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Monash Pharmacology > Endocrine, Diabetes, Osteoporosis > Flashcards

Endocrine, Diabetes, Osteoporosis Flashcards

1
Q

Hyperthyroidism - symptomatic treatment (tachycardia, arrhythmia, angina, tremor, agitation )

A

Propanolol

Beta blocker - DONT use with Ca channel blocker verapamil

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2
Q

Hyperthyroidism - prolonged, or short term before surgery

A

Carbimazole, thionamide

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3
Q

Hyperthyroidism - Grave’s disease

A

Carbimazole, thionamide

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4
Q

Hyperthyroidism - short term for throtoxic criss, prep for thyroidectomy

A

Iodine/ iodide supplement

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5
Q

Hyperthyroidism and thyroid carcinoma

A

Radioactive iodine - not for pregnant ladies.

Side note, low iodine for pregnant female, results in baby with cretinism

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6
Q

Hypothyroidism drug of choice

A

T4 - thyroxine

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7
Q

Hypothyroidism treatment 2 drugs

A

T4 thyroxine

T3 triiodothyronine

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8
Q

Medicines that weaken bone

A 
Glucocorticoids (prednisolone)
thyroid hormone
heparin 
antiepileptic drugs
glitazones 
aromatase inhibitors (anastrazole)
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9
Q

Osteoporosis - preventative treatment

A

Calcitriol (Vit D)

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10
Q

Osteoporosis - what drug is not generally recommended for use to prevent bone loss or fractures

A

Hormone replacement therapy

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11
Q

Osteoporosis - what drug has beneficial effects on the bone without effect on other tissues?

A

Raloxifene

Selective estrogen receptor modulator (SERM)

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12
Q

Osteoporosis - what drug is 1st line management for post menopausal osteoporosis?

A

Alendronate - a biphosphate.

DO NOT take with glucocorticoids, due to increased risk of atypical fractures.

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13
Q

Biphosphate alendronate what are three main side effects -

and why low compliance?

A
  1. Oesophagitis
  2. Atypical fractures
  3. Osteonecrotising Jaw

Take in morning before breakfast, remain standing for thirty minutes afterwards.

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14
Q

Osteoporosis - what do you give if biphosphate are unsuitable?

A

Densumab - monoclonal antibody against RANKL

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15
Q

What’s the relationship between RANKL, RANK and OPG

A

RANK Ligand found on osteoblasts - activate RANK found on osteoclast progenitors. OPG (osteoprotegerin) act as antibodies against RANKL inhibiting osteoclast activation.

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16
Q

Osteoporosis drug with low efficacy

A

Calcitonin

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17
Q

Osteoporosis drug of choice when there is a high risk of fractures or other treatments are unsuitable.

A

Teriparatide (PTH/PTH fragments), anabolic bone agent

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18
Q

Diabetes drug - take immediately before a meal

A

Insulin lispro, insulin aspart, ultra short acting insulin

19
Q

Diabetes - IV in hyperglycaemic emergency or before a meal.

A

Soluble insulin (neutral), short acting insulin

20
Q

Diabetes - combine with short acting and give twice a day (mimics basal release)

A

Isophane - intermediate acting insulin

21
Q

Diabetes- give AT BREAKFAST with short acting given at meals (mimics basal release)

A

Ultralente Long acting insulin

22
Q

Diabetes - first choice sensitising agent unless renal problems

A

Metformin - insulin sensitisor

23
Q

Diabetes - less efficacious than metformin or sulphonureas

A

Thiazolidinediones

TZDs/glitazones, insulin sensitiser

24
Q

Diabetes - useful in early stages of diabetes

A

Glicazides

Sulphonylureas - insulin secretion

25
Q

Diabetes - may be used in patients with allergy to sulphonylureas

A

Repaglinide - glitinide.

Insulin secretion

26
Q

Diabetes- usual when postprandial BG remains high despite dietary modification

A

Acarbose
A-glucosidase inhibitor

Oral hypoglycaemic agent

27
Q

Propanolol BB S/E

A

Bronchoconstriction, bradycardia, AV block, depression, sedation, exacerbate diabetes, mask hypoglycaemia, impotence

28
Q

Carbimazole - thionamide S/E

A

Agranulocytosis, cross placenta and milk, rashes, headache, nausea, joint pain

29
Q

Iodine/iodide supplement S/E

A

possible allergic reactions.

30
Q

Radioactive iodine S/E

A

Hypothyroidism, thyroid cancer (small increase in risk)

31
Q

T4 (thyroxine) S/E

A

Elderly at risk of angina, arrhythmia, heart failure, osteoporosis

32
Q

Calcitriol (Vit D) S/E

A

Hypercalcaemia, hypercalciuria

33
Q

Hormone Replacement Therapy S/E

A

Increased risk of cancers (breast), adverse cardiovascular effects

34
Q

Raloxifene (Selective estrogen receptor modulator SERM) S/E

A

May affect breast and endometrial tissue, adverse cardiovascular effects

35
Q

Alendronate (Biphosphate) - S/E

A

Osteonecrosis of jaw, effect limited after 5 years, GI effects, compliance issues, atypical fractures

36
Q

Densumab (Monoclonal Antibody RANKL) - S/E

A

Lacks long term safety and efficacy data

37
Q

Teriparatide (PTH/PTH fragments bone anabolic agent) - S/E

A

Possible increase in osteosarcoma, stopped after 18 months

38
Q

Insulin - all duration - S/E

A

Hypoglycaemia, formation of antibodies, local allergic reactions

39
Q

Metformin - insulin sensitiser - S/E

A

Weight loss, nausea, diarrhoea

40
Q

Thiazolidinediones (glitazone, insulin sensitiser) S/E

A

Weight gain, long term safety still unsure

41
Q

Glicazide - sulphonylureas insulin secretion - S/E

A

Hight protein binding, hypoglycaemia, weight gain (stimulate appetite)

42
Q

Repaglinide - glitinide insulin secretion - S/E

A

Hypoglycamia

43
Q

Acarbose - A-glucosidase inhibitor - S/E

A

Flatulence diarrhoea

44
Q

Hyperaldosteronism; often used with thiazides or loop diuretics to prevent hypokalaemia, resistant hypertension, CHF

A

Spironolactone

Aldosterone receptor antagonist (K+ sparing)

Monash Pharmacology (13 decks)

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