Endocrine pharmacology

Question 1

Most serious adverse effect of Metformin

Answer 1

Lactic acidosis (contraindicated in renal insufficiency)

Question 2

Action of metformin

Answer 2

decrease gluconeogenesis, increase glycolysis, increase peripheral glucose uptake (insulin sensitivity)

Question 3

First-line therapy for T2DM

Answer 3

Metformin

Question 4

Detemir and Glargine are

Answer 4

long acting insulin analogs used for basal glucose control in all types of diabetics

Question 5

Clinical use of Insulin (short acting)

Answer 5

Hyperkalemia (+ glucose), stress hyperglycemia

Question 6

Clinical use of rapid acting Lispro, Aspart, Glulisine

Answer 6

postprandial glucose control

Question 7

Chlorpropamide and Tolbutamide are

Answer 7

First generation sulfonylureas

Question 8

Mechanism of sulfonylureas

Answer 8

Close K+ channel in beta-cell membrane to depolarize it and stimulate endogenous insulin release in T2DM

Question 9

Glimepiride, Glipizide and Glyburide are

Answer 9

second generation sulfonylureas

Question 10

Adverse effects of first generation sulfonylureas

Answer 10

Hypoglycemia, lactic acidosis, disulfiram-like effects

Question 11

Adverse effects of second generation sulfonylureas

Answer 11

Hypoglycemia, lactic acidosis

Question 12

Mechanism of Pioglitazone and Rosiglitazone

Answer 12

Bind PPAR-gamma nuclear transription regulator to increase insulin sensitivity in peripheral tissue and muscles

Question 13

Clinical use of glitazones (Thiazolidinediones)

Answer 13

T2DM, take some time to take effect, found to increase HDL

Question 14

Adverse effects of Glitazones

Answer 14

Weight gain, edema, hepatotoxicity, HF, increased risk of fractures

Question 15

Levothyroxine (T4) is used to treat

Answer 15

Hypothyroidism

Question 16

Nateglinide and repaglinide action

Answer 16

Bind K+ channels on beta-cell membranes to induce depolarization and increase release of insulin

Question 17

Adverse effects of nateglinide and repaglinide

Answer 17

Weight gain and hypoglycemia (increased risk in renal failure)

Question 18

Name two GLP-1 analogs

Answer 18

Exenatide and Liraglutide

Question 19

Mechanismm of Liraglutide and Exenatide

Answer 19

Increase glucose-dependent insulin release, decrease glucagon release, decrease gastric emptying and increase satiety

Question 20

Adverse effeects of exenatide and liraglutinide

Answer 20

N/V, pancreatitis, modest weight loss

Question 21

Linagliptin, saxagliptin, sitagliptin are

Answer 21

DPP-4 inhibitors

Question 22

Mechanism of the -gliptins

Answer 22

Inhibit DPP-4 so it cannot deactivate GLP-1, thus increasing glucose-dependent insulin release, decreasing glucagon release and increasing satiety

Question 23

Adverse effects of DPP-4 inhibitors (-gliptins)

Answer 23

Mild urinary or respiratory infections (nasopharyngitis)

Question 24

What is Pramlitined used for

Answer 24

decrease gastric emptying and decrease glucagon

Question 25

Mechanism of SGLT-2 inhibitors (-gliflozin)

Answer 25

Block reabsorption of glucose in PCT by inhibiting Na/Glu (SGLT2)

Question 26

Adverse effects of SGLT-2 inhibitors (-gliflozins)

Answer 26

Glucosuria, UTIs, vaginal yeast infections, hyperkalemia, dehydration, hypotension

Question 27

Acarbose and miglitol are

Answer 27

alpha-glucosidase inhibitors, delay postprandial hyperglycemia reducing intestinnal disaccharide absorption

Question 28

PTU and Methimazole are used for

Answer 28

Hyperthyroidism (block TPO), PTU also blocks 5' deiodinase and is used in pregnancy

Question 29

Conivaptan and Tolvaptan use

Answer 29

ADH antagonists, block ADH action at V2R (SIADH treatment)

Question 30

Desmopressin use

Answer 30

Central DI

Question 31

Which medication can be used to control uterine hemorrhage

Answer 31

Oxytocin

Question 32

Somatostatin (octreotide) can be used for

Answer 32

Acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices

Question 33

Demeclocycline is used to treat

Answer 33

SIADH

Question 34

Nephrogenic DI, photosensitivity and abnormalities of bone and teeth caused by

Answer 34

Demeclocycline

Question 35

Drug used to treat hyperparthyroidism

Answer 35

Cinacalcet

Question 36

Mechanism of Cinacalcet

Answer 36

Increase sensitivity of CaSR in parathyroid gland

Question 37

Fludrocoritosne is used as

Answer 37

mineralocorticoid replacement in primary adrenal insuffieciency

Question 38

SGLT-2 inhibitors (-flozins) are contraindicated in which patients

Answer 38

Moderate-to-severe renal impairment patients

Question 39

Competitive inhibitors of Iodine transportation

Answer 39

Perchlorate or Pertechnetate

Question 40

Adverse effects of alpha-glucosidase inhibitors (Acarbose and Miglitol)

Answer 40

diarrhea, flatulece