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Résidence - Pharmacology > Endocrino (DB) > Flashcards

Endocrino (DB) Flashcards

1
Q

Name categories of tx (6)

A
  • Insulin
  • Metformin
  • SLT2 inhibitor
  • Sulphonylurea
  • GLP-1 Agonist
  • DPP4 inhibitor
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2
Q

Name class members : SGLT2 inhibitor (3)

A
  • GLIFLOZIN
  • Dapaglifozin
  • Empagliflozin
  • Canagliflozin
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3
Q

Name class members : Sulfonylurée (4)

A

GLI -
* Glipizide
* Glyburide
* Gliclazide

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4
Q

Name class members : GLP-1 agonist (4)

A
  • GLUTIDE
  • Liraglutide
  • Semaglutide
  • Dulaglutide
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5
Q

Name class members : DPP4 inhibitor (5)

A
  • GLIPTIN
  • Linagliptin
  • Sitagliptin
  • Saxagliptin
  • Alogliptin
  • Vildagliptin
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6
Q

Name indication : Insulin (2)

A
  • DB1m DB2
  • Diabetic ketoacidosis
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7
Q

Name adverse effects : Insulin (6)

A
  • Peripheral edema
  • Injection site reaction
  • Hypoglycemia
  • Weight gain
  • HypoK
  • Lipodystrophy

Remember : patients shoudl rotate sites regularly to prevent this side efect

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8
Q

Describe mechanism : Insulin

A

Effect on liver :
* Stimulatie glycogen synthesis
* Promote fatty acids synthesis

Effect on muscle and adipose tissue :
* Promote glucose transport across the cell mebrane
* Increase proteins synthesis
* Promote glycogen synthesis

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9
Q

Name classfication of insulin (5)

A
  • Rapid
  • Short
  • Intermediate
  • Long
  • Ultra long
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10
Q

Name examples of rapid insulin (3)

A
  • Lispro (Humalog)
  • Aspart (Novolog)
  • Glulisine (Aspidra)
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11
Q

Describe rapid insuline (5)

A
  • Onset : 15-30 mins
  • Peak : 1-3 h
  • Duration : 4-6 h
  • Use just before meal
  • Highest risk of hypoglycemia
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12
Q

Name short acting insulins (2)

A
  • Humulin Regular
  • Novalin Regular
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13
Q

Name short acting insulins : Humulin R, Novalin R (2)

A
  • Onset : 30 - 60 mins
  • Peak : 2-4 h
  • Durtion : 5-8h
  • Take 30-60 mins before meal
  • Useful for managing diabetic ketoacidosis
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14
Q

Name intermediate insulin (2)

A

NPH (Humulin N)
NPH (Novalin N)

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15
Q

Describe intermediate insulin : Humulin N, Novalin N (5)

A
  • Onset : 2-4h
  • Peak 8-12h
  • Duration 10-18 h
  • Act as basal insulin
  • Cover insulin need around 0.5 day
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16
Q

Name long acting insulin (2)

A
  • Glargin (lantus)
  • Detenir (Levemir)
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17
Q

Describe long acting insulin : Glargine, Detenir (5)

A
  • Onset 1-2 hours
  • No peak
  • Duration 24h+
  • Act as basal insulin
  • Cover insulin need around 1 day
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18
Q

Name ultra long acting insulin (1)

A

**Degludec (Tresiba) **

19
Q

Name ultra long acting insulin : Degludec (Tresiba) (1)

A
  • Onset 1h
  • No peak
  • Dureation 42h+
  • Useful for extra long glucose control
20
Q

Describe indication : Metformin (4)

A
  • 1st line tx DB2
  • GDM
  • Polycystic ovary syndrome
  • Antipsychotic-induced weight gain
21
Q

Name adverse effects : Metformine (3)

A
  • Weight loss
  • Lactis acidosis (myalgia, respiratory distress, somnolence, abdominal pain)
  • Vit B12 deficiency (long-term uses)
22
Q

