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Pharm > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Rapid acting insulins

A

Insulin (short acting)
Lispro
Aspart
Glulisine

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2
Q

Intermediate acting insulin

A

NPH

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3
Q

Long acting insulin

A

Glargine

Detemir

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4
Q

Biguanides: Metformin

A
  • bypass insulin receptors
  • Mech: activates PPAR
  • Use: 1st line therapy for DM2
  • Tox: GI upset, lactic acidosis (C/I in renal failure)
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5
Q

Sulfonylureas: First generation
Tolbutamide
Chlorpropamide

A
  • Stimulates insulin release
  • Mech: Close K+ channel in β-cell membrane => cell depolarizes & triggers insulin release via Ca2+ influx.
  • Use: DM2, useless in DM1.
  • Tox: Hypoglycemia in renal failure, disulfiram-like effects.
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6
Q

Sulfonylureas: Second generation:
Glyburide
Glimepiride
Glipizide

A
  • Stimulates insulin release
  • Mech: Close K+ channel in β-cell membrane => cell depolarizes & triggers insulin release via Ca2+ influx.
  • Use: DM2, useless in DM1.
  • Tox: Hypoglycemia.
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7
Q

Glitazones/thiazolidinediones:
Pioglitazone
Rosiglitazone

A
  • bypass insulin receptors
  • Mech: activates PPAR
  • Use: DM2
  • Tox: Weight gain, edema, hepatotoxicity, heart failure.
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8
Q

α-glucosidase inhibitors:
Acarbose
Miglitol

A
  • dec. postprandial hyperglycemia.
  • Use: DM2
  • Tox: GI disturbance
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9
Q

Amylin analogs:

Pramlintide

A
  • dec. gastric emptying, dec. glucagon.
  • Use: DM1 & 2
  • Tox: Hypoglycemia, nausea, diarrhea.
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10
Q

GLP-1 analogs:
Exenatide
Liraglutide

A
  • inc. insulin prod.
  • Mech: stimulating beta-cells to prod. insulin
  • Use: DM2
  • Tox: Nausea, vomiting, pancreatitis.
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11
Q

DPP-4 inhibitors:
Linagliptin
Saxagliptin
Sitagliptin

A
  • inc. insulin prod.
  • Mech: inhibiting DPP-4 from digesting GLP-1
  • Use: DM2
  • Tox: Mild urinary or respiratory infections.
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12
Q

Sulfonylureas: First generation

A

Tolbutamide

Chlorpropamide

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13
Q

Sulfonylureas: Second generation:

A

Glyburide
Glimepiride
Glipizide

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14
Q

Glitazones/thiazolidinediones:

A

Pioglitazone

Rosiglitazone

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15
Q

α-glucosidase inhibitors:

A

Acarbose

Miglitol

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16
Q

Amylin analogs:

A

Pramlintide

17
Q

GLP-1 analogs:

A

Exenatide

Liraglutide

18
Q

DPP-4 inhibitors:

A

Linagliptin
Saxagliptin
Sitagliptin

19
Q

Mifepristone (RU-486)

A
  • Comp. inhibitor of progestins at progesterone receptors.
  • Use: Abortion (w/misoprostol).
  • Tox: Heavy bleeding, GI effects, abdominal pain.
20
Q

Ketoconazole

A
  • Inhibits steroid synthesis (inhibits 17,20-desmolase).
  • Use: Polycystic ovarian syndrome to prevent hirsutism.
  • Tox: gynecomastia, amenorrhea.

*also anti-fungal. Its the gynecomastia w/athletes foot drug.

21
Q

Spironolactone

A
  • Inhibits steroid binding, 17α-hydroxylase, and 17,20-desmolase.
  • Use: Polycystic ovarian syndrome to prevent hirsutism.
  • Tox: gynecomastia, amenorrhea.
22
Q

Estrogens:
ethinyl estradiol
Diethylstilbestrol (DES)
mestranol

*“est” in the name

A

-Estrogen analog
-Use:
Female hypogodanism (ie. Turners)
HRT in menopause (w/progestrins)
Contraception
Etc.
-Tox: endometrial hyperplasia/carcinoma, bleeding in postmenopausal women, clear cell adenocarcinoma (DES only), inc. risk of thrombi,

23
Q

Anastrozole, exemestane

A
  • aromatase inhibitors

- Use: Estrogen-dependent postmenopausal breast cancer.

24
Q

Clomiphene

A
  • Stimulates ovulation. “Fertility pill”.
  • Mech: ER antagonist prevents normal E feedback to hypoT, inc. FSH and LH, causes ovulation.
  • Causes LH/FSH surge.
  • Use: infertility due to anovulation (ie. PCOS)
  • Tox: hot flashes, ovarian enlargement, multiple simultaneous pregnancies, and visual disturbances.
25
Q

Raloxifene

A
  • SERM: ER agonist on bone; antagonist at uterus.
  • Use: prophylaxis of post-meno. osteoporosis
  • Tox: thrombi formation
26
Q

Tamoxifen

A
  • SERM: Antagonist @ breast; agonist @ uterus, bone.
  • Use: Treat and prevent recurrence of ER pos. breast cancer.
  • Tox: Endometrial cancer, thrombus formation.
27
Q

Progestrins

A
  • Thicken cervical mucus, inhibit endometrial prolif., also E & P have neg. feedback on LH & FSH.
  • Use: Oral contraceptives.
  • Tox: C/I in smokers => thrombus formation.

*OCP => liver adenoma

28
Q

Flutamide

A
  • androgen receptor antagonist

- Use: prostate carcinoma

29
Q

Leuprolide

A
  • GnRH analog:
  • -agonist: pulsatile doses
  • -antagonist: continuous dose
  • Use:
  • -pulsatile (agonist): infertility,
  • -cont. (antagonist): prostate cancer, uterine fibroids (leiomyoma), precocious puberty.
  • Tox: Antiandrogen, nausea, vomiting.
30
Q

Propylthiouracil

A
  • blocks thyroid peroxidase & 5′-deiodinase.
  • Use: Hyperthyroidism
  • Tox: Skin rash, agranulocytosis (rare), aplastic anemia, hepatotoxicity.
31
Q

methimazole

A
  • blocks thyroid peroxidase
  • Use: Hyperthyroidism
  • Tox: Skin rash, agranulocytosis (rare), aplastic anemia, hepatotoxicity, possible teratogen (causing aplasia cutis).
32
Q

bromocriptine, capergoline

A
  • dopamine analog
  • PRL inhibitor
  • Use: hyperprolactinemia
  • Tox: dyskinesia, nausea, vomitting, psychosis
33
Q

Bisphosphonates

*-dronates

A
  • Dec. bone resorption by inhibiting osteoclasts.
  • Use: Paget disease, Osteoporosis, hypercalcemia
  • Tox: Corrosive esophagitis, