Endocrine and reproductive systems Flashcards by Harry Holmes

Alendronic acid

Bisphosphonate

Osteoporotic fragility fractures

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Disodium pamidronate

Biphosphonate

Hypercalcemia of malignancy

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Zoledronic acid

Biphosphonate

Hypercalcemia of malignancy

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(Biphosphonate)

Reduce bone turnover by inhibiting osteoclast
Pagets disease
✖severe renal imparement
✖hypophosphataemia

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(Calcium and vitamin D)

Calcium important in muscle, bone, nerves and clotting
Vitamin D increases serum calcium
 Osteoparosis 
 Chronic kidney dosease 
✖Hypercalcemia

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Calcium carbonate / Calcium gluconate

Calcium

Severe hyperkalemia

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Colecalciferol / Alfacalcidol

Vitamin D

Vit D deficiency

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(Calcium channel blocker)

Decrease calcium ion entry into vascular and cardiac cells
Stable angina
✖Unstable angina
✖Severe aortic stenosis

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Amlodipine

(Calcium channel blocker)
Hypertension
Stable angina

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Nifedipine

(Calcium channel blocker)
Hypertension
Stable angina

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Diltiazem

(Calcium channel blocker) 
Supraventricular arrhythmias (i.e. supracentriular tachycardia, atrial flutter, atrial fib)

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Verapamil

(Calcium channel blocker) 
Supraventricular arrhythmias (i.e. supracentriular tachycardia, atrial flutter, atrial fib)

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(Glucocorticoid)

Binds to cytolytic glucocorticoid receptors, translocation to nucleus and bind to glucocorticoid response elements that regulate gene expression. Upregulate inflammatory genes and down regulate pro-inflammatory genes.

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Prednisolone

(Glucocorticoid) 
Treat allergic or inflammatory disorders 
Autoimmune disease
Some cancers 
Adrenal insufficiency or hypopituitarism

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Hydrocortisone

(Glucocorticoid) 
Treat allergic or inflammatory disorders 
Autoimmune disease
Some cancers 
Adrenal insufficiency or hypopituitarism

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Dexamethasone

(Glucocorticoid) 
Treat allergic or inflammatory disorders 
Autoimmune disease
Some cancers 
Adrenal insufficiency or hypopituitarism

(Dipeptidylpeptidase-4 inhibitors)

Incretins (e.g. GLP-1 and glucose-dependant insulinotropic peptide) released in response to food. Incretins promote insulin secretion and are deactivated by dipeptidylpeptidase-4. DDP-4 inhibitors reduced incretin degradation. Action of incretin is glucose-dependaent, less chance of hypoglycemia compared to sulphonylureas
✖Hypersensitivity 
✖Type 1 diabetes 
✖Ketoacidosis 
✖Pregnancy or breastfeeding

Sitagliptin

(Dipeptidylpeptidase-4 inhibitors)

Type 2 diabetes

Lingagliptin

(Dipeptidylpeptidase-4 inhibitors)

Type 2 diabetes

Saxagliptin

(Dipeptidylpeptidase-4 inhibitors)

Type 2 diabetes

(Glucose, dextrose)

5% solution is a mean of providing water. Glucose serum initially isotonic. Rapid glucose uptake by cells leads to hypotonic water that distributes across body. Also used in hypoglycemia. In hyperkalaemia, insulin and glucose used together. Insulin stimulates Na+/K+ ATPase to shift K+ into cells. Glucose prevent hypoglycaemia during this process

Glucose 5%

(Glucose, dextrose)
Provide water when oral not possible
Reconstitution or dilution of frugs

Glucose 10%

(Glucose, dextrose)
Treat hypoglycemia
+ insulin to treat hyperkalaemia

Glucose 20%

(Glucose, dextrose)
Treat hypoglycemia
+ insulin to treat hyperkalaemia

Glucose 50%

(Glucose, dextrose) Treat hypoglycemia + insulin to treat hyperkalaemia

(Insulin)

Stimulates glucose uptake into cells + glycogen, lipid and protein synthesis + inhibits gluconeogenesis and ketogenesis. Also drives K+ into cells in the short term for hyperkalcemic patients

Insulin aspart

(Rapid-acting insulin) Type 1 and 2 diabetes Diabetic emergencies (e.g. diabetic ketoacidosis, hyperosmolar syndrome, perioperative glycaemic control + glucose to treat hyperkalemia

Soluble insulin

(Short acting insulin) Type 1 and 2 diabetes Diabetic emergencies (e.g. diabetic ketoacidosis, hyperosmolar syndrome, perioperative glycaemic control + glucose to treat hyperkalemia

Isophane

(Intermediate acting insulin) Type 1 and 2 diabetes Diabetic emergencies (e.g. diabetic ketoacidosis, hyperosmolar syndrome, perioperative glycaemic control + glucose to treat hyperkalemia

Insulin glargine

(Long-acting insulin) Type 1 and 2 diabetes Diabetic emergencies (e.g. diabetic ketoacidosis, hyperosmolar syndrome, perioperative glycaemic control + glucose to treat hyperkalemia

30% insulin aspart + 70% insulin aspart protamine

(Biphasic insulin) Type 1 and 2 diabetes Diabetic emergencies (e.g. diabetic ketoacidosis, hyperosmolar syndrome, perioperative glycaemic control + glucose to treat hyperkalemia

(Metformin)

Lowers glucose by reducing hepatic glucose output (glucogenolysis + gluconeogenesis). Increases glucose uptake. In cells it activates AMP kinase (cellular metabolic sensor involved in several metabolic processes) Type 2 diabetes ✖Acute kidney injury ✖Severe tissue hypoxia

(Oestrogen and progestogens)

Oestrogen and progestogen exert negative feedback effect on LH and FSH release. Fall in oestrogen and progestogen occur during menopause. Exogenous forms used in supplementation ✖Breast cancer ✖VTE

Combined ethinylestradiol products

(Oestrogen and progestogens) Reversible hormonal contraception Hormone replacement therapy

(Sulphonylureas)

Lower blood glucose by stimulating pancreatic insulin secretion. Blocks ATP-dependant K+ channels in beta cells, causes depolarisation eading to opening of Ca2+ channels. Increase in intracellular Ca2+ concentration stimulate insulin secretion.

Gliclazide

(Sulphonylureas) | Type 2 diabetes

(Thyroid hormones)

Thyroid produces T4. T3 is converted to more active T4 in target tissues. Thyroid hormone important for growth and metabolism. Levothyroxine (T4) used for long term replacement. Liothyroxine (T3) has shorter half life and quicker onset, used in emergency or acute hypothyroidism

Levothyroxine

(Thyroid hormones) Primary hypothyroidism Hypothyroidism secondary to hypopituitarism

Liothyronine

(Thyroid hormones) Primary hypothyroidism Hypothyroidism secondary to hypopituitarism