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Endocrinology First Aid > Endocrine Pharmacology > Flashcards

Endocrine Pharmacology Flashcards

1
Q

name 7 insulin drugs and their timing of action

A 
lispro (fast-acting)
aspart (fast-acting_
glulisine (fast-acting)
regular (short-acting)
NPH (intermediate)
glargine (long-acting)
detemir (long-acting)
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2
Q

how do insulin drugs work?

A

bind insulin receptor (a tyrosine kinase) and

1: increase glycogen synthesis in liver
2: increase glycogen and protein synthesis in muscle and K+ uptake in muscle
3: aid triglyceride storage

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3
Q

for what conditions (name 5) would you use insulin drugs

A

T1DM, T2DM, gestational diabetes, life-threatening hyperkalemia, stress-induced hyperglycemia

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4
Q

what toxicities are associated with insulin administration

A

hypoglycemia, and very rarely hypersensitivity reactions

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5
Q

what class of drug is metformin

A

biguanide

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6
Q

how does metformin work

A

mechanism unknown, but it decreases gluconeogenesis, increases glycolysis and increases insulin sensitivity and thereby glucose uptake in the periphery

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7
Q

what is metformin used for

A

T2DM as a first line therapy (taken orally)

can also be used in patients without islet function

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8
Q

what toxicities are associated with metformin

A

GI upset; lactic acidosis (so contraindicated in renal failure patients)

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9
Q

name two first generation sulfonylureas

and three second generation sulfonylureas

A

first: tolbutamine, chlorpropamide
second: glyburide, glimepiride, glipizide

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10
Q

what are the side effects of first generation and second generation sulfonylureas

A

first: disulfiram effects (unpleasant hypersensitivity to alcohol)
second: hypoglycemia

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11
Q

name two glitazones/thiazolidinediones

A

pioglitazone and rosiglitazone

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12
Q

how do glitazones/thiazolidinediones work

A

they increase insulin activity by binding and activating (inhibiting the inhibitor of) PPAR-gamma (nuclear transcription regulator)

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13
Q

what are glitazones/thiazolidinediones used for

A

as monotherapy or as part of combined therapy for T2DM

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14
Q

what are some side effects of glitazones/thiazolidinediones

A

weight gain, ededma, hepatotoxicity, heart failure

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15
Q

name two alpha-glucosidase inhibitors

A

acarbose and miglitol

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16
Q

how do alpha-glucosidase inhibitors work

A

inhibit intestinal brush border alpha-glucosidase leading to delayed sugar hydrolysis and delayed glucose absorption and thereby decreased postprandial hyperglycemia

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17
Q

when are alpha-glucosidase inhibitors used

A

monotherapy or part of combo therapy for T2DM

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18
Q

what side effect do alpha-glucosidase inhibitors cause

A

GI disturbances (bacteria get more sugars)

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19
Q

name an amylin analog

A

pramlintide

20
Q

how does pramlintide (amylin analogue) work

A

decreases glucagon

21
Q

when is pramlintide used

A

T1DM and T2DM

22
Q

what side effects are caused by pramlintide

A

hypoglycemia, nausea, diarrhea

23
Q

name two GLP-1 analogs

A

exenatide and liraglutide

24
Q

how do GLP-1 analogs work

A

increase insulin and decrease glucagon release

25
Q

what are GLP-1 analogs used for

A

T2DM

26
Q

what side effects do GLP-1 analogs cause

A

nausea, vomiting, pancreatitis (though no hypoglycemia because they act only after meals)

27
Q

name three DPP-4 inhibitors

A

linagliptin, saxagliptin, sitagliptin

28
Q

how do DPP-4 inhibitors work

A

increase insulin and decrease glucagon release

29
Q

what are DPP-4 inhibitors used for

A

T2DM

30
Q

what are side effects of DPP-4 inhibitors

A

mild urinary or respiratory infections

31
Q

what condition to propylthiouracil and methimazole treat

A

hyperthyroidism

32
Q

what is the mechanism of action for propylthiouracil and methimazole

A

block peroxidase which organifies iodide and thyroid synthesis

33
Q

what does propylthiouracil do that methimazole does not

A

propylthiouracil blocks 5’-deiodinase which prevents conversion of T4 to T3

34
Q

what toxicities are associated with propylthiouracil and methimazole

A

propylthiouracil: skin rah, agranulocytosis (rare), aplastic anemia, hepatotoxicity
methimazole: teratogenic

35
Q

what two conditions do levothyroxine and triiodothyronine treat

A

hypothyroidism and myxedema (mucousy edema)

36
Q

how do synthroid and triiodothyronine work

A

they are thyroxine replacements

37
Q

what side effects do levothyroxine and triiodothyronine cause

A

tachycardia, heat intolerance, tremors, arrhythmias

38
Q

what two conditions does GH administration treat

A

Turner’s syndrome and GH deficiency

39
Q

what conditions does octreotide treat

A

acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varicies

40
Q

what is oxytocin used for

A

induce labor, stimulate milk let-down, control uterine hemorrhage

41
Q

what is demeclocycline used for and how does it work

A

used to treat SIADH (causes nephrogenic DI)

works by antagonizing ADH

42
Q

what toxicities are associated with demeclocycline

A

nephrogenic diabetes insipidus, photosensitivity, abnormalities of bone and teeth

43
Q

name five glucocorticoids

A

prednisone, hydroxycortisone, triamcinolone, dexamethasone, beclomethasone

44
Q

how do glucocorticoids work

A

they decrease production of leukotrienes and prostaglandins by inhibiting phopholipase A2 and by inhibiting expression of COX-2

45
Q

what are glucocorticoids used to treat

A

Addison’s disease, inflammation, need for immune suppression, asthma

46
Q

what side effects are associated with glucocorticoid use

A

iatrogenic Cushing’s (moon facies, proximal atrophy, truncal obesity, striae, buffalo hump, peptic ulcers, diabetes, osteoporosis, thin skin and easy bruising
adrenal insufficiency after the drug is stopped

Endocrinology First Aid (3 decks)

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