Endocrine Pharmacology Flashcards by Tsion Aberra

name 7 insulin drugs and their timing of action

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

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how do insulin drugs work?

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

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

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what toxicities are associated with insulin administration

hypoglycemia, and very rarely hypersensitivity reactions

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what class of drug is metformin

biguanide

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how does metformin work

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

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what is metformin used for

T2DM as a first line therapy (taken orally)

can also be used in patients without islet function

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what toxicities are associated with metformin

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

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name two first generation sulfonylureas

and three second generation sulfonylureas

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

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

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

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name two glitazones/thiazolidinediones

pioglitazone and rosiglitazone

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how do glitazones/thiazolidinediones work

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

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what are glitazones/thiazolidinediones used for

as monotherapy or as part of combined therapy for T2DM

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what are some side effects of glitazones/thiazolidinediones

weight gain, ededma, hepatotoxicity, heart failure

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name two alpha-glucosidase inhibitors

acarbose and miglitol

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how do alpha-glucosidase inhibitors work

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

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when are alpha-glucosidase inhibitors used

monotherapy or part of combo therapy for T2DM

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what side effect do alpha-glucosidase inhibitors cause

GI disturbances (bacteria get more sugars)

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name an amylin analog

pramlintide

how does pramlintide (amylin analogue) work

decreases glucagon

when is pramlintide used

T1DM and T2DM

what side effects are caused by pramlintide

hypoglycemia, nausea, diarrhea

name two GLP-1 analogs

exenatide and liraglutide

how do GLP-1 analogs work

increase insulin and decrease glucagon release

what are GLP-1 analogs used for

T2DM

what side effects do GLP-1 analogs cause

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

name three DPP-4 inhibitors

linagliptin, saxagliptin, sitagliptin

how do DPP-4 inhibitors work

increase insulin and decrease glucagon release

what are DPP-4 inhibitors used for

T2DM

what are side effects of DPP-4 inhibitors

mild urinary or respiratory infections

what condition to propylthiouracil and methimazole treat

hyperthyroidism

what is the mechanism of action for propylthiouracil and methimazole

block peroxidase which organifies iodide and thyroid synthesis

what does propylthiouracil do that methimazole does not

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

what toxicities are associated with propylthiouracil and methimazole

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

what two conditions do levothyroxine and triiodothyronine treat

hypothyroidism and myxedema (mucousy edema)

how do synthroid and triiodothyronine work

they are thyroxine replacements

what side effects do levothyroxine and triiodothyronine cause

tachycardia, heat intolerance, tremors, arrhythmias

what two conditions does GH administration treat

Turner's syndrome and GH deficiency

what conditions does octreotide treat

acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varicies

what is oxytocin used for

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

what is demeclocycline used for and how does it work

used to treat SIADH (causes nephrogenic DI) | works by antagonizing ADH

what toxicities are associated with demeclocycline

nephrogenic diabetes insipidus, photosensitivity, abnormalities of bone and teeth

name five glucocorticoids

prednisone, hydroxycortisone, triamcinolone, dexamethasone, beclomethasone

how do glucocorticoids work

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

what are glucocorticoids used to treat

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

what side effects are associated with glucocorticoid use

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