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USMLE > Endocrine - Pharmacology > Flashcards

Endocrine - Pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

Pharmacologic drug: Lispro

A

Rapid-acting insulin

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2
Q

Is regular insulin short or long acting?

A

Short acting

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3
Q

Pharmacologic drug: NPH

A

Intermediate acting insulin

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4
Q

Pharmacologic drug: Glargine

A

Long acting insulin

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5
Q

Insulin: Mechanism of Action

A

Binds insulin receptor (RTK activity) Increases liver glucose storage as glycogen, muscle glycogen synthesis and protein snthesis; K+ uptake Increase TG storage

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6
Q

Insulin: Clinical Use

A

Type 1 and 2 DM Gestational diabetes Life-threatening hyperkalemia Stress-induced hyperglycemia

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7
Q

Insulin: Toxicity

A

Hypoglycemia, very rarely hypersensitivity reaction

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8
Q

Metformin: Mechanism of Action

A

Biguanide Decrease gluconeogenesis, increase glycolysis, increase peripheral glucose uptake (insulin sensitivity)

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9
Q

Metformin: Clinical Use

A

First-line therapy in Type 2 DM (oral) Can be used in patients without islet function

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10
Q

Metformin: Toxicities

A

GI upset Lactic acidosis (contraindicated in renal failure)

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11
Q

Pharmacologic drug: Tolbutamide

A

1st generation sulfonylurea

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12
Q

Pharmacologic drug: Glyburide

A

Second generation sulfonylurea

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13
Q

Sulfonylureas: Mechanism of Action

A

Close K+ channel in beta-cell membrane -> increase Ca2+ influx

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14
Q

Sulfonylureas: Clinical Use

A

Stimulate release of endogenous insulin in type 2 DM Requires some islet functions (not for DMI)

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15
Q

Sulfonylureas: Toxicities

A

First generation: disulfiram-like Second generation: hypoglycemia

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16
Q

Pharmacologic drug: Pioglitazone

A

Thiazolidinedione

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17
Q

Thiazolidinediones: Mechanism of Action

A

Increase insulin sensitivity in peripheral tissue Binds to PPAR-gamma nuclear transcription regulator

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18
Q

Thiazolidinediones: Clinical Use

A

Monotherapy in type 2 DM or combined

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19
Q

Thiazolidinediones: Toxicities

A

Weight gain, edema Hepatotoxicity Heart failure

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20
Q

Pharmacologic drug: Acarbose

A

Alpha-glucosidase inhibitor

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21
Q

Alpha-glucosidase inhibitors: Mechanism of action

A

Inhibit intestinal brush-border alpha-glucosidases Delayed sugar hydrolysis and glucose absorption -> decrease postprandial hyperglycemia

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22
Q

Alpha-glucosidase inhibitors: Clinical Use

A

Monotherapy in type 2 DM or in combination

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23
Q

Alpha-glucosidase inhibitors: Toxicities

A

GI disturbances

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24
Q

What is the amylin analog?

A

Pramlintide

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25
Q

Amylin analog (Pramlintide): Mechanism of action

A

Decreases glucagon

26
Q

Amylin analog (Pramlintide): Clinical use

A

Type 1 and 2 DM

27
Q

Amylin analog (Pramlintide): Toxicities

A

Hypoglycemia, nausea, diarrhea

28
Q

Pharmacologic drug: Exenatide

A

GLP-1 analog

29
Q

GLP-1 analogs: Mechanism of action

A

increase insulin, decrease glucagon release

30
Q

GLP-1 analogs: Clinical use

A

Type 2 DM

31
Q

GLP-1 analogs: Toxicities

A

Nausea, vomiting, pancreatitis

32
Q

Pharmacologic drugs: Linagliptin, Saxagliptin, Sitagliptin

A

DPP-4 inhibitors

33
Q

DPP-4 inhibitors: Mechanism of action

A

Increases insulin, decrease glucagon release

34
Q

DPP-4 inhibitors: Clinical use

A

Type 2 DM

35
Q

DPP-4 inhibitors: Toxicities

A

Mild urinary or respiratory infections

36
Q

Propylthiouracil, Methimazole: Mechanism of action

A

Block peroxidase (inhibit organification of iodide and coupling of thyroid hormone synthesis) PTU also blocks 5’-deiodinase (decrease peripheral conversion of T4 to T3)

37
Q

Propylthiouracil, Methimazole: Clinical use

A

hyperthyroidism

38
Q

Propylthiouracil, Methimazole: Toxicity

A

Skin rash Agranulocytosis (rare) Aplastic anemia Hepatotoxicity (PTU) Possible teratogen (methimazole)

39
Q

Levothyroxine, Triiodothyronine: Mechanism of action

A

Thyroxine replacement

40
Q

Levothyroxine, Triiodothyronine: Clinical use

A

Hypothyroidism, myxedema

41
Q

Levothyroxine, Triiodothyronine: Toxicity

A

Tachycardia, heat intolerance, tremors, arrhythmias

42
Q

GH: Clinical use

A

GH deficiencies, Turner syndrome

43
Q

Somatostatin (Octreotide): Clinical use

A

Acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

44
Q

Oxytocin: Clinical use

A

Stimulates labor, uterine contractions, milk let-down Controls uterine hemorrhage

45
Q

ADH (Desmopressin): Clinical use

A

pituitary (central, not nephrogenic) DI

46
Q

Demeclocycline: mechanism of action

A

ADH antagonist (member of the tetracycline family)

47
Q

Demeclocycline: Clinical use

A

SIADH

48
Q

Demeclocycline: Toxicity

A

Nephrogenic DI Photosensitivity Abnormalities of bone and teeth

49
Q

Pharmacologic drugs: hydrocortisone, prednisone, dexamethasone, beclomethasone

A

Glucocorticoid

50
Q

Glucocorticoids: Mechanism of action

A

Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2

51
Q

Glucocorticoids: Clinical use

A

Addison’s disease Inflammation Immune suppression Asthma

52
Q

Glucocorticoids: Toxicity

A

Iatrogenic Cushing’s syndrome Adrenal insufficiency when drug stopped abruptly after chronic use

53
Q

Pharmacologi drug triamcinolone

A

Glucocorticoid

54
Q

Pharmacologic drug: Aspart

A

Rapid-acting insulin

55
Q

Pharmacologic drug: Glulisine

A

Rapid acting insulin

56
Q

Pharmacologic drug: Chlorpropamide

A

First generation sulfonylurea

57
Q

Pharmacologic drug: Glimepiride

A

Second generation sulfonylurea

58
Q

Pharmacologic drug: Glipizide

A

2nd generation sulfonylurea

59
Q

Pharmacologic drug: Rosiglitazone

A

2nd generation sulfonylurea

60
Q

Pharmacologic drug: Miglitol

A

alpha-glucosidase inhibitor

61
Q

Pharmacologic Drug: Liraglutide

A

GLP-1 analog

62
Q

Pharmacologic drug: Detemir

A

Long acting insulin

USMLE (13 decks)

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