Endocrine Pharm

Question 1

What drug class is metformin

Answer 1

biguanide

Question 2

metformin MOA

Answer 2

dec. GNG, inc. glycolysis, inc. insulin sensitivity

Question 3

metformin toxicity

Answer 3

GI upset; lactic acidosis (can’t use in renal failure)

Question 4

Name the first gen. sulfonylureas

Answer 4

Tolbutamide, chlorpropamide

Question 5

Second gen. sulfonylureas names

Answer 5

glyburide, glimepiride, glipizide

Question 6

sulfonylurea MOA

Answer 6

close K+ channels in beta-cells to trigger insulin release via inc. Ca influx due to depolarization

Question 7

sulfonylurea toxicity

Answer 7

inc. risk of hypoglyemia in renal failure
first gen: disulfiram-like reactions
second gen: hypoglycemia

Question 8

glitazones/thiazolidinediones drug names

Answer 8

pioglitazone, rosiglitazone

Question 9

glitazones MOA

Answer 9

inc. insulin sensitivity in periphearl tissues by binding to PPAR-gamma nuclear transcription regulator.

Question 10

Glitazones toxicity

Answer 10

weight gain, edema, hepatotoxicity, heart failure

Question 11

alpha-glucosidase inhibitors name

Answer 11

acarbose, miglitol

Question 12

alpha-glucosidase MOA

Answer 12

brush border alpha-glucosidases to delay sugar hydrolysis leading to dec. postprandial hyperglycemia. Can cause GI disturbances

Question 13

amylin analogs name

Answer 13

pramlintide

Question 14

amylin analogs MOA

Answer 14

dec. gastric emptying, dec. glucagon, can cause hypoglycemia, nausea, diarrhea

Question 15

GLP-1 analogs name

Answer 15

Exenatide (not to be confused with ezetimibe)

Liraglutide

Question 16

GLP-1 analogs MOA

Answer 16

inc. insulin, dec. glucagon

Question 17

what is GLP-1 essentially

Answer 17

incretin

Question 18

GLP-1 analog toxicities

Answer 18

nausea, vomiting, pancreatitis

Question 19

DPP-4 inhibitors names

Answer 19

linagliptin, saxagliptin, sitagliptin

Question 20

DPP-4 inhibitors MOA

Answer 20

inc. insulin. dec. glucagon

Question 21

DPP-4 inhibitors toxicities

Answer 21

Mild urinary or respiratory infections

Question 22

fact: Genes activated by PPAR-gamma regulate fatty acid storage and glucose metabolism. Activation of PPAR-gamma inc. insulin sensitivity and levels of adiponectin

Answer 22

.

Question 23

adiponectin is…

Answer 23

produced by adipose, inversely associated with BMI

Question 24

Leptin effects

Answer 24

leptin mutants are obese, it inhibits hunger.

Obese people have more because they have more adipose tissue, and they have leptin resistance.

Question 25

Propylthiouracil and methimazole MOA

Answer 25

blocks thyroid peroxidase, which blocks the oxidation of iodide and the organification (coupling) of iodine.

Question 26

Propylthiouracil extra effects

Answer 26

aside from blocking thyroid peroxidase like methimazole, it also blocks 5'-deiodinase, which dec. peripheral conversion of T4 to T3.

Question 27

Which drug used in pregnancy hyperthyroid

Answer 27

PTU

Question 28

thyroid med toxicities

Answer 28

skin rash, agranulocytosis, aplastic anemia, hepatotoxicity (PTU). Methimazole can cause aplasia cutis.

Question 29

aplasia cutis

Answer 29

Congenital focal absence of epidermis.

Question 30

Octreotide clinical uses

Answer 30

acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

Question 31

demeclocycline MOA and use

Answer 31

ADH antagonist and used in SIADH

Question 32

Demeclocycline toxicity

Answer 32

nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Question 33

key glucocorticoid transcription factor effect

Answer 33

inhibits NF-kappaB