Endocrine Drugs Flashcards
This is a drug for hypothyroidism that is used for hypothyroid crisis. It is 3 to 4 times more active than Levothyroxine (T4)
Liothyronine (T3)
This is a drug for hypothyroidism that is a combination of synthetic T4 and T3 in a ratio of 4:1
Liotrix
This is a drug for hypothyroidism that contains T4 but without T3
Levothyroxine
This is a drug for hyperthyroidism that inhibits thyroid peroxidase and condensation/coupling.
SE: Pruritic maculopapular rash
Thioamides/ Thionamides
Propylthiouracil, Methimazole, Carbimazole
This is a thioamide that also inhibits peripheral conversion of T4 to T3. It has a short DOA, less potent, and is indicated for pregnant women and for thyroid storm
AE: Hepatitis
PTU/ propylthiouracil
A thioamide that has longer DOA, 10x more potent, used as maintenance treatment but should not be used by pregnant women as it is teratogenic and can cause cutis aplasia. It is the first like drug of choice for hyperthyroidism
AE: Cholestatic jaundice
MMI/ methimazole
This is a drug for hyperthyroidism that inhibits iodide uptake through competitive inhibition of Na/I symporter
SE: Aplastic anemia
Anionic inhibitors or inorganic anions
Potassium perchlorate, thiocyanate
This is a drug for hyperthyroidism that exerts Wolff-Chaikoff effects (negative feedback). It is not for long term use
AE: Iodism
CI: Pregnancy
Iodides
Lugol’s solution, KIss (potassium iodide saturated solution)
This is a drug for hyperthyroidism that inhibits the release of thyroid hormone and inhibits peripheral conversion of T4 to T3. It can be indicated for thyroid storm
Radiocontrast dyes
This is a drug for hyperthyroidism that inhibits peripheral iodination of T4 to T3. It can be used for thyroid storm
Propranolol
This is a drug for hyperthyroidism that interferes with peripheral conversion of T3 to T4. It is an adjunct treatment for thyroid storm
Prednisone
Dexamethasone
This is a drug for hyperthyroidism that emits a high dose beta radiation for cellular and DNA damage. It is the most commonly used hyperthyroid treatment in the US
Precaution: Stop thioamides 1 week before this
CI: Pregnancy
Radioactive iodine (I-131)
This is a type of insulin based on therapeutic use where it is used to control post-prandial hyperglycemia and are usually short acting
SE: Hypoglycemia, lipodystrophy
Prandial insulin
This is a type of insulin based on therapeutic use where it provides control of blood sugar throughout the day and are long acting
SE: Hypoglycemia, lipodystrophy
Basal insulin
This is a type of insulin based on duration that is in monomer form and should be given right before or after meals
Ultra rapid acting insulin
Insulin Lispro (Humalog)
Insulin Aspart (Novolog/ Novorapid)
Insulin Glulisine (Apidra)
This is a type of insulin based on duration that is hexamer in form and is given 30 minutes before the meal. This is the only insulin that is given IV
Short acting
Regular insulin
Humulin, Actrapid or Novolin
Velosulin
This is a type of insulin based on duration that is given twice a day to control blood sugar throughout the day
Intermediate acting
Isophane insulin (Neutral Protamine Hagedorn/ NPH insulin)
Lente
This is a type of insulin based on duration that is given once daily to control blood sugar throughout the day
This insulin is soluble and ‘peakless’
Long acting
Ultralente
Insulin Glargine/ Lantus
Insulin Detemir/Levemir
Insulin Degludec
Insulin Glargine/Lantus
They are oral hypoglycemic agents that promote insulin release from the beta cells of the pancreas by blocking the ATP-sensitive K channels which lead to insulin exocytosis
SE: Hypoglycemia, weight gain
Insulin secretagogues
Sulfonylurea and meglitinides
An insulin secretagogue that cannot control post-prandial hyperglycemia
Sulfonylurea
1st gen: Chlorpropamide, Tolbutamide, Acetohexamide, Tolazamide
2nd gen: Glibenclamide, Glipizide, Gliclazide, Glimepiride
A first generation secretagogue that has the longest half life but has the most side effects
Chlorpropamide
A first generation secretagogue that has the fastest onset but is the most cardiotoxic. It is the safest 1st generation sulfonylurea for the elderly
Tolbutamide
A first generation secretagogue that is converted to an active metabolite (hydrohexamide)
Acetohexamide
They are the second generation secretagogues that are more potent than the first generation but have less side effects
Glibenclamide, Glipizide, Gliclazide, Glimepiride
An insulin secretagogue that acts on the liver to decrease hepatic glucose production and on the muscle and tissue to increase peripheral tissue response to insulin
Biguanides
Phenformin, Metformin
A biguanide that is the only drug that is indicated for pre-diabetes. It is also the first line for type-2 DM, especially those who are newly diagnosed with it and has no contraindications
SE: Diarrhea, lactic acidosis
CI: Renal failure, hepatic failure, CHF
Metformin
They are oral hypoglycemic agents that inhibits the alpha-glucosidase located in the intestinal bush border
AE: Flatulence, abdominal pain, diarrhea
CI: Intestinal bowel disease
Alpha-glucosidase inhibitors
Acarbose, Miglitol
They are oral hypoglycemic agents that decreases insulin resistance. It is an agonist for peroxisome proliferator-activated receptor (PPAR) to increase insulin sensitivity
AE: Edema, weight gain, HTN
CI: Heart failure
One of the drugs in this class has an AE of bladder cancer
One of the drugs in this class has an AE of HF
Thiazolidinediones
Pioglitazone, Rosiglitazone
Pioglitazone
Rosiglitazone
They are oral hypoglycemic agents that decrease glucagon secretion and increases peripheral tissue response. The analog of the drug is co-secreted with insulin following food intake
One of the drugs has an AE of weight loss and hypoglycemia
Amylin analogue
Pramlintide
They are oral hypoglycemic agents that stimulate insulin release, reduce food intake by enhancing satiety, decrease glucagon secretion, and promote beta cell proliferation. The hormone named after this drug is the hormone produced after eating
Incretin mimetics
Glucagon-like peptide agonist (GLP-1), Dipeptidyl peptidase IV inhibitor (DPP-4)
They are incretin mimetics that exert activity by activating the GLP-1 receptor. It is direct acting and can be given SC
GLP-1 (Glucagon-like peptide) agonist
Exenatide, Liraglutide
They are incretin mimetics used to prevent the deactivation of GLP-1 and is taken orally. It is indirect acting
DPP-4 (Dipeptidyl peptidase IV) inhibitor
They are oral hypoglycemic agents that is responsible for reabsorbing filtered glucose in the kidney, thereby having decreased reabsorption
AE: UTI, frequent urination
SGLT2 (Sodium glucose transporter-2 inhibitor)
Oral hypoglycemic agents that cause weight loss
GLP-1 agonists
SGLT2 inhibitors
Amylin analogue
Oral hypoglycemic agents used to control post-prandial glucose elevation
Alpha-glucosidase inhibitors
GLP-1 agonists
DPP-4 inhibitors
Amylin analogue
Oral hypoglycemic agents that can cause weight loss and control post-prandial glucose elevation
GLP-1 agonist
Amylin analogue
