Endocrine drugs Flashcards
A 17-year-old type 1 diabetic patient is currently on diabetic medications. All of the following antidiabetic drugs are not used in type I diabetes EXCEPT: A-Chlorpropamide B-Glyburide C-Repaglinide D-Nateglinide E-Pioglitazone
E??
But Thiazolidinediones DEPEND on INSULIN PRESENCE for MOA
Pioglitazone and Rosiglitazone effects on TG, HDL and LDL
P: ↓ TG (have more lipid effect, more DIs)
R: ↑LDL and HDL, ↓ TG
Drug class antidiabetic drug is gender selective?
Thiazolidinediones: Pio and Rosi
Diabetic patient with hypercholesterolemia has high cholesterol, high LDL, normal TG. What would be the drug of choice?
Statins— Lovastatin
-Antidiabetic drug may be taken regardless of meals?
Thiazolidinediones— Rosiglitazone (OD, w or wo food)
The risk of lactic acidosis, associated with metformin, is enhanced by what factors?
Alcohol, renal and hepatic disease
Which antidiabetic drug should be skipped if you skip meals?
Which does not cause hypoglycemia?
Both Acarbose:
- taken upon first bite of meal
- by itself does not cause hypoglycemia
Metformin most common SE and rare?
Diarrhea (most common)
-Lactic acidosis
A obese patient has CHF, renal disease and drinks alcohol. Recently diagnosed with type II DM, what is drug of choice amongst the antidiabetic drugs?
Acarbose
** Metformin is CI in renal, hepatic, diseases. Chlorpropamide dose adjustment required in renal impairment rosiglitazone contraindicated in congestive heart failure CHF.
Diabetic patient have increased risk following infections:
skin and foot infections, Cellulitis, Gangrene, UTI
What are symptoms of hypoglycemia?
sweating, hunger, dizziness, fainting, fatigue
What are symptoms of hyperglycemia?
Polyurea, polydipsea, polyphagea, neuropathic pains, and blurred vision
If a patient is not treated for asymptomatic sexually transmitted infections, this can lead to?
Can cause pelvic inflammatory disease and infertility
-NOT endometrial and cervical cancer
DOC for pregnancy in hyperthyroidism
Propylthiouracil
Patient receiving levothyroxine (L-T4) (Synthroid) should monitor levels of:
TSH
Instructions for Synthroid (levothyroxin) tablet, give CIs.
I. Should not be taken with Iron supplements
II. Should not be taken within 4 hours of Ibuprofen
III. Should not be cut
Synthroid should not be taken with aluminum hydroxide, cholestyramine resins, colestipol, ferrous sulfate, sod. Polystyrene sulfonate, soybean flour (infant formula) due to decreased absorption of levothyroxin from GI tract
What is the most common side effects of propylthiouracil?
Agranulocytosis- reduction in WBC
What is the elevated TSH value and what does it indicate? Also for the opposite.
> 5mU/L hypothyroidism
< 0.5mU/L hyperthyroidism
Excessive dose of Prednisone can lead to what disease/syndrome? State the opposite.
Cushing’s
Addison’s
Which of the following is the least likely decrease absorption of levothyroxine A) Al antacids B) Mg antacids C) Diary products D) Iron supplements E) Low fiber diet
E. Food and formula containing large amount of soybean, fiber, or iron should not be used for administration of levothyroxine. However low fiber food does not interact with thyroxin.
Antidiabetic drugs taken with or after food?
Biguanides, Sulfonylureas, Thiazolidinediones
Antidiabetic drugs not used for DM type 1?
Sulfonylureas and Meglitinides
Metformin monitoring
BSL, HbA1C, CrCl, CBC