Describe mechanism : Metformine (3)

A
  • Decrese hepatic glucose production
  • Decrease intestinal absorption of glucose
  • Improve insulin sensitivity
23
Q

Name C-I : Metformine (1)

A

Severe renal impairment eGFR < 30ml/min/1.73 m2

24
Q

Describe metformine with iodinated contrast (3)

A
  • Discontinue metformine 48h before injecting contrast
  • Evaluate eGFR 48h after imaging
  • Restart metformin if eGFR stable
25
Q

Name class members : SGLT2 inhibitor (3)

A
  • GLIFLOZIN
  • Dapaglifozin
  • Empagliflozin
  • Cana**gliflozin **
26
Q

When is SGLT2 inhibitor prefered ?

A

May be preferred in patients with multiple risk factors of CARDIAC disease, such as atherosclerotic cardiovascular disease or heart failure

27
Q

Name adverse effects : SGLT2 inhibitor (5)

A
  • Urinary tract infection
  • Acute kidney injury
  • Increase risk of bone fx
  • Hypotension, caused by volume depletion
  • Ketoacidosis (rare)
28
Q

Describe mechanism : SGLT2 inhibitor (4)

A
  • Inhibit sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubules
  • Reduse reabsorption of filtered glucose from the tubular lumen
  • Increasing excretion of gluclose
  • End result : Reduse body’s glucose
29
Q

SGLT2 inhibitor is not recommended in who?

A

In patients with severe renal failure (eGFR < 30) BECAUSE mechanism of action relies on renal gluclose extreaction. So if renal failure, won’T work properly

30
Q

Name class members : DPP4 inhibitor (5)

A
  • GLIPTIN
  • Linagliptin
  • Sitagliptin
  • Saxagliptin
  • Alogliptin
  • Vildagliptin
31
Q

Name indications : DPP4 inhibitor (3)

A
  • DB2
  • Cannot tolerate metformin
  • Patients with stage 4 or 5 CKD
32
Q

Name adverse effects : DPP4 inhibitor (5)

A
  • Risk hypoglycemia
  • Increase risk of heart failure
  • Bullous pemphigoid
  • Acute pancreatitis
  • Muscle pain
33
Q

Describe DPP4 inhibitor and renal impairment

A

Dosing adjustment is required in renal failiure (except Linagliptin)

34
Q

DPP4 inhibitors need to be careful with what other rx?

A

With CYP3A4 inhibitors (ex. Clarithromycin)

35
Q

Name class members : GLP-1 agonist (4)

A
  • GLUTIDE
  • Liraglutide
  • Semaglutide
  • Dulaglutide
36
Q

Name indications : GLP-1 agonist (3)

A
  • DB2
  • For patients with CARDIORENAL comorbidities that cannot tolerate metformine
  • Chronic weight management
37
Q

Name adverse effect : GLP-1 agonist (3)

A
  • GI upset
  • AKI
  • Gallbladder disease
  • Acute pancreatitis
38
Q

Name C-I : GLP-1 agonist (1)

A

Family history Medullary thyroid carinoma

39
Q

Name class members : Sulfonylurée (4)

A

GLI -
* Glipizide
* Glyburide
* Gliclazide

40
Q

Name indicatiosn : Sulfonylurée (2)

A
  • DB2
  • Adjunctive agent, or monotherapy for patients unable to tolerate metformin
41
Q

Name adverse effects : Sulfonylurée (4)

A
  • Risk of hypoglycemia
  • Weight gain
  • GI upset
  • Rash
42
Q

Describe renal and Sulfonylurée (1)

A

In patients with CKD, prefer shorter-acting sulfonylurée such as glipzide and glimepiride

43
Q

Name agents at risk of hypoglycemia (3)

A
  • Insulin
  • Sulfonylurée
  • DPP4 inhibitor

Résidence - Pharmacology (4 decks)

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