Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr3 Pharmacology > Endocrine drugs > Flashcards

Endocrine drugs Flashcards

1
Q

What are the 3 methods of action of insulin?

A

Stimulates glucose uptake to tissues from circulation
Stimulates glycogen, lipid and protein synthesis, and inhibits gluconeogenesis and ketogenesis
Drives K+ from bloodstream into cells (short term)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 4 indications of insulin

A

T1DM: replacing endogenous insulin
T2DM: For control when oral isn’t enough
Diabetic emergencies eg ketoacidosis
Hyperkalaemia along with glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What effect does renal impairment have on insulin dosages?

A

Reduce dose as less insulin clearence, so more risk of hypos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name one major and one minor sde effect of insulin use

A

Major:Hypos!
Minor: fat growth around overused injection site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name a sulphonurea

A

Gliclazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does gliclazide work?

A

Stimulates pancreatic insulin secretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What kind of diabetics can gliclazide be used effectivley in, and who can’t it be used it?

A

Requires residual pancreatic beta cell function, so it can only be used in type 2 diabetics with pancreatic function
Can’t be used in type one of end stage type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When would gliclazide be prescribed?

A

T2DM 2nd line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some side effects of gliclazide

A

GI upset eg nausea, vomiting
Hypos
Rare hypersensitivity reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of drug is metformin? When is it prescribed?

A

Bigluanide

Type 2 diabetes, first line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does metformin work?

A

Lowers blood glucose by increasing the sensitivity to insulin
Increases glucose uptake and utilisation by skeletal muscles and supresses intestinal glucose absorbtion
Doesn’t increase pancreatic insulin secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When wouldn’t metformin be used?

A

Severe renal impairment
AKI
Severe hypoxia
Acute alcohol intoxication (can precipitate lactic acidosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name 2 interactions with metformin

A

CT contrast: withold 48hours before and after due to nephrotoxicity, reduces insulin clearence so more chance of hypos
Prednisolone, thiazide and loop diuretics raise BMs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 1 common and one rare side effect of metformin

A

GI upset

rare: lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does levothyroxine work?

A

Replaces lost T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why shouldn’t levothyroxine and antacids, calcium, or iron salts be given within 4 hours of each other

A

Affect levothyroxines GI uptake

17
Q

Why would you need to take more levothyroxine if yu were also on phenytoin or carbemazepine?

A

They are cytochrome p450 inducers, which break down levothyroxine

18
Q

Carbemazepine or carbimazole: Which is which?????

A

Carbemazepine: antiepileptic cytochrome p450 inducer
Carbimazole: antithyroid

19
Q

How does carbimazole work?

A

Converted to methimazole, which prevents the thyroid peroxidase enzyme from coupling tyrosine residues in thyroglobulin, stoping T3 and T4 production.

20
Q

When is carbimazole contraindicated?

A

Severe blood disorders and hepatic insufficiency

21
Q

What is an interaction of carbimazole?

A

Vitamin K antagonist, so can have an effect on anticoagulants

22
Q

Name a bisphosphonate and describe their method of action

A

Alendronate

Reduce the amount of bone turnover by limiting osteoclastic activity (absorbed by them, they then signal for apoptosis)

23
Q

Give 3 indications for alendronic acid

A

OSteoporosis
Bone mets in breast Ca (reduce risk of fractures)
Pagets disease of bone
Also hypercalcaemia of malignancy

24
Q

When is alendronic acid contraindicated?

A

severe renal impairment
hypocalcaemina
oral administration contraindicated in upper GI disorders

25
Q

Name some side effects of alendronic acid

A

Oesophageal inflammation
Hypophosphataemia
Hypocalcaemia

26
Q

How is calcium homeostasis controlled?

A

Parathyroid hormone and vitamin D levels increase serum levels and bone mineralisation
Calcitonin reduces serum levels

27
Q

When are calcium and vitamin D indicated:

A

Osteoporosis
CKD (often hypocalcaemia)
Calcium in hypocalcaemia
Vit D in Vit D deficiency

28
Q

What does oral calcium do to iron, bisphosphonates, tetracyclines and levothyroxine?

A

reduces uptake of them

29
Q

Why can’t you give IV calcium with sodium bicarbonate/

A

risk of precipitation(!)

30
Q

Name some side effects of calcium

A

dyspepsia, confusion

calcium gluconate IV: cardiac collapse if given too fast, tissue damage if accidentally subcut

31
Q

What is fludrocortisone?

A

Mineralocorticoid

32
Q

What do mineralocorticoids do?

A

Bind to mineralocorticoid receptor, raising extracellular fluid levels, raising blood pressure and lowering potassium levels

33
Q

When would a mineralocorticoid be given?

A

Adrenocortical insufficiency addisons disease

34
Q

Name some side effects of fludrocortisone

A

CNS: convulsions, dizziness headache
Acne, rash, bruising
Hypokalaemia, hyperglycaemia
Peptic ulcers

Yr3 Pharmacology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions