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STEP 1 (2) > Endocrine- Pharmacology > Flashcards

Endocrine- Pharmacology Flashcards

1
Q

What are some rapid acting insulins?

A

Aspart, Glulisine, Lispro

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2
Q

How do rapid acting insulins work?

A

they bind insulin receptors (tyrosine kinase activity) and cause:

  • increased glycogenogenesis in the liver
  • increased TAG formation
  • protein synthesis
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3
Q

What are the clinical uses of rapid acting insulins?

A

type I, II, and GDM

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4
Q

What are the intermediate acting insulins?

A

NPH

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5
Q

What are the long acting insulins?

A

Detemir, Glargine

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6
Q

What are the biguanides?

A

Metformin

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7
Q

How do biguanides like metformin work?

A

exact mechanism unknown but results in:

decreased gluconeogenesis

increased peripheral glucose uptake/intake

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8
Q

What are the AEs of metformin?

A

GI upset

lactic acidosis (contraindicated in renal insufficiency)

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9
Q

What are the sulfonylureas?

A

First gen: chlorporamide, tolbutamide

Second gen: Glimepiride, Glipizide, Glyburide

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10
Q

How do sulfonylureas work?

A

they close K+ channels in B-cell membrane so that the cel depolarizes leading to increased insulin release via Ca2+ influx

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11
Q

T or F. Sulfonylureas can be used for both Type I and II DM

A

F. Only II because it reuqires some islet function

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12
Q

What are the AEs of sulfonylureas?

A

Risk of hypoglyceia in renal failure

First gen: disulfram-like effects

Second gen: hypoglycemia

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13
Q

What are the glitazones/thiazolidinediones?

A

pioglitazone

rosiglitazone

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14
Q

How do the thiazolidinediones work?

A

they increase insulin sensitivity in peripheral tissue by binding to PPAR-y nucelar transcription regulators

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15
Q

What are the AEs of thiazolidinediones?

A

weight gain, edema

Hepatotoxicity

HF

increased risk of fracture

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16
Q

What are the GLP-1 analogs?

A

exenatide

liraglutide

17
Q

How do GLP-1 analogs work and what are they used for?

A

they increase insulin and decrease glucagon release for tx of type II DM only

18
Q

What are the AEs of GLP-1 analogs?

A

N/V

pancreatitis

19
Q

What are the DPP-4 inhibitors?

A

-gliptins like linagliptin, saxagliptin

20
Q

How do DPP-4 inhibitors work and what are they used for?

A

they increase insulin and decrease glucagon release for tx of type II DM only

21
Q

What are the AEs of DDP-4 inhibitors?

A

mild urinary or respiratory infections

22
Q

What are the amylin analogs that work for Type I and II Dm tx by decreasing gastric emptying and glucagon levels?

A

pramlintide

23
Q

What are the SGLT-2 inhibitors that block reabsorption of glucose in the PCT?

A

-glifozins

24
Q

What are the a-glucosidase inhibitors?

A

Acarbose, miglitol

25
Q

How do a-glucosidase inhibitors work?

A

they inhibit brush border a-glucosidease that causes delayed carb hydrolysis and glucose absorption, decreasing posprandial hyperglycemia (type II only)

26
Q

What is the mechanism of propylthiouracil and methimazole?

A

they block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine, inhibiting thyroid hormone synthesis. PTU also blocks 5’-deiodinase

27
Q

What are the AEs of PTU and methimazole?

A

skin rash

agranulocytosis

aplastic anemia

hepatotoxicity (PTU)

methimazole is a teratogen (hold until late pregnancy)

28
Q

What are the main tx options for hypothyroidism?

A

levothyroxine (T4) and triiodothyronine (T3)

29
Q

What are some ADH antagonists used in the tx of SIADH by competitvely binding to V2 receptors?

A

Convaptan and tolvaptan

Demeclocycline

30
Q

What is an ADH analog used in the tx of central DI?

A

Desmopressin acetate

31
Q

What are the clinical uses of giving oxytocin?

A

stimulating labor, uterine contractions, milk let-down, and controlling uterine-hemorrhage

32
Q

What are the uses of somatostatin (octreotide)?

A

acromegaly

carcinoid syndrome

gastrinoma or glucagonoma

esophaeal varices

33
Q

What is Cinacalcet?

A

it sensitizes the CaSR in the PTH gland to criculating Ca2+ to decrease the release of PTH for the tx of hypercalcemia/hyperPTHism

STEP 1 (2) (16 decks)

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