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Advanced Pharm Exam 3 > Endocrine Medications > Flashcards

Endocrine Medications Flashcards

1
Q

metformin dosing

A

500-2000 mg daily

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2
Q

metformin AEs

A

GI - consider XR formulation

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3
Q

metformin dosing adjustment

A

do not initiate if gfr <45

hold 48h before/after contrast

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4
Q

glupizide, glimepride, glyburide class

A

sulfonylureas

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5
Q

sulfonylureas AEs

A

hypoglc, wt gain, insulin dependence

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6
Q

sulfonylureas dosing adjustment

A

glupizide preferred for renal impairment

sulfa allergy hypersensitivity

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7
Q

AE of SGLT-2 inhibitors

A

genital mycotic infections, UTIs, dehydration, hypotension

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8
Q

canagliflozin, empagloflozin, dapagliflozin class

A

SGLT-2 inhibitors

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9
Q

sitagliptin, saxagliptin, linagliptin, alogliptin class

A

DPP-IV inhibitors

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10
Q

which DPP-IV inhibitor does not require renal dosing?

A

linagliptin

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11
Q

exenatide, semaglutide, iraglutide, dulaglutide class

A

GLP-1 agonists

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12
Q

AEs of GLP-1 agonists

A

GI, injection site rxns (Exenatide)
BBW for pancreatitis and thyroid C-cell tumors
wt loss (semaglutide)

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13
Q

dosing adjustment for GLP-1 agonists

A

do not use exenatide w gfr <45

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14
Q

semaglutide precautions

A

may increase absorption of levothyroxine
no renal dosing adjustment needed :))))
take 30 min before/after meals d/t peak 1h

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15
Q

degludec PK

A

very long acting - >40 h
good for pts that may miss dose

(hours)
onset - 1-2
peak - none
duration - >40

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16
Q

glargine PK

A

(hours)
onset - 3-4
peak - none
duration - 22-24

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17
Q

NPH PK

A

(hours)
onset - 2-4
peak - 4-8
duration - 8-18

dose BID

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18
Q

regular insulin PK

A

onset - 30-60 min
peak - 1-3 h
duration - 5-10 h

19
Q

rapid acting insulin PK

A

(min)
onset - 5-30
peak - 30-90
duration - 184-313

20
Q

thyroid hormones/origins

A

hypothalamus - thyroid releasing hormone
pituitary - thyroid stimulating hormone
thyroid - gland - T3 and T4
T3 and T4 negative feedback decreases TSH secretion

21
Q

free T4 normal range

A

0.8-1.5

unbound and active

22
Q

TSH normal range

A

0.25-6.7

INVERSE of thyroid hormone levels

23
Q

hypothyroidism hormonal change and treatmen

A

deficient T3 and T4

supplement with T4: levothyroxine

24
Q

levothyroxine dosing, admin, interactions

A

1.6 mcg/kg/day IBW
empiric dosing 50 mcg/day

daily dosing

half-life 7 days, takes 6-8 weeks to reach steady-state

take on empty stomach x2h, separate from other meds 4h

many drug interactions

25
Q

liothyronine

A

T3

shorter half life than levothyroxine, BID/TID admin

26
Q

thyroid replacement combo products

A

liotrix - 4:1 levothyroxine:liothyronine

dessicated thyroid - variable potency & unstable shelf life

27
Q

levothyroxine interactions

A

WARFARIN - separate doses to prevent bleeding, estrogens/contraceptives, androgens, cholestyramine, phenytoin, phenobarb, rifampin, sertraline

28
Q

hyperthyroid treatment

A

thionamides (methimazole, propylthiouracil, iodides)
radioactive iodine

beta blockers - adjunct therapy

29
Q

thionamides MOA

A

inhibit thyroid peroxidase - diverts iodine away from receptor sites of TG - blocks thyroid hormone synthesis

30
Q

thionamides PK

A

short half life 1-2.5 h, quick onset

clinical improvement seen in 4-8 weeks

remission likely

31
Q

thionamides AEs

A

pruritic maculopapular rashes
benign transient leukopenia
arthralgias, myangias

severe - agranulocytosis (s/s of infection), hepatic toxicity

PTU>hepatic tox than methimazole

PTU preferred for first trimester of pregnancy

32
Q

iodides MOA

A

acutely blocks thyroid hormone synthesis and release, reduces size and vascularity

quick symptom resolution (2-7 d), but not for long term therapy

33
Q

iodides AEs

A

hypersensitivity,

iodism - metallic, burning taste, sore teeth/gums, “head cold”, Gi disturbance, skin lesions

34
Q

radioactive iodine indication

A

treatment htat ablates thyroid gland - but often causes hypothyroid

for patients who have adverse rxns to other meds

NO USE IN PREGNANCY

35
Q

adjunct therapy for hyperthyroid

A

beta blockers - propranolol 20-40 mg crosses BBB

corticosteroids, cholestyramine, rituximab

36
Q

regular insulin U-500 dosing

A

TID or BID before eating w/o other insulin

37
Q

contraindication for pioglitazone

A

NYHA class 3 HF

38
Q

approved insulin for gestational DM

A

detemir, lispro, aspart

39
Q

MOA of empagliflozin

A

inhibits sodium-glucose cotransporter 2

40
Q

meglitinides MOA

A

stimulates pancreatic beta cells to secrete insulin in a non-glucose dependent manner

41
Q

which DPP-4 inhibitor can decrease hospitalizations in HF

A

saxagliptin

42
Q

GLP-1 receptor agonists MOA

A

glucagon suppression, increased beta cell insulin secretion after meals, slowed gastric emptying, increased satiety

43
Q

Afrezza duration

A

ultra-rapid

Advanced Pharm Exam 3 (5 decks)

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