Endocrine Drugs Flashcards
What does Insulin do in the body?
Stimulates glucose uptake from circulation into tissues
Stimulates glycogen and lipid/protein synthesis
Inhibits gluconeogenesis and ketogenesis
What can Insulin drive into cells?
K+
Insulin Indications
Type I Diabetes (Type II if other medication ineffective), Diabetic ketoacidosis (given IV)
What drug class can increase Insulin requirement?
Systemic Corticosteroids
What drug class does Gliclazide belong to?
Sulphonylureas
How do Sulphonylureas’s Work?
Block K+ channels in pancreatic B-cell membrane = Increases Ca2+ concentration (and therefore insulin secretion)
Sulphonylureas Indications
Type II Diabetes (in combination with or instead of Metformin)
Who is at risk of Hypoglycaemia?
Hepatic impairment, Malnutrition, Adrenal/Pituitary insufficiency, Elderly
What drug class is Metformin?
Biguanide
What does Metformin do?
Supresses hepatic glucose production, Increases glucose uptake, Suppresses intestinal absorption
Metformin Indications
Type II Diabetes (first-line)
When should Metformin be withheld?
Acute Alcohol Intoxication ( = lactic acidosis)
Metformin Side Effects
Nausea, Vomiting, Taste disturbance, Anorexia, Diarrhoea
Metformin Interactions
IV Contrast media, Drugs that can impair renal function (ACE, NSAIDs, Diuretics)
Thyroxine Indications
Hypothyroidism
What must you do when administering Thyroxine in Hypopituitarism?
Give Corticosteroid therapy before (avoid Addisonian crisis)
Thyroxine Side Effects
Similar to Hyperthyroidism symptoms
What is Levothyroxine?
Synthetic T4 (most commonly used)
What is Liothyronine and when is it used?
Synthetic T3 (used in emergencies - quicker onset)
What is levothyroxine metabolised by?
CYP450 system
Levothyroxine Interactions
Increase insulin requirement
Enhance effects of warfarin
Anti-Thyroid drug examples?
Carbimazole, Methimazole, PTU
Anti-Thyroid Drugs Indications
Hyperthyroidism/Graves
Anti-Thyroid Drugs Side Effects
Agranulocytosis, Granulocytopenia, Aplastic Anaemia
Which Bisphosphonate is used for Osteoporosis?
Alendronic Acid
Which Bisphosphonates are used for Hypercalcaemia and Cance Bone Metastases?
Pamidronate and Zoledronic acid
Bisphosphonate Contra-indications
Renal Impairment, Hypocalcaemia
Bisphosphonate Side Effects
Oesophagitis, Osteonecrosis of Jaw, Femoral Fracture
Bisphosphonate Interactions
Bind calcium so absorption reduced with Calcium salts (milk), Antacids, Iron salts
Calcium and Vitamin D Indications
Osteoporosis, CKD, Hyperkalaemia, Hypocalcaemia, Vitamin D deficiency
What drug is used IV in Hyperkalaemia and how is it administered?
Calcium Gluconate, Administered slowly
Fludrocortisone Indication
Addison’s / Adrenal Insufficiency, Low BP
How does Fludrocortisone work?
Decreases amount of sodium lost in urine (derivative of cortisol)
