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Endocrine drugs Flashcards

1
Q

levothyroxine uses

A

hypothyroidism (T4)

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2
Q

levothyroxine roa

A

oral or IV

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3
Q

levothyroxine ae

A

Overdosing can cause:
cardiac arrest, hypertension, palpitations. tachycardia, anxiety, heat intolerance, insomnia, hyperactivity, irritability, weight loss

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4
Q

liothyronine uses

A

hypothyroidism (T3)

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5
Q

liothyronine roa

A

oral/ IV

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6
Q

liothyronine ae

A

Overdosing can cause:
cardiac arrest, hypertension, palpitations. tachycardia, anxiety, heat intolerance, insomnia, hyperactivity, irritability, weight loss

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7
Q

levothyroxine monitoring and what time of day should it be taken

A

Levothyroxine monitoring:
When initiating L-T4 therapy, serum TSH should be measured to monitor for adequate replacement.
2. TSH should be measured 6-8 weeks after initiation of, or a change in L-T4 dose

What time of day:
Taken 30-45 minutes before breakfast on empty stomach.

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8
Q

thioamides examples

A

Carbimazole (1st line)
Propylthiouracil (PTU)

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9
Q

thioamides uses

A
  1. Graves disease
  2. Thyroid storm: PTU may be favoured because it has a small but additional effect of blocking the peripheral conversion of T4 to T3
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10
Q

thioamides moa

A

Inhibit thyroid peroxidase enzyme (TPO) and interfere with the iodination of thyroglobulin

  • Propylthiouracil also inhibits deiodination of T4 to T3 systemically
  • Carbimazole is converted to the active metabolite, thiamazole
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11
Q

thioamides roa

A

oral

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12
Q

thioamides ae

A
  • Relatively low incidence of ADRs
  • Most serious: Agranulocytosis
    • If the patient develops a sore throat, fever, or
      other signs or symptoms of infection, they should
      stop and have a complete blood count
  • The most common reaction is a mild, occasionally purpuric, urticarial papular rash
  • Cholestatic jaundice with carbimazole
  • Severe liver injury and acute liver failure with PTU
    • therefore, carbimazole preferred for its less
      hepatotoxicity
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13
Q

strong iodine examples

A

Lugol’s Solution
Potassium Iodide

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14
Q

strong iodine uses

A
  1. Used in the preoperative period for thyroidectomy
  2. Useful in thyroid storm
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15
Q

strong iodine moa

A
  • Suppress iodination of tyrosine
  • Can be used to temporarily inhibit T4 and T3 synthesis and release, hence useful in thyroid storm
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16
Q

strong iodine ae

A

Allergic-like reactions can occur

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17
Q

radioactive iodine examples

A

131 Iodide
123 Iodide

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18
Q

radioactive iodine uses

A

graves disease
toxic nodular goitre

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19
Q

radioactive iodine roa

A

oral

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20
Q

radioactive iodine moa

A
  • Radioactive iodine is rapidly and efficiently trapped by the thyroid sodium-iodide transporter, into the follicular cells, from which it is slowly liberated
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21
Q

radioactive iodine ae

A
  • High incidence of delayed hypothyroidism
  • Radioactive iodine therapy has been associated with worsening Graves’ ophthalmopathy
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22
Q

Biguanides examples

A

Metformin

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23
Q

Biguanides uses

A

First-line therapy for Type II DM

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24
Q

Biguanides moa

A

Decreases hepatic glucose production (gluconeogenesis)
Increases the density of insulin receptors at the tissues

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25
Q

Biguanides roa

A

oral

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26
Q

Biguanides ae

A
  1. GI issues - diarrhoea, vomiting, indigestion.
  2. Raise risk of Vit B12 malabsorption and hence Vit B12 deficiency
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27
Q

Thiazolidinediones examples

A

Pioglitazone

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28
Q

Thiazolidinediones uses

A
  1. High glucose-lowering efficacy
  2. Does not affect insulin secretion
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29
Q

Thiazolidinediones moa

A

Raise insulin-dependent glucose disposal and lower insulin resistance in liver

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30
Q

Thiazolidinediones roa

A

oral

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31
Q

Thiazolidinediones ae

A
  • Weight gain
  • Peripheral edema
  • Increased risk of heart failure (fluid retention)
  • Bone fractures
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32
Q

