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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
Glitazones / Thiazolidinediones: AE | Pioglitazone, Rosiglitazone
weight gain, edema, hepatotoxicity, HF, increased risk of fractures [no risk of hypoglycemia]
26
metformin
Oral hypoglycemic drug: Biguanides
27
chlorpropamide
Oral hypoglycemic drug: 1st Gen Sulfonylureas
28
Tolbutamide
Oral hypoglycemic drug: 1st Gen Sulfonylureas
29
Glimepiride
Oral hypoglycemic drug: 2nd Gen Sulfonylureas
30
glipizidine
Oral hypoglycemic drug: 2nd Gen Sulfonylureas
31
Glyburide
Oral hypoglycemic drug: 2nd Gen Sulfonylureas
32
Pioglitazone
Oral hypoglycemic drug: Glitazones / Thiazolidinediones
33
Rosiglitazone
Oral hypoglycemic drug: Glitazones / Thiazolidinediones
34
GLP-1 analogs: action | exenatide, Liraglutide
Increase insulin, decrease glucagon
35
GLP-1 analogs: use | exenatide, Liraglutide
DM T2
36
GLP-1 analogs: AE | exenatide, Liraglutide
Pancreatitis, N/V [no risk of hypoglycemia]
37
DPP-4 inhibitors: Action | linagliptin, Saxagliptin, sitagliptin
Increase insulin, decrease glucagon
38
DPP-4 inhibitors: Use | linagliptin, Saxagliptin, sitagliptin
DM T2
39
DPP-4 inhibitors: AE | linagliptin, Saxagliptin, sitagliptin
Mild urinary or resp infections [no risk of hypoglycemia]
40
Amylin analogs: action | Pramlintide
decrease gastric emptying, decrease glucagon
41
Amylin analogs: Use | Pramlintide
DM T1, DM T2
42
Amylin analogs: AE | Pramlintide
Hypoglycemia, N/D
43
SGLT-2 inhibitors: Action | canagliflozin
block reabsorption of glucose in PCT
44
SGLT-2 inhibitors: use | canagliflozin
DM T2
45
SGLT-2 inhibitors: AE | canagliflozin
Glucosuria, UTIs, vaginal yeast infections [no risk of hypoglycemia]
46
alpha-glucosidase inhibitors: Action | Acarbose, miglitol
inhibit Brush border glucosidase. Delayed carbohydrate hydrolysis and glucose absorption --> decreased postprandial hyperglycemia
47
alpha-glucosidase inhibitors: Use | Acarbose, miglitol
monotherapy in DM T2, or in combination
48
alpha-glucosidase inhibitors: AE | Acarbose, miglitol
GI disturbances [no risk of hypoglycemia]
49
exenatide
Oral hypoglycemic drug: GLP-1 analogs:
50
Liraglutide
Oral hypoglycemic drug: GLP-1 analogs:
51
linagliptin
Oral hypoglycemic drug: DPP-4 inhibitors:
52
Saxagliptin
Oral hypoglycemic drug: DPP-4 inhibitors:
53
sitagliptin
Oral hypoglycemic drug: DPP-4 inhibitors:
54
Pramlintide
Oral hypoglycemic drug: Amylin analogs:
55
canagliflozin
Oral hypoglycemic drug: SGLT-2 inhibitors:
56
Acarbose
Oral hypoglycemic drug: alpha-glucosidase inhibitors
57
miglitol
Oral hypoglycemic drug: alpha-glucosidase inhibitors
58
Propylthiouracil: mechanism
Block thyroid peroxidase (also methimazole). Propylthiouracil also blocks 5' deiodinase --> decreased peripheral conversion of T4-->T3
59
Propylthiouracil: Use
Hyperthyroidism, pregnancy
60
Propylthiouracil: Adverse effects
Skin rash, agranulocytosis, aplastic anemia, (also methimazole) hepatotoxicity (only propylthiouracil)
61
Methimazole: Mechanism
Block thyroid peroxidase (also propylthiouracil)
62
Methimazole: use
Hyperthyroidism
63
Methimazole: AE
``` Skin rash, agranulocytosis, aplastic anemia, (also propylthiouracil) possible teratogen(only methimazole) ```
64
Levothyroxine (T4), Triiodothyronine (T3): Use
hypothyroid, myxedema, weight loss suppliments (off-label)
65
Conivaptan
ADH antagonist | conivaptan, tolvaptan
66
Desmopressin acetate: use
Central DI
67
Tolvaptan
ADH antagonist | conivaptan, tolvaptan
68
GH: use
GH def., turner syndrome
69
Oxytocin: use
Contractions, milk letdown, controls uterine hemorrhage
70
Somatostatin (ocreotide): Use
Acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices
71
Demeclocyline: action
ADH antagonist
72
Demeclocyline: AE
N DI, photosenstiivity, abnormalities of bone and teeth
73
Glucocorticoids: action (beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)
catabolic, anti-inflammatory and immunosuppresive (inhibit PLA2), inhibit NF-kB
74
Glucocorticoids: use (beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)
Addisons, inflammation, immunosuppression, asthma
75
Glucocorticoids: AE (beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)
Iatrogenic cushings, adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis. Adrenal insufficiency if drug stopped prematurely
76
Cinacalcet: mechanism
sensitizes Ca++ sensing receptor in parathyroid gland to circulating Ca++ --> decrease PTH
77
Cinacalcet: use
hypercalcemia due to hyperparathyroidism
78
Cinacalcet: AE
Hypocalcemia

DRUGS (41 decks)

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