Endocrine Pharmacology

Question 1

State whether the following is rapid, short, intermediate, or long-acting: lispro; detemir; aspart; glargine; glulisine; NPH; regular insulin.

Answer 1

Rapid; long; rapid; long; rapid; intermediate; short

Question 2

How does insulin work?

Answer 2

Binds to insulin receptor (tyrosine kinase activity)

Question 3

T/F: Insulin is safe to use in women with gestational diabetes?

Answer 3

TRUE

Question 4

What is the toxicity associated with insulin?

Answer 4

Hypoglycemia

Question 5

What is metformin’s effects on gluconeogenesis, glycolysis, and peripheral glucose uptake?

Answer 5

Dec, inc, dec

Question 6

What is the first-line therapy for type 2 DM?

Answer 6

Metformin

Question 7

T/F: Metformin cannot be used in patients without islet function.

Answer 7

FALSE: CAN be used

Question 8

What is the most serious adverse effect associated with metformin?

Answer 8

Lactic acidosis (thus contraindicated in renal failure)

Question 9

Describe how sulfonylureas work.

Answer 9

Close K+ channel in B-cell membrane, so cell depolarizes, triggering insulin release via increased Ca influx.

Question 10

T/F: Sulfonylureas require some islet function, so it is useless in type 1 DM.

Answer 10

TRUE

Question 11

What are the toxicities associated with sulfonylureas?

Answer 11

First generation: disulfiram-like effects; second generation: hypoglycemia

Question 12

Glitazones/thiazolidinediones bind to which regulator?

Answer 12

PPAR-gamma

Question 13

Can glitazones/thiazolidinediones be used as monotherapy in type 2 DM?

Answer 13

Yes, or can be used in combination with other agents

Question 14

What are the toxicities associated with glitazones/thiazolidinediones?

Answer 14

Weight gain, edema, hepatotoxicity, heart failure

Question 15

T/F: Pramlintide is used in type 2 DM only.

Answer 15

FALSE: Types 1 AND 2 DM

Question 16

What are some toxicities associated with GLP-1 analogs?

Answer 16

Nausea, vomiting, pancreatitis

Question 17

Name 2 GLP-1 analogs.

Answer 17

Exenatide, liraglutide

Question 18

Name 3 DPP-4 inhibitors.

Answer 18

Linagliptin, saxagliptin, sitagliptin

Question 19

T/F: GLP-1 analogs and DPP-4 inhibitors are used in type 2 DM only.

Answer 19

TRUE

Question 20

Propylthiouracil blocks _____ and _____.

Answer 20

Peroxidase and 5’-deiodinase

Question 21

Name some toxicities associated with propylthiouracil.

Answer 21

Skin rash, agranulocytosis (rare), aplastic anemia, hepatotoxicity

Question 22

T/F: Methimazole is safe to use in pregnancy.

Answer 22

FALSE: Methimazole is a possible teratogen

Question 23

What are some toxicities associated with levothyroxine?

Answer 23

Tachycardia, heat intolerance, tremors, arrhythmias

Question 24

Name 2 conditions for which GH is used.

Answer 24

GH deficiency, Turner syndrome

Question 25

Name 5 conditions for which somatostatin (octreotide) is used.

Answer 25

Acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

Question 26

Name 4 conditions for which oxytocin is used.

Answer 26

Stimulates labor, uterine contractions, milk-let down; controls uterine hemorrhage

Question 27

Name a condition for which ADH (desmopressin) is used.

Answer 27

Pituitary (central, not nephrogenic) DI

Question 28

Demeclocycline is a _____ antagonist used to treat _____.

Answer 28

ADH; SIADH

Question 29

What are some toxicities associated with demeclocycline?

Answer 29

Nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Question 30

Glucocorticoids decrease the production of _____ and _____ by inhibiting _____ and expression of _____.

Answer 30

Leukotrienes; prostaglandins; phospholipase A2; COX-2

Question 31

What is a toxicity of glucocorticoids?

Answer 31

Iatrogenic Cushing’s syndrome

Question 32

A patient has been using glucocorticoids for several years, but abruptly stopped using it. What is the patient at risk for?

Answer 32

Adrenal insufficiency