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Medicine: Pharmacology > Endocrine Drugs > Flashcards

Endocrine Drugs Flashcards

1
Q

Mechanism of action of insulin

A

Lowers plasma glucose concentration by:

  • stimulating glucose transport into fat and muscle cells
  • stimulate glycogen synthesis
  • inhibiting gluconeogenesis and lipolysis
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2
Q

Indications for insulin

A
  • diabetes type 1 and 2
  • ketoacidosis
  • hyperglycaemic hyper osmotic non-ketotic coma
  • emergency treatment hyperkalaemia
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3
Q

Side effects of insulin

A
  • hypoglycaemia
  • weight gain
  • fat hyper trophy at injection sites
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4
Q

Possible interactions of insulin ?

A
  • B-blockers: masks the warning signs of hypoglycaemia by interfering with sympathetic nervous system
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5
Q

What type of drug is insulin ?

A

Peptide Hormone

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6
Q

What drug class is gliclazide ?

A

Sulphonylurea

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7
Q

Mechanism of action if gliclazide ?

A
  • stimulates insulin production by binding Sulphonylurea receptors and blocking ATP-dependent potassium channels in pancreatic B cells,
  • inhibiting potassium efflux
  • causes internal depolarisation which stimulates insulin release
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8
Q

Indications for gliclazide ?

A
  • type 2 diabetes (when diet and exercise have not worked, and when Metformin is contraindicated/not tolerated)
  • only if beta cells are still functional to release endogenous insulin, effect becomes less effective as beta cells depleted*
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9
Q

Contraindications for gliclazide ?

A
  • ketoacidosis

- pregnancy/breastfeeding

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10
Q

Side effects of gliclazide ?

A
  • hypoglycaemia
  • weight gain
  • rarely: headache, rash, GI disturbance, bone marrow suppression
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11
Q

Possible interactions of gliclazide ?

A

Fluconazole: increased plasma concentrations of gliclazide

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12
Q

Route of elimination of gliclazide ?

A

Hepatic

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13
Q

What drug class is Metformin ?

A

Biguanides

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14
Q

Mechanism of action of Metformin ?

A

Lowers blood glucose by:

  • reduces gluconeogenesis
  • promotes sensitivity of tissues to insulin
  • delays glucose absorption and stimulates glycolysis
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15
Q

Indications for Metformin ?

A

Type 2 diabetes (when diet and exercise have not worked)

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16
Q

Side effects of Metformin ?

A
  • flatulence
  • anorexia
  • abdo bloating
  • nausea/vomiting/diarrhoea
  • lactic acidosis
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17
Q

Contraindications if Metformin ?

A
  • pregnancy/breastfeeding
  • surgery, infections, trauma
  • hepatic or renal impairment
  • alcohol ingestion
  • DKA
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18
Q

Possible interactions of Metformin

A
  • alcohol: increased risk of lactic acidosis

- corticosteroids: antagonise hypoglycaemia

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19
Q

Elimination of Metformin

A

Kidneys

20
Q

What drug class is thyroxine ?.

A

Thyroid hormone replacement

21
Q

How does thyroxine work ?

A

Mimics endogenous thyroxine (T4) and so has effects:

  • metabolic (energy, temp, appetite, weight)
  • CV (HR, rhythm, BP,)
  • skin/hair (thickness, texture)
  • MSK (reflexes, bone growth)
  • reproductive (ovulation/spermatogenesis)
  • increased GI motility
  • erythropoiesis
22
Q

Side effects of thyroxine ?

A
  • thyrotoxicosis -> palpitations, diarrhoea, tremors, anxiety
  • result of therapeutic overdosage *
23
Q

Indications for thyroxine ?

A

Hypothyroidism

24
Q

Contraindications of thyroxine ?

A
  • MI (acute recovery phase)
  • thyrotoxicosis
  • uncorrected adrenal insufficiency
  • transient hypothyroidism during recovery phase of subacute thyroiditis
25
Q

Route of elimination of thyroxine

A

Liver

26
Q

Interactions of levothyroxine

A
  • antacids: reduce absorption
  • increase met of thyroxine: carbamazepine, phenytoin, rifampicin,
  • warfarin: effects of warfarin increased (anticoag)
27
Q

What drug class is carbimazole?

A

Anti thyroid

28
Q

How does carbimazole work ?

A
  • Inhibits thyroid peroxidase, which is necessary for thyroid hormone synthesis
  • decreases the production thyroid hormones T3 and T4
29
Q

Indications for carbimazole

A
  • thyrotoxicosis
30
Q

Side effects of carbimazole

A

GI Disturbance, headache, skin rash, pruritis, joint pain

31
Q

What drug class is alendronate ?

A

Bisphosphonates

32
Q

Mechanisms of action of alendronate ?

A

Poorly understood mechanism: inhibits osteoclasts, preventing the breakdown of bone tissue

33
Q

Indications for alendronate ?

A
  • post-menopausal osteoporosis
  • corticosteroid associates osteoporosis
  • Paget’s disease of the bone
  • osteoporosis in men to decrease incidence of fractures
34
Q

Contraindications of alendronate ?l

A
  • renal impairment
  • hypocalcaemia
  • oesophageal stricture/achalasia
  • inability to sit or stand upright for at least 30 mins
35
Q

Main route of elimination of alendronate ?

A

Kidneys

36
Q

Side effects of alendronate ?

A
  • oesophageal irritation/ulceration
  • MSK pain
  • abdo pain/nausea/vomiting/diarrhoea
  • osteoporosis of the jaw
37
Q

Possible interactions of alendronate ?

A
  • antacids decrease absorption
38
Q

What drug class is calcium?

A

Mineral / supplement

39
Q

Indications for calcium ?

A
  • supplementation for prevention of osteoporosis

- treatment of acid reflux (calcium carbonate only)

40
Q

Contraindications of calcium ?.

A
  • hypercalciuria
  • hypercalcaemia
  • renal calculi
41
Q

What is the main route of elimination of calcium ?

A

Faeces(80%) urine (20%)

42
Q

Side effects of calcium ?

A
  • nausea/flatulence/constipation

- arrhythmias

43
Q

What drug class is vitamin D ?

A

Vitamin/supplement

44
Q

Indications for vitamin D ?

A

Vit D deficiency due to:

  • lack of sunlight
  • insufficient diet
  • osteoporosis
45
Q

Contraindications of vitamin D ?

A
  • hypercalcaemia

- metastatic calcification

46
Q

Side effects of giving vitamin D ?

A

Hypercalcaemia symptoms: weakness, renal dysfunction, osteoporosis, anaemia etc

47
Q

Possible interactions of vitamin D ?

A

Carbmazepine/phenytoin: increased vit d requirements

Diuretics: increased risk of hypercalcaemia

Medicine: Pharmacology (10 decks)

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