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Foundations of Biomedical Science > Endocrine and Metabolic Drugs > Flashcards

Endocrine and Metabolic Drugs Flashcards

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1
Q

What class of drug is Insulin (NovoRapid, Levemir, Lantus, Humalog)?

A

Anti-diabetic medication

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2
Q

What class of drug is Metformin (Diabex)?

A

Anti-diabetic medication

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3
Q

What class of drug is Glibenclamide (Daonil, Glimel)?

A

Sulfonylurea anti-diabetic medication

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4
Q

What class of drug is Exenatide (Byetta, Bydureon)?

A

GLP-1 analogue

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5
Q

What class of drug is Risedronate (Actonel)?

A

Bisphosphonate

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6
Q

What class of drug is Raloxifene (Evista)?

A

Selective oestrogen receptor modulator

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7
Q

What class of drug is Denosumab (Prolia)?

A

RANK-L inhibitor

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8
Q

What class of drug is Disulfiram (Antabuse)?

A

Aldehyde dehydrogenase inhibitor

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9
Q

What class of drug is Thyroxine (Oroxine)?

A

Thyroid hormone

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10
Q

What class of drug is Liothyronine (Tertroxin)?

A

Thyroid hormone

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11
Q

What class of drug is Carbimazole (Neo-Mercazole)?

A

Anti-thyroid drug

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12
Q

What class of drug is Propylthiouracil (PTU)?

A

Anti-thyroid drug

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13
Q

What is the mechanism of action of Insulin (NovoRapid, Levemir, Lantus, Humalog)?

A

Increases or restores ability to metabolise glucose by enhancing cellular glucose uptake; inhibits endogenous glucose output and lipolysis

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14
Q

What is the mechanism of action of Metformin (Diabex)?

A

Acts on liver to decrease insulin resistance

Reduces hepatic glucose production; increases peripheral utilisation of glucose

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15
Q

What is the mechanism of action of Glibenclamide (Daonil, Glimel)?

A

Stimulates insulin secretion by binding to and blocking KATP channels on pancreatic β cells, thereby leading to depolarisation and exocytosis of insulin granules into the circulation

May also decrease insulin resistance

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16
Q

What is the mechanism of action of Exenatide (Byetta, Bydureon)?

A

Analogues of glucagon-like peptide-1 (an incretin); increase glucose-dependent insulin secretion and suppress inappropriate glucagon secretion

They also delay gastric emptying, which slows glucose absorption, and decrease appetite

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17
Q

What is the mechanism of action of Risedronate (Actonel)?

A

Decreases bone resorption by inhibiting osteoclasts

BPs are resorbed into bone matrix as bone mineralises

Bisphosphonates are toxic to osteoclasts when they are attempting to resorb bone

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18
Q

What is the mechanism of action of Raloxifene (Evista)?

A

Oestrogen agonistic effects on bone mass and lipid; antagonistic effects at other oestrogen-receptive tissues, eg breast and endometrium

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19
Q

What is the mechanism of action of Denosumab (Prolia)?

A

Human monoclonal antibody that binds receptor activator of nuclear factor-kappa B ligand (RANKL) preventing activation of the RANK receptor, resulting in decreased formation and activity of osteoclasts, thus reducing bone resorption

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20
Q

What is the mechanism of action of Disulfiram (Antabuse)?

A

Deters alcohol use

Disulfiram prevents the usual metabolism of alcohol (irreversibly inhibits aldehyde dehydrogenase), blocking acetaldehyde breakdown, which causes unpleasant, potentially serious effects if alcohol is consumed:

e.g. flushing, sweating, nausea, vomiting, palpitations, headache, dyspnoea, chest pain, hypotension, cardiovascular collapse, seizures, arrhythmias

21
Q

What is the mechanism of action of Thyroxine (Oroxine)?

A

Thyroxine is the thyroid hormone T4. It is converted to T3, which is much more potent

However, T4 is administered in preference to T3 for hypothyroidism because it has a longer half-life and its levels better approximate TSH levels

22
Q

What is the mechanism of action of Liothyronine (Tertroxin)?

