Endocrine Drugs

Question 1

Lispro, Aspart, Glulisine

Answer 1

Fast acting insulins
can cause hypoglycemia (dose related)
rare allergic reactions

Question 2

NPH

Answer 2

intermediate acting insulin

Question 3

Glargine, detemir

Answer 3

long acting insulins

used for ‘basal’ glucose control

Question 4

Metformin

Answer 4

exact mechanism unknown, though thought to increase insulin sensitivity
oral only, first line in T2DM
tox: GI upset, super scary effect is (anion gap) lactic acidosis, and is contraindicated in renal failure

Question 5

Sulfonylureas, General

Answer 5

close the K+ channel on the beta-cell membrane, depolarizing the cell and causing insulin release
these are USELESS in T1DM

Question 6

Tolbutamide, chlorpropamide

Answer 6

First Generation SUs

tox: risk of hypoglycemia, disulfiram like effect

Question 7

Glyburide, glimepiride, glipizide

Answer 7

Second Generation SUs

tox: risk of hypoglycemic

Question 8

Glitazones, TZDs

Answer 8

increase insulin sensitivity by activating PPAR-gamma (a transcription factor)
tox: weight gain, edema, hepatotoxicity, heart failure

Question 9

Acarbose, miglitol

Answer 9

inhibit intestinal alpha-glucosidase leading to decreased sugar absorption
tox: GI upset

Question 10

Pramlintide

Answer 10

amylin analog: decreases gastric emptying, decreases glucagon
used in T1 and T2DM
tox: hypoglycemia, nausea, diarrhea

Question 11

Exenatide, Liraglutide

Answer 11

GLP-1 analogs
increase insulin, decrease glucagon
used only in T2DM
tox: nausea, vomiting, pancreatitis

Question 12

-gliptins

Answer 12

DPP-4 inhibitors
increase insulin, decrease glucagon
used only in T2DM
tox: mild urinary or respiratory infections

Question 13

Propylthiouracil (PTU)

Answer 13

blocks thyroid peroxidase AND 5’-deiodinase, thus inhibiting oxidation and organification of iodine AND blocking T4 -> T3
used in hyperthyroid
SAFE in preggo
tox: rash, rare agranulocytosis, hepatotoxicity

Question 14

Methimazole

Answer 14

blocks thyroid peroxidase thus inhibiting oxidation and organification of iodine
used in hyperthyroid
CONTRAINDICATED in preggo
tox: rash, agranulocytosis, teratogenic effect

Question 15

Levothyroxine, triidodothyronine

Answer 15

thyroxine replacement in hypothyroid

tox: tachycardia, heat intolerance, tremors, arrhythmias (basically symptoms of hyperthyroid)

Question 16

Human Growth Hormone

Answer 16

GH replacement

used in GH deficiency, Turner’s

Question 17

Somatostatin (octreotide)

Answer 17

blocks GH

used in acromegaly, carcinoid syndrome, gastrinoma, glucagonomas, and bleeding esophageal varices

Question 18

Oxytocin

Answer 18

stimulates labor, uterine contractions, milk let-down; controls uterine hemorrhage

Question 19

ADH (DDAVP)

Answer 19

Given in CENTRAL DI, not in nephrogenic DI

Question 20

Demeclocycline

Answer 20

ADH antagonist
used in SIADH
tox: can cause nephrogenic DI, photosensitivity, bone and teeth abnormalities (like others in tetracycline family)

Question 21

Toxicity of glucocorticoids

Answer 21

iantrogenic Cushing’s

adrenal insufficiency when abruptly stopped