Endocrine--Pharmacology Flashcards
rapid acting insulins:
lispro, aspart, glulisine
insulin, intermediate acting
NPH
insulin long acting
glargine, detemir
metformin moa
decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake–increasing insulin sensitivity;
metformin contraindication
lactic acidosis; renal failure
sulfonylureas:
1st generation: tolbutamide, chlorpropamide, 2nd generation: glyburide, glimepiride, glipizide
sulfonyurea moa:
close K channel in B cell membrane so cell depolarizes–>triggers insulin release via increase Ca2+ influx
sulfonylurea tox?
disulfiram like effects w/ first generation; hypoglycemia in 2nd generation
pioglitazone/rosiglitazone moa?
increases insulin sensitivty in peripheral tissue; binds to PPAR-gamma nuclear transcription regulator
-glitazone tox?
weight gain, edema, liver tox, exacerbate existing heart failure
alpha-glucosidase inhibitors, moa?
acarbose, miglitol; inhibit intestinal brush border alpha-glucosidases–>delayed sugar hydrolysis and glucose absorption–>decrease postprandial hyperglycemia
amylin analogs: moa?
pramlintide; decrease gastric empting–>decrease glucagon secretion;
GLP-1 analogs; moa?
exenatide, liraglutide; increase insulin, decrease glucagon release
risk of GLP1-analogs?
pancreatitis
DPP4-inhibitors; moa?
-gliptins; inhibit DPP4 (the enzyme that degrades GLP-1);
DPP4 inhibitor tox?
mild urinary/respiratory infections
PTU, methimazole moa?
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
PTU, methimazole use?
hyperthyroidism, PTU can be used in pregnancy
PTU, methimazole tox?
skin rash, agranulocytosis, aplastic anemia, hepatotoxicity with PTU; methimazole is possible teratogen (aplasia cutis)
somatostatin (octreotide) use?
acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices
oxytocin use?
stimulates labor, uterine contractions, milk-let down, controls uterine hemorrhage
Demeclocycline moa? tox?
ADH antagonist used in SIADH; can cause nephrogenic DI, photosensitivity, abnormalities of bone and teeth