A

Liothyronine is also known as T3 or tri-iodothyronine

It is administered in cases of severe hypothyroidism and myoedema coma because it is more active than T4 and acts more rapidly

23
Q

What is the mechanism of action of Carbimazole (Neo-Mercazole)?

A

Inhibits thyroid peroxidase, which usually catalyses the addition of iodide to tyrosine during synthesis of thyroid hormones

24
Q

What is the mechanism of action of Propylthiouracil (PTU)?

A

Inhibits thyroid peroxidase, which usually catalyses the addition of iodide to tyrosine during synthesis of thyroid hormones

Also inhibits the conversion of T4 to T3

25
Q

What are the side effects of Insulin (NovoRapid, Levemir, Lantus, Humalog)?

A
  • Hypoglycaemia
  • Weight gain
  • Allergic reactions

Local reactions including erythema, itching, lipodystrophy, lipoatrophy

26
Q

What are the side effects of Metformin (Diabex)?

A
  • Malabsorption of vitamin B12
  • Nausea
  • Vomiting
  • Anorexia
  • Diarrhoea
27
Q

What are the side effects of Glibenclamide (Daonil, Glimel)?

A
  • Hypoglycaemia
  • Weight gain
  • Nausea
  • Diarrhoea
  • Metallic taste
  • Headache
  • Rash
28
Q

What are the side effects of Exenatide (Byetta, Bydureon)?

A
  • Headache
  • Dizziness
  • Feeling jittery
  • Nausea and/or vomiting
  • Diarrhoea
  • Constipation
  • Dyspepsia
  • GORD
  • Abdominal pain
  • Hypoglycaemia
  • Injection site reactions
  • Taste disturbance
29
Q

What are the side effects of Risedronate (Actonel)?

A
  • Nausea
  • Vomiting
  • Diarrhoea
  • Headache
  • Hypocalcaemia
  • Musculoskeletal pain
  • Oesophagitis
  • Oesophageal erosions and ulcers
  • Gastritis
  • Duodenitis
  • Glossitis
  • Rash
  • Osteonecrosis of jaw
30
Q

What are the side effects of Raloxifene (Evista)?

A
  • Hot flushes
  • Sweating
  • Leg cramps
  • Peripheral oedema
  • Sleep disorders
  • VTE (venous thromboembolism)
31
Q

What are the side effects of Denosumab (Prolia)?

A
  • Eczema
  • Hypercholesterolaemia
  • Musculoskeletal pain (in men)
  • Cataracts
  • Urinary retention
32
Q

What are the side effects of Disulfiram (Antabuse)?

A
  • Drowsiness
  • Nausea
  • Headache
  • Fatigue
  • Taste disturbance
33
Q

What are the side effects of Thyroxine (Oroxine)?

A
  • Tachycardia
  • Arrhythmia
  • Excitability
  • Insomnia
  • Flushing
  • Sweating
  • Diarrhoea
  • Excessive weight loss
  • Worsening ischaemic symptoms in those with IHD

Decreased bone density

34
Q

What are the side effects of Liothyronine (Tertroxin)?

A
  • Tachycardia
  • Arrhythmia
  • Excitability
  • Insomnia
  • Flushing
  • Sweating
  • Diarrhoea
  • Excessive weight loss
  • Worsening ischaemic symptoms in those with IHD

Decreased bone density

35
Q

What are the side effects of Carbimazole (Neo-Mercazole)?

A
  • Itching
  • Rash
  • Mild leukopenia
  • Nausea
  • Vomiting
  • Gastric discomfort
  • Headache
  • Arthralgia
  • Agranulocytosis
  • Goitre
36
Q

What are the side effects of Propylthiouracil (PTU)?

A
  • Itching
  • Rash
  • Mild leukopenia
  • Nausea
  • Vomiting
  • Gastric discomfort
  • Headache
  • Arthralgia
  • Agranulocytosis
  • Hepatotoxicity

Goitre

37
Q

What are the indications for use of Insulin (NovoRapid, Levemir, Lantus, Humalog)?

