Endocrine Drugs Flashcards
Short acting Insulins:
Just regular insulin
Intermediate acting Insulins:
NPH
Long acting insulins
Glargine, Detemir
Metformin use
First line in type 2 DM. decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake
Metformin toxicity
GI upset, lactic acidosis (don’t give in renal failure)
First Gen Sulfonylureas Names:
Tolbutamide, Chlorpropamide
Second Gen Sulfonylureas Names:
Glyburide, Glimepiride, Glipizide (short acting)
Sulfonylureas mechanism and use
Close K channels in beta-cells to depolarize cells and trigger insulin release. Used only in DM2.
Sulfonylureas toxicities
first gen no one cares: disulfiram effects
second gen is hypoglycemia
Glitaones names and mech
(-glitazone) Pioglitazone. increase insulin sensitivity via binding PPAR-gamma nuclear receptor
Glitazone use
monotherapy or combo in diabetes type 2
Glitazone tox
weight gain, edema, hepatotox, heart failure
Acarbose/Miglitol
alpha glucosidase inhibitors on brush boarder, stop sugar absorption. used in type 2 DM
Amylin mech and us
decreases glucagon. DM1/2
GLP1 analog/DPP4 inhib
(-tide)(-gliptin) increase insulin and decrease glucagon for DM2
Propylthiouracil, methimazole mech and use
Use: hyperthyroid
Mech: both-inhib peroxidase from organification of iodine to make T4. Propylthiouracil also blocks 5’-deiodinase to block peripheral T4->T3
Propylthiouracil/ methimazole toxicities
skin rash, aplastic anemia, agranulocytosis
Propyl: hepatotox
Methimazole: teratogen
Levothyroxine, triiodothyronine
Thyroxine replacement for hypothyroid. May cause tachycardia, heat intolerance, tremors, arrhythmias
Turner syndrome give them?
GH (still won’t cause preggo)
Octreotide
Somatostatin: ACromegaly, carcionoid, gastrionoma, glucagonoma, esophageal varices
oxytocin
stim labor, uterine contractions, milk letdown, control utermine hemorrhage
Demeclocycline
ADH antagonist (tetracycline antibiotic), given in SIADH. tox: nephrogenic DI, photosensitivity, abnormal of bones and teeth
Glucocorticoids names
hydrocortizone, prednisone, triamcinolone, dexamethasone, beclomethasone
glucocorticoid mech
inhib phospholipase A2 and COX2 (no PG, LT)
Glucocorticoid uses
Addisons, inflammation, immune suppression, asthma
Glucocorticoid Tox
abrupt withdrawl causes adrenal insufficiency
can cause iatrogenic cushings (buffalo hump, moon face truncal obesity, muscle wasitng, thin skin)
Rapid Acting Insulins
LAG: Lispro, Aspart, Glulisine