Endocrine Flashcards
Glucagon
Glucagon
Synthetic Analogue of endogenous polypeptide hormone.
Increases adenylate cyclase, leads to increase of cAMP.
Increases HR, contractility, increases release of catecholamines. Relaxes smooth muscles, leads to decrease in SVR, relaxation of sphincter of oddi, and derease gastric motility. Leads to glycogenolysis and hyperglycemia, followed by insulin release. Used in BB overdose, to relax SOO after spasm, and s/p MI and cardiopulmonary bypass.
Pk:
onset: immediate
DOA: 1 hour
E1/2t : 2- 5 minutes
metabolized in liver, kdineys, and tissues to inactive metabolites.
Dose:
1-5 mg IV bolus
20 mg/hr
0.3 mg for SOO spasm
SE:
Hyperglycemia
paradoxical hypoglycemia
hypokalemia
decrease in gastric motility - n/V
tachycardia with a.fib
C/I:
pheochromacytoma
insulinoma
caution with DM
caution with LIVER failure
Insulin - regular
Insulin - regular
Identical to pancreatic polypeptide hormine with zinc ions added for stability
MOA:
Binds to insulin receptors on plasma membrane, leads to GPCR reaction that results in GLUT-4 transportes on cell membrane. Leads to
- increased diffusion of insulin into cell
- increased up take of amino acids, potassium, mag, phos.
- Increased protein synthesis, decreased proteolytic activity.
- increased synthesis of fatty acids and triglycerides, decreased lipolysis
- regulates DNA/gene expression
Pk:
Onset: rapid
peak: 1-5 hours
DOA: cleared from plasma in 1 hr, DOA of effect 5-8 hours
E1/2t: 5 minutes
metabolized in liver, kidneys, and tissues to inactive metabolites.
Dose:
1 unit decreases blood glucose by 30-50 mg/dL
SE:
Hypoglycemia -> tachycardia, neuroglycopenia, diaphoresis
HTN, CNS agitation, coma death
hypokalemia
injection site rxn / lipodystrophy at injxn site
with NPH can potentially lead to protamine allergy
weight gain
MAO-I’s may potentiate effect
C/I:
Hypoglycemia
caution in liver or kidney failure r/t prolonged DOA and higher risk of hypoglycemia