Sulfonylurea examples

A

Glipizide
Gliclazide
Glibenclamide

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33
Q

Sulfonylurea uses

A

Overall hypoglycaemic effects are potentiated when prescribed alongside Metformin / Thiazoldinediones

34
Q

Sulfonylurea moa

A

stimulates the release of insulin from the pancreas

35
Q

Sulfonylurea roa

36
Q

Sulfonylurea ae

A
  • Can cause weight gain
  • Risk for hypoglycemia (highest with Glibenclamide)
37
Q

Meglitinides examples

A

Nateglinide
Repaglinide

38
Q

Meglitinides uses

A

administered just before meals to control post prandial glucose levels

39
Q

Meglitinides moa

A

bind and close the K-ATP channels on the pancreatic beta cells in a glucose-dependent manner stimulating insulin release

40
Q

Meglitinides roa

41
Q

DPP-4 inhibitors examples

A

Sitagliptin
Vildagliptin
Linagliptin

42
Q

DPP-4 inhibitors uses

A

Intermediate glucose-lowering efficacy

43
Q

DPP-4 inhibitors moa

A

stimulate pancreatic β-cells to increase glucose-stimulated insulin release

44
Q

DPP-4 inhibitors roa

45
Q

DPP-4 inhibitors ae

A
  1. GI issues - Diarrhoea, nausea, stomachache
  2. Flu-like symptoms - headache, runny nose, sore throat
46
Q

GLP-1 Receptor Agonist examples

A

Semaglutide
Liraglutide

47
Q

GLP-1 Receptor Agonist uses

A

reduce appetite and helps with weight loss

48
Q

GLP-1 Receptor Agonist moa

A

suppression of glucagon release by the pancreas

49
Q

GLP-1 Receptor Agonist roa

A

subcutaneous injection

50
Q

GLP-1 Receptor Agonist ae

A

Gastrointestinal problems such as nausea, vomiting, diarrhea

51
Q

Rapid-acting insulin examples

A

Lispro
Aspart

52
Q

Rapid-acting insulin roa and doa

A
  • Can be injected subcutaneously just before meals
  • Can also be injected IV in times of emergency
  • SHORTER DOA -> lower incidence of hypoglycaemia
53
Q

intermediate acting insulin examples

54
Q

intermediate acting insulin roa and doa

A
  1. When injected Subcutaneously, precipitated crystals of NPH insulin released slowly causing longer DOA.
55
Q

Long-acting insulin examples

A

Glargine
Detemir

56
Q

Long-acting insulin roa and doa

A

Used as background insulin, injected once and its acts for 18-24 hours

57
Q

AE for insulin therapy

A

hypoglycemia: symptoms like dizziness, tremor, sweating
NPH highest risk of hypoglycaemia

lipodystrophy: accumulation of fat due to repeated insulin injections

58
Q

what class of drug is Propylthiouracil (PTU)

59
Q

what class of drug is Pioglitazone

A

Thiazolidinediones

60
Q

what class of drug is Sitagliptin

A

DPP-4 inhibitor

61
Q

what class of drug is Aspart

A

rapid acting insulin

62
Q

what class of drug is 131 Iodide

A

radioactive iodine

63
Q

what class of drug is Lugol’s Solution

A

strong iodine

64
Q

what class of drug is Semaglutide

A

GLP-1 receptor agonist

65
Q

what class of drug is Gliclazide

A

Sulfonylurea

66
Q

what class of drug is Potassium Iodide

A

strong iodine

67
Q

what class of drug is Liraglutide

A

GLP-1 receptor agonist

68
Q

what class of drug is Vildagliptin

A

DPP-4 inhibitors

69
Q

what class of drug is Glipizide

A

Sulfonylurea

70
Q

what class of drug is Nateglinide

A

Meglitinides

71
Q

what class of drug is Glargine

A

Long-acting insulin

72
Q

what class of drug is Carbimazole

A

Thioamides

73
Q

what class of drug is 123 Iodide

A

Radioactive Iodine

74
Q

what class of drug is Linagliptin

A

DPP-4 inhibitors

75
Q

what class of drug is Lispro

A

rapid acting insulin

76
Q

what class of drug is Metformin

A

biguanides

77
Q

what class of drug is Repaglinide

A

Meglitinides

78
Q

what class of drug is NPH

A

Intermediate-acting insulin

79
Q

what class of drug is Detemir

A

Long-acting insulin

80
Q

what class of drug is Glibenclamide

A

Sulfonylurea

Pharmacology (4 decks)

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