endocrine pharm

Question 1

Lispro

Answer 1

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

Question 2

Aspart

Answer 2

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

Question 3

Glulisine

Answer 3

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

Question 4

NPH

Answer 4

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

Question 5

Glargine

Answer 5

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

Question 6

Detemir

Answer 6

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

Question 7

Metformin

Answer 7

Biguanide

Increased insulin sensitivity, dec gluconeogenesis, inc glycolysis

FIrst line in DM II

Toxicity: lactic acidosis (do not use in renal failure)

Question 8

Tolbutamide

Answer 8

Sulonylurea

CLose K+ channel in B cell -> inc insulin release via Ca2+ entry

DM II release of insulin

Toxicity: DIsulfiram like effects

Question 9

Chlorpropramide

Answer 9

Sulfonylureas

CLose K+ channel in B cell membrane-> inc ca2+ entry and insulin release

DM II only

Disulfiram like effects

Question 10

Glyburide

Answer 10

Close K+ channel in B cell -> inc Ca2+ influx leading to insuin release

Used in DM II only

Toxicity: hypoglycemia

Question 11

Glimepiride/Glipizide

Answer 11

CLose K+ channel in B cell membrane -> Inc Ca2+ influx -> insuin release

Toxicity: hypogycemia

Question 12

Piogliazone/Rosiglitazone

Answer 12

Inc insulin sensitivity -> binds to PPAR-gamma transcription regulator

Used in DM II

TOxicity: Wt gain, edema, hepatotoxic, heart failure

Question 13

Acarbose

Answer 13

Inhibits brush border glucosidase -> decreased glucose absorption

DM II

Toxicity: GI upset

Question 14

Miglitol

Answer 14

Decreased brush border glucosidase -> decreased glucose absorption

DM II

Toxicity: GI upset

Question 15

Pramlintide

Answer 15

Decrease glucagon

Use: DM I/DM II

TOxicity: Hypoglycemia, nausea, diarrhea

Question 16

Exenatide/Liraglutide

Answer 16

GLP-1 analog -> Inc insuin, dec glucagon

DM II

Toxicity: Pancreatitis, GI upset

Question 17

Linagliptin/Saxagliptin

Answer 17

Inc insulin, dec glucagon release

DM II

Toxicity: Urinary infection, respiratory infection

Question 18

Propylthiouracil

Answer 18

Blocks peroxidase -> Decrease organification of iodide -> decreased 5’-deiodinase activity

Dec T3

Used in hyperthyroidism

TOxicity: Skin rash, aplastic anemia, hepatotoxic

Question 19

Methimazole

Answer 19

Vs peroxidase -> dec T3 via dec iodide organification

Use: hyperthyroidism

TOxicity: Aplastic anemia, skin rash, teratogen

Question 20

Levothyroxine/triiodothyronine

Answer 20

Thyroxine replacement

Use: Hypothyroidism

Toxicity: Tachycardia, heat inolterance, arrythmia

Question 21

Somatostatin (octreotide)

Answer 21

Vs carcinoid/acromegaly/gastrinoma

Question 22

Demeclocycline

Answer 22

ADH antagonist

Use: SIADH

Toxicity: Nephrogenic DI, photosensitivity, bone abnormalities/teeth

Question 23

GLucocorticoids (hydrocortisone/dexamethasone)

Answer 23

Dec leukotrienes and prostaglandsins

Use; addisons disease, inflammation

TOxicity: Cushings syndrome