A

Administration: usually subcutaneous injection, but IV during acute care

  • Type 1 diabetes
  • Type 2 diabetes inadequately controlled with diet, exercise and oral anti-diabetic drugs
38
Q

What are the indications for use of Metformin (Diabex)?

A

Administration: oral tablet

  • Type 2 diabetes in patients > 10 years

Contraindications:

Type 1 diabetes

39
Q

What are the indications for use of Glibenclamide (Daonil, Glimel)?

A

Administration: oral tablet

  • Type 2 diabetes

Contraindications:

Hepatic impairment
Elderly patients
Renal impairment
Ketoacidosis
Type 1 DM
Acute illness

May be administered in fixed-dose combination with metformin (Glucovance). Should be taken with food to minimise risk of hypoglycaemia.

40
Q

What are the indications for use of Exenatide (Byetta, Bydureon)?

A

Administration: SC injection

  • Type 2 diabetes with metformin and/or a sulfonylurea, when these are inadequate
  • Type 2 diabetes with metformin and a basal insulin, when these are inadequate

Contraindications:

Treatment with insulin
Severe GI disease
History of pancreatitis with a GLP-1 analogue

Pregnancy

41
Q

What are the indications for use of Risedronate (Actonel)?

A

Administration: oral tablet

  • Paget’s disease
  • Prevention and treatment of osteoporosis (including postmenopausal and corticosteroid-induced)

Contraindications:

Immobile patients
Oesophageal disorders
Upper GI conditions (e.g. dysphagia, gastritis)
Hypocalcaemia

Pregnancy

42
Q

What are the indications for use of Raloxifene (Evista)?

A

Administration: oral tablet

  • Prevention and treatment of postmenopausal osteoporosis
  • Primary prevention of invasive breast cancer in high-risk postmenopausal women

Contraindications:

Patients with previous venous thromboembolism or at high risk of VTE (venous thromboembolism)
History of breast cancer
Before surgery

Pregnancy

43
Q

What are the indications for use of Denosumab (Prolia)?

A

Administration: injection

  • Treatment of postmenopausal osteoporosis
  • Increase bone mineral density in men with osteopenia or osteoporosis
  • Prevention of skeletal-related events due to bone metastases from solid tumours
  • Giant cell tumour of bone

Contraindications:

Hypocalcaemia
Pregnancy

44
Q

What are the indications for use of Disulfiram (Antabuse)?

A

Administration: oral tablet

  • Maintenance of abstinence in alcohol dependence

Contraindications:

Ischaemic heart disease
Psychosis
Severe myocardial disease
Severe renal disease
Severe hepatic disease
Pregnancy

Breastfeeding

45
Q

What are the indications for use of Thyroxine (Oroxine)?

A

Administration: oral tablet

  • Hypothyroidism
  • Block-replacement regimen in hyperthyroidism
  • Suppressive regimen in thyroid cancer and euthyroid goitre

Contraindications:

Untreated hyperthyroidism
Hypopituitarism and adrenal insufficiency
Cardiovascular disorders

Diabetes

46
Q

What are the indications for use of Liothyronine (Tertroxin)?

A

Administration: oral tablet, IV

  • Severe hypothyroidism, such as myxoedema coma
  • Thyroid cancer (may be used to shorten the period of symptomatic hypothyroidism due to thyroxine withdrawal before or after thyroid scanning during long-term follow up)

Contraindications:

Untreated hyperthyroidism
Hypopituitarism and adrenal insufficiency
Cardiovascular disorders

Diabetes

47
Q

What are the indications for use of Carbimazole (Neo-Mercazole)?

A

Administration: oral tablet

  • Graves’ disease
  • Short-term treatment before thyroid surgery, or before and after radioactive iodine treatment
  • Thyroid storm

Contraindications:

First trimester pregnancy

48
Q

What are the indications for use of Propylthiouracil (PTU)?

A

Administration: oral tablet

  • Graves’ disease
  • Short-term treatment before thyroid surgery, or before and after radioactive iodine treatment
  • Thyroid storm

Must be dosed more frequently than carbimazole.

Foundations of Biomedical Science (9 decks)

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