Endocrine--Pharmacology

Question 1

rapid acting insulins:

Answer 1

lispro, aspart, glulisine

Question 2

insulin, intermediate acting

Answer 2

NPH

Question 3

insulin long acting

Answer 3

glargine, detemir

Question 4

metformin moa

Answer 4

decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake–increasing insulin sensitivity;

Question 5

metformin contraindication

Answer 5

lactic acidosis; renal failure

Question 6

sulfonylureas:

Answer 6

1st generation: tolbutamide, chlorpropamide, 2nd generation: glyburide, glimepiride, glipizide

Question 7

sulfonyurea moa:

Answer 7

close K channel in B cell membrane so cell depolarizes–>triggers insulin release via increase Ca2+ influx

Question 8

sulfonylurea tox?

Answer 8

disulfiram like effects w/ first generation; hypoglycemia in 2nd generation

Question 9

pioglitazone/rosiglitazone moa?

Answer 9

increases insulin sensitivty in peripheral tissue; binds to PPAR-gamma nuclear transcription regulator

Question 10

-glitazone tox?

Answer 10

weight gain, edema, liver tox, exacerbate existing heart failure

Question 11

alpha-glucosidase inhibitors, moa?

Answer 11

acarbose, miglitol; inhibit intestinal brush border alpha-glucosidases–>delayed sugar hydrolysis and glucose absorption–>decrease postprandial hyperglycemia

Question 12

amylin analogs: moa?

Answer 12

pramlintide; decrease gastric empting–>decrease glucagon secretion;

Question 13

GLP-1 analogs; moa?

Answer 13

exenatide, liraglutide; increase insulin, decrease glucagon release

Question 14

risk of GLP1-analogs?

Answer 14

pancreatitis

Question 15

DPP4-inhibitors; moa?

Answer 15

-gliptins; inhibit DPP4 (the enzyme that degrades GLP-1);

Question 16

DPP4 inhibitor tox?

Answer 16

mild urinary/respiratory infections

Question 17

PTU, methimazole moa?

Answer 17

block thyroid peroxidase–>inhibits oxidation of iodide and organification (coupling) of iodine–>inhibition of thyroid hormone synthesis. PTU also blocks 5’-deiodinase which decreases peripheral conversion of T4 to T3

Question 18

PTU, methimazole use?

Answer 18

hyperthyroidism, PTU can be used in pregnancy

Question 19

PTU, methimazole tox?

Answer 19

skin rash, agranulocytosis, aplastic anemia, hepatotoxicity with PTU; methimazole is possible teratogen (aplasia cutis)

Question 20

somatostatin (octreotide) use?

Answer 20

acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

Question 21

oxytocin use?

Answer 21

stimulates labor, uterine contractions, milk-let down, controls uterine hemorrhage

Question 22

Demeclocycline moa? tox?

Answer 22

ADH antagonist used in SIADH; can cause nephrogenic DI, photosensitivity, abnormalities of bone and teeth