Endocrine Drugs

Question 1

INSULIN

Answer 1

I: DMT1/DMT2, DKA,
CX: Liver/renal disease, acute illness (lower requirement)
SE: oedema, Lipodystrophy, hypos
How: stimulates glucose uptake into cells
Elim: liver and kidneys Excreted: Urine
Interact: w/ hypoglycaemic agents e.g metformin.

Question 2

INSULIN regimens

Answer 2

1) Novomix BD 30% short 70% long acting (DMT1/2)
2) Before meals ultra fast TDS and Long OD before bed
3) Long acting OD before bed (DMT2)

When acutely ill check cap glucose QDS

Question 3

METFORMIN

Answer 3

Class: Biguanide
I: 1st line therapy for DMT2, 2nd and 3rd. Also PCOS
Cx: Hypos, acidosis (lactic acidosis/DKA), renal disease.
SE: abdominal pain, gastro.
How: decreases gluconeogensis
Elim: kidneys

Question 4

GLICLAZIDE

Answer 4

Class: Sulphonylureas (Glimepiride, Gilbenclamide, Glipizide)
I: DMT2, Hb1ac >58 2nd therapy.
Cx: DKA, liver/renal disease
SE: weight gain, gastro, Agranulocytosis (serious)
How: stimulates insulin secretion
Elim: kidneys/faeces

Question 5

THYROXINE

Answer 5

I: hypothyroidism. (pregancy higher dose)
Cx: Thyrotoxicosis
SE: predicted effects, aniexty, angina.
How: mimics t4
Elim: kidneys

Question 6

CARBIMAZOLE

Answer 6

I: Hyperthyroidism
Cx: BEWARE Neutropenia and agranulocytosis. Blood disorders
SE: Bone disorders
How: Antithyroid agent

Question 7

ALENDRONATE

Answer 7

Class: Bisphosphonate ( ibandronate, risedronic acid)
I: Osteoporosis
Cx: oesophageal abnorms
SE: atypical fractures! oestonecrosis jaw/auditory! gastro, alopecia, dizziness.
How: absorbed into hydroxyapatite crystals, reduce bone turnover
Elim: kidneys

Question 8

CALCIUM

Answer 8

I: Ca deficiency, hyperphosphataemia
Cx: nephrolithiasis; sarcoidosis, hyperca.
SE: constipation, diarrhoea,
Elim: faeces

Question 9

FLUDROCORTISONE

Answer 9

I: adrenal insufficiency
Cx: illness (immunosupressant) Do not suddenly withdraw steroids.
How: mimics, increase sodium reabsorption and potassium excretion
SE: adrenal suppression, infections.
Elim: kidneys- urine.