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DRUGS > Endocrine > Flashcards

Endocrine Flashcards

1
Q

DM 1 treatment plan

A

Low carbohydrates, insulin replacement

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2
Q

DM 2 treatment plan

A

Diet and exercise for weight loss; oral agents, non-insulin injectables, insulin replacement

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3
Q

Gestational diabetes treatment plan

A

Diet and excercise; insulin if these fail

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4
Q

Aspart Onset

A

Insulin rapid acting

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5
Q

Glulisine Onset

A

Insulin rapid acting

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6
Q

Lispro Onset

A

Insulin rapid acting

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7
Q

Regular insulin Onset

A

Insulin short acting

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8
Q

NPH Onset

A

Insulin intermediate acting

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9
Q

Determir Onset

A

Insulin long acting

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10
Q

Glargine Onset

A

Insulin long acting

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11
Q

Insulin Action: (liver, muscle, fat)

A

Liver: increase glucose –> glycogen
Muscle: increase glycogen, protein synthesis; K+ uptake
Fat: increased triglyceride stores

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12
Q

Insulin rapid acting: Use

A

DM T1, DM T2, GDM, post prandial glucose control

[Glulisine, Lispro, Aspart]

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13
Q

Insulin short acting: use

A

DM T1, DM T2, GDM, hyperkalemia (with glucose), DKA(IV), stress hyperglycemia

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14
Q

Insulin intermediate acting: Use

A

DM T1, DM T2, GDM

[NPH]

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15
Q

Insulin long acting: Use

A

DM T1, DM T2, GDM

[Determir, Glargine]

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16
Q

Insulin rapid acting: AE

A

Hypoglycemia / rare hypersensitivity

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17
Q

Biguanides: action

metformin

A

Decrease gluconeogenesis, increase glycolysis, increase peripheral glucose uptake (increase glucose sensitivity)

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18
Q

Biguanides: use

metformin

A

First line for DM T2, modest weight loss. Can be used in patients without islet function

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19
Q

Biguanides: AE

metformin

A

GI upset; LACTIC ACIDOSIS (contraindicated in renal insufficiency)

[no risk of hypoglycemia]

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20
Q

Sulfonylureas: Action
(1stG= chlorpropamide, Tolbutamide)
(2ndG= Glimepiride, glipizidine, Glyburide)

A

K+ channel blockade in beta cells –> increased insulin release

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21
Q

Sulfonylureas: Use
(1stG= chlorpropamide, Tolbutamide)
(2ndG= Glimepiride, glipizidine, Glyburide)

A

DM T2, (needs some islet function)

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22
Q

Sulfonylureas: AE
(1stG= chlorpropamide, Tolbutamide)
(2ndG= Glimepiride, glipizidine, Glyburide)

A

risk of hypoglycemia in renal failure
1st gen: disulfram like reactions
2nd gen: hypoglycemia

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23
Q

Glitazones / Thiazolidinediones: action

Pioglitazone, Rosiglitazone

A

PPAR-gamma nuclear transcription regulator (peripheral tissue) –> increased insulin sensitivity

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24
Q

Glitazones / Thiazolidinediones: use

Pioglitazone, Rosiglitazone

A

Used as monotherapy for DM T2, or in combination

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25
Q

Glitazones / Thiazolidinediones: AE

Pioglitazone, Rosiglitazone

A

weight gain, edema, hepatotoxicity, HF, increased risk of fractures

[no risk of hypoglycemia]

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26
Q

metformin

A

Oral hypoglycemic drug: Biguanides

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27
Q

chlorpropamide

A

Oral hypoglycemic drug: 1st Gen Sulfonylureas

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28
Q

Tolbutamide

A

Oral hypoglycemic drug: 1st Gen Sulfonylureas

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29
Q

Glimepiride

A

Oral hypoglycemic drug: 2nd Gen Sulfonylureas

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30
Q

glipizidine

A

Oral hypoglycemic drug: 2nd Gen Sulfonylureas

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31
Q

Glyburide

A

Oral hypoglycemic drug: 2nd Gen Sulfonylureas

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32
Q

Pioglitazone

A

Oral hypoglycemic drug: Glitazones / Thiazolidinediones

33
Q

Rosiglitazone

A

Oral hypoglycemic drug: Glitazones / Thiazolidinediones

34
Q

GLP-1 analogs: action

exenatide, Liraglutide

A

Increase insulin, decrease glucagon

35
Q

GLP-1 analogs: use

exenatide, Liraglutide

36
Q

GLP-1 analogs: AE

exenatide, Liraglutide

A

Pancreatitis, N/V

[no risk of hypoglycemia]

37
Q

DPP-4 inhibitors: Action

linagliptin, Saxagliptin, sitagliptin

A

Increase insulin, decrease glucagon

38
Q

DPP-4 inhibitors: Use

linagliptin, Saxagliptin, sitagliptin

39
Q

DPP-4 inhibitors: AE

linagliptin, Saxagliptin, sitagliptin

A

Mild urinary or resp infections

[no risk of hypoglycemia]

40
Q

Amylin analogs: action

Pramlintide

A

decrease gastric emptying, decrease glucagon

41
Q

Amylin analogs: Use

Pramlintide

A

DM T1, DM T2

42
Q

Amylin analogs: AE

Pramlintide

A

Hypoglycemia, N/D

43
Q

SGLT-2 inhibitors: Action

canagliflozin

A

block reabsorption of glucose in PCT

44
Q

SGLT-2 inhibitors: use

canagliflozin

45
Q

SGLT-2 inhibitors: AE

canagliflozin

A

Glucosuria, UTIs, vaginal yeast infections

[no risk of hypoglycemia]

46
Q

alpha-glucosidase inhibitors: Action

Acarbose, miglitol

A

inhibit Brush border glucosidase. Delayed carbohydrate hydrolysis and glucose absorption –> decreased postprandial hyperglycemia

47
Q

alpha-glucosidase inhibitors: Use

Acarbose, miglitol

A

monotherapy in DM T2, or in combination

48
Q

alpha-glucosidase inhibitors: AE

Acarbose, miglitol

A

GI disturbances

[no risk of hypoglycemia]

49
Q

exenatide

A

Oral hypoglycemic drug: GLP-1 analogs:

50
Q

Liraglutide

A

Oral hypoglycemic drug: GLP-1 analogs:

51
Q

linagliptin

A

Oral hypoglycemic drug: DPP-4 inhibitors:

52
Q

Saxagliptin

A

Oral hypoglycemic drug: DPP-4 inhibitors:

53
Q

sitagliptin

A

Oral hypoglycemic drug: DPP-4 inhibitors:

54
Q

Pramlintide

A

Oral hypoglycemic drug: Amylin analogs:

55
Q

canagliflozin

A

Oral hypoglycemic drug: SGLT-2 inhibitors:

56
Q

Acarbose

A

Oral hypoglycemic drug: alpha-glucosidase inhibitors

57
Q

miglitol

A

Oral hypoglycemic drug: alpha-glucosidase inhibitors

58
Q

Propylthiouracil: mechanism

A

Block thyroid peroxidase (also methimazole). Propylthiouracil also blocks 5’ deiodinase –> decreased peripheral conversion of T4–>T3

59
Q

Propylthiouracil: Use

A

Hyperthyroidism, pregnancy

60
Q

Propylthiouracil: Adverse effects

A

Skin rash, agranulocytosis, aplastic anemia, (also methimazole)
hepatotoxicity (only propylthiouracil)

61
Q

Methimazole: Mechanism

A

Block thyroid peroxidase (also propylthiouracil)

62
Q

Methimazole: use

A

Hyperthyroidism

63
Q

Methimazole: AE

A 
Skin rash, agranulocytosis, aplastic anemia,  (also propylthiouracil)
possible teratogen(only methimazole)
64
Q

Levothyroxine (T4), Triiodothyronine (T3): Use

A

hypothyroid, myxedema, weight loss suppliments (off-label)

65
Q

Conivaptan

A

ADH antagonist

conivaptan, tolvaptan

66
Q

Desmopressin acetate: use

A

Central DI

67
Q

Tolvaptan

A

ADH antagonist

conivaptan, tolvaptan

68
Q

GH: use

A

GH def., turner syndrome

69
Q

Oxytocin: use

A

Contractions, milk letdown, controls uterine hemorrhage

70
Q

Somatostatin (ocreotide): Use

A

Acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

71
Q

Demeclocyline: action

A

ADH antagonist

72
Q

Demeclocyline: AE

A

N DI, photosenstiivity, abnormalities of bone and teeth

73
Q

Glucocorticoids: action
(beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)

A

catabolic, anti-inflammatory and immunosuppresive (inhibit PLA2), inhibit NF-kB

74
Q

Glucocorticoids: use
(beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)

A

Addisons, inflammation, immunosuppression, asthma

75
Q

Glucocorticoids: AE
(beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)

A

Iatrogenic cushings, adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis. Adrenal insufficiency if drug stopped prematurely

76
Q

Cinacalcet: mechanism

A

sensitizes Ca++ sensing receptor in parathyroid gland to circulating Ca++ –> decrease PTH

77
Q

Cinacalcet: use

A

hypercalcemia due to hyperparathyroidism

78
Q

Cinacalcet: AE

A

Hypocalcemia

DRUGS (41 decks)

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