endocrine pharm Flashcards
Lispro
Rapid acting insulin
Binds insulin receptor -> tyrosine kinase
Inc glycogen in liver, increase K+ uptake and glycogen in muscle, inc TG storage in muscle
Used vs DM
Toxicity: Hypoglycemia
Aspart
Rapid acting insulin
Binds insulin receptor -> tyrosine kinase
Inc glycogen in liver, increase K+ uptake and glycogen in muscle, inc TG storage in muscle
Used vs DM
Toxicity: Hypoglycemia
Glulisine
Rapid acting insulin
Binds insulin receptor -> tyrosine kinase
Inc glycogen in liver, increase K+ uptake and glycogen in muscle, inc TG storage in muscle
Used vs DM
Toxicity: Hypoglycemia
NPH
Intermediate acting insulin
Binds insulin receptor -> tyrosine kinase
Inc glycogen in liver, increase K+ uptake and glycogen in muscle, inc TG storage in muscle
Used vs DM
Toxicity: Hypoglycemia
Glargine
Long acting
Binds insulin receptor -> tyrosine kinase
Inc glycogen in liver, increase K+ uptake and glycogen in muscle, inc TG storage in muscle
Used vs DM
Toxicity: Hypoglycemia
Detemir
Long acting insulin
Binds insulin receptor -> tyrosine kinase
Inc glycogen in liver, increase K+ uptake and glycogen in muscle, inc TG storage in muscle
Used vs DM
Toxicity: Hypoglycemia
Metformin
Biguanide
Increased insulin sensitivity, dec gluconeogenesis, inc glycolysis
FIrst line in DM II
Toxicity: lactic acidosis (do not use in renal failure)
Tolbutamide
Sulonylurea
CLose K+ channel in B cell -> inc insulin release via Ca2+ entry
DM II release of insulin
Toxicity: DIsulfiram like effects
Chlorpropramide
Sulfonylureas
CLose K+ channel in B cell membrane-> inc ca2+ entry and insulin release
DM II only
Disulfiram like effects
Glyburide
Close K+ channel in B cell -> inc Ca2+ influx leading to insuin release
Used in DM II only
Toxicity: hypoglycemia
Glimepiride/Glipizide
CLose K+ channel in B cell membrane -> Inc Ca2+ influx -> insuin release
Toxicity: hypogycemia
Piogliazone/Rosiglitazone
Inc insulin sensitivity -> binds to PPAR-gamma transcription regulator
Used in DM II
TOxicity: Wt gain, edema, hepatotoxic, heart failure
Acarbose
Inhibits brush border glucosidase -> decreased glucose absorption
DM II
Toxicity: GI upset
Miglitol
Decreased brush border glucosidase -> decreased glucose absorption
DM II
Toxicity: GI upset
Pramlintide
Decrease glucagon
Use: DM I/DM II
TOxicity: Hypoglycemia, nausea, diarrhea
Exenatide/Liraglutide
GLP-1 analog -> Inc insuin, dec glucagon
DM II
Toxicity: Pancreatitis, GI upset
Linagliptin/Saxagliptin
Inc insulin, dec glucagon release
DM II
Toxicity: Urinary infection, respiratory infection
Propylthiouracil
Blocks peroxidase -> Decrease organification of iodide -> decreased 5’-deiodinase activity
Dec T3
Used in hyperthyroidism
TOxicity: Skin rash, aplastic anemia, hepatotoxic
Methimazole
Vs peroxidase -> dec T3 via dec iodide organification
Use: hyperthyroidism
TOxicity: Aplastic anemia, skin rash, teratogen
Levothyroxine/triiodothyronine
Thyroxine replacement
Use: Hypothyroidism
Toxicity: Tachycardia, heat inolterance, arrythmia
Somatostatin (octreotide)
Vs carcinoid/acromegaly/gastrinoma
Demeclocycline
ADH antagonist
Use: SIADH
Toxicity: Nephrogenic DI, photosensitivity, bone abnormalities/teeth
GLucocorticoids (hydrocortisone/dexamethasone)
Dec leukotrienes and prostaglandsins
Use; addisons disease, inflammation
TOxicity: Cushings syndrome
