endocrine drugs Flashcards
rapid acting insulins
LAG
lispro, aspart, glulisine
short acting insulins
regular
intermediate acting insulins
NPH
long acting insulins
glargine, detemir
metformin
- decreased gluconeogenesis
- increased glucolysis and peripheral glucose uptake
- tox: GI upset, lactic acidosis, contraindicated in renal failure (check Cr before)
sulfonylureas
close K channel in B cell membrane – triggering insulin release via Ca influx
- first gen: tolbutamide, chlorpropamide
- second gen: glyburide, glimepiride, glipizide
- risk of hypoglycemia (inc risk in renal failure)
- first gens can cause disulfram-like reaction
glitazones
increase insulin sensitivity by binding PPARgamma nuclear transcription factor and increasing adiponectin and GLUT 4 transcription
- can cause weight gain, edema, hepatotox and heart failure
alpha-glucosidase inhibitors
acarbose, miglitol
- inhibit brush border enzymes, delayed sugar hydrolysis and glucose absorption
- causes GI disturbances
amylin analogs
pramlintide
- decreased gastric emptying, decreased glucagon
- hypoglycemia, nausea, diarrhea
SGLT2 inhibitors
- increased urinary glucose by blocking reuptake
- tox: UTIs, symptomatic hypotension (need to assess renal function first)
GLP-1 analogs
exenatide, liraglutide
- increase insulin, decrease glucagon release
- tox: n/v, pancreatitis
DPP-4 inhibitors
linagliptin, saxagliptin, sitagliptin
- increase insulin, decrease glucagon release
- tox: mild urinary and respiratory tract infections
PTU and methimazole
- both block thyroid peroxidase, and PTU blocks 5’deiodinase (peripheral conversion) and is used in preggos
- tox: skin rash, agranulocytosis, aplastic anemia, hepatotoxicity (PTU). Methimazole is possible teratogen
GH uses
GH deficiency, Turner syndrome
somatostatin/octreotide uses
acromegaly, carcinoid tumors, gastrinomas, glucagonomas, esophageal varices
