gliclazide?

A

sulphonylurea

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7
Q

how does gliclazide work?

A

lower blood glucose by stimulating pancreatic insulin secretion.

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8
Q

what are the indications to take gliclazide?

A

type 2 diabetes (only used if metformin not tolerated)

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9
Q

what are the contraindications to taking gliclazide?

A

hepatic and renal impairment

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10
Q

what are the side effects of gliclazide?

A

hypoglycaemia, GI disturbances (nausea, vomiting, diarrhoea, constipation), hyponatraemia, rarely causes liver disturbances

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11
Q

what are the interactions with gliclazide?

A

other antidiabetic drugs including metformin, thiazolidinediones (e.g. pioglitazone) and insulin.

The efficacy of sulphonylureas is reduced by drugs that elevate blood glucose, e.g. prednisolone, thiazide and loop diuretics.

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12
Q

how does metformin work?

A

lowers blood glucose by increasing the response (sensitivity) to insulin

suppresses hepatic glucose production, increases glucose uptake and utilisation and suppresses intestinal absorption. Also reduces weight gain, preventing worsening insulin resistance

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13
Q

what are the indications to take metformin?

A

Type 2 DM (first choice for blood glucose control)

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14
Q

what are the contraindications to taking metformin?

A

hepatic and renal impairment

Ketoacidosis, general anaesthesia

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15
Q

what are the side effects of metformin?

A

Anorexia, nausea, vomiting, diarrhoea, abdo pain, taste disturbance and rarely lactic acidosis

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16
Q

what are the interactions with metformin?

A

any drug that interferes with hepatic or renal function

Prednisolone, thiazide and loop diuretics elevate blood glucose, hence oppose the actions and reduce efficacy of metformin.

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17
Q

how does thyroxine work?

A

replaces T4 in the body which regulate metabolism and growth

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18
Q

what are the indications to take thyroxine?

A

Primary hypothyroidism.

Hypothyroidism secondary to hypopituitarism.

19
Q

what are the contraindications to taking thyroxine?

A

coronary artery disease
hypopituitarism (can induce addisonian crisis)
thyrotoxicosis

20
Q

what are the side effects of thyroxine?

A

only get in excessive dose - gastrointestinal (e.g. diarrhoea, vomiting, weight loss), cardiac (e.g. palpitations, arrhythmias, angina) and neurological (e.g. tremor, restlessness, insomnia) manifestations.

(same as hyperthyroidism)

21
Q

what are the interactions with thyroxine?

A

gastrointestinal absorption of levothyroxine is reduced by antacids, calcium or iron salts

increased dose may be necessary in patients taking cytochrome P450 inducers (phenytoin, carbamazepine)

increase insulin or oral hypoglycaemic requirements in diabetes mellitus and enhance the effects of warfarin.

22
Q

what class of drug is carbimazole?

A

Anti-thyroid drugs

23
Q

how does carbimazole work?

A

Decreases uptake and concentration of inorganic iodine by thyroid also reducing the formation of di-iodotyrosine and thyroxine (so reduces production of T3 and T4)

24
Q

what are the indications to take carbimazole?

A

hyperthyroidism

25
Q

what are the contraindications to taking carbimazole?

A

Severe blood disorders

26
Q

what are the side effects of carbimazole?

A

Nausea, mild GI disturbance, taste disturbance, headache, fever, malaise, rash, pruritus, arthralgia

27
Q

what class of drug are alendronic acid, disodium pamidronate and zoledronic acid?

A

Bisphosphonates

28
Q

how do bisphosphonates work?

A

reduce bone turnover by inhibiting the action of osteoclasts, the cells responsible for bone resorption

net effect is reduction in bone loss and improvement in bone mass.

29
Q

what are the indications to take bisphosphonates?

A

osteoporotic fragility fractures

Paget’s disease

30
Q

what are the contraindications to taking bisphosphonates?

A

renal impairment
hypocalcaemia
upper GI disorders
smokers/ dental disease (risk of jaw osteonecrosis)

31
Q

what are the side effects of bisphosphonates?

A

oesophagitis (when taken orally) and hypophosphataemia

osteonecrosis of the jaw

32
Q

what are the interactions with bisphosphonates?

A

absorption is reduced if taken with calcium salts (including milk), as well as antacids and iron salts

33
Q

how do calcium and vitamin D supplements work?

A

Calcium – essential for normal muscle/bone/nerve/clotting function
Vitamin D – controls calcium homeostasis along with parathyroid hormone)
Reduces rate on bone loss

34
Q

what are the indications to take calcium/Vit D?

A

Osteoporosis, chronic kidney disease, severe hyperkalaemia, hypocalcaemia, vitamin D deficiency

35
Q

what are the contraindications to taking calcium/Vit D?

A

hypercalaemia

36
Q

what are the side effects of calcium/Vit D?

A

Dyspepsia, constipation, risk of cardiovascular collapse when given too quickly in treatment of hyperkalaemia

37
Q

what are the interactions with calcium/ Vit D?

A

Iron, bisphonsphonates, tetracyclines, levothyroxine (reduces absorption); sodium bicarbonate when given IV (risk of precipitation)

38
Q

what class of drug is fludrocortisone?

A

mineralcorticoid

39
Q

how do mineralcorticoids work?

A

works by causing the kidneys to retain sodium and acting as a replacement for cortisone when the body does not produce enough.

40
Q

what are the indications to take mineralcorticoids?

A

adrenocortical insufficiency in Addison disease

treating salt-losing adrenogenital syndrome.

41
Q

what are the contraindications to taking mineralcorticoids?

A

Systemic infection, avoid live virus vaccines when receiving immunosuppressive doses

42
Q

what are the interactions with mineralcorticoids?

A

Anabolic steroids increase the risk of fludrocortisone’s side effects
Barbiturates, carbamazepine, estrogens, phenytoin, rifampin decrease fludrocortisone’s effectiveness

live vaccines, or smallpox vaccine because the effectiveness of these medicines may be decreased

Anticoagulants because their effectiveness may be decreased or the risk of their side effects may be increased

43
Q

what are the side effects of mineralcorticoids?

A

Difficulty sleeping; dizziness or lightheadedness; headache; increased appetite; increased sweating; indigestion; nervousness; increase susceptibility to infection

Year 3 - Drug Profiles (9 decks)

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