Endocrine Pharm

Question 1

Biguanides - Metformin
MOA
ADE

Answer 1

MOA:
inhibit hepatic gluconeogenesis & glucagon (inhibit mGPD)
Increase glycolysis & insulin sensitivity (glucose uptake)

Lactic Acidosis
GI upset, weight loss
B12 def

Question 2

Sulfonylureas 
1st gen - chlorpropamide, tolbutamide
2nd gen - glipizide, glyburide, glimepiride 
MOA
ADE

Answer 2

MOA:
close K channel in pancreatic beta cell
=> depol => Ca in => insulin secreted

hypoglycemia, weight gain
1st gen - disulfiram rxn

Question 3

Meglitinides
nateglitide
repaglitide

MOA
ADE

Answer 3

MOA:
close K channel in pancreatic beta cell
=> depol => Ca in => insulin secreated

hypoglycemia, weight gain

Question 4

Thiazolidinediones

pioglitazone, rosiglitazone

Answer 4

MOA
bind intranuclear PPAR-y TF
=> increased insulin sensitivity & adiponectin
=> regulation of glucose met & FA storage

Weight gain, edema, HF, increased risk fractures

Question 5

DPP-4 Inhibitors

Linagliptin, saxagliptin, sitagliptin

Answer 5

Inhibit DPP-4 (DPP-4–| GLP-1) => increased GLP-1
=> increased glucose dependent insulin release, decreased glucagon release, gastric emptying (satiety)

mild URI/UTI, weight neutral

Question 6

GLP-1 Analogues - Injected
Liraglutide, Exenatide
MOA
ADE

Answer 6

MOA:
increased glucose dependent insulin release,
decreased glucagon release, gastric emptying (satiety)

N/V, pancreatitis, promotes weight loss

Question 7

SGLT2 inhibitors
canagliflozin, dapagliflozin, empagliflozin
MOA
ADE

Answer 7

MOA: 
block Glucose (and Na) resorption in PCT

Glucosuria, dehydration, UTI, vaginal yeast infxn
hyperK, weight loss

Question 8

alpha-glucosidase inhibitors
acarbose, miglotol
MOA
ADE

Answer 8

MOA:
inhibit intestinal brush border alpha-glucosidase
=> delayed carb hydrolysis and glucose absorption

GI upset

Question 9

Thioamides
MOA
ADE

Answer 9

methimazole, propylthiouracil
MOA:
inhibit thyroid perioxidase
PTU blocks 5’-deiodinase => block peripheral conversion T4–>T3

agranulocytosis, aplastic anemia, hepatotoxicity, skin rash

Question 10

Levothyroxine, Liothyronine

Answer 10

T4/T3 analogue

can be abused for weight loss (sx of hyperthyroid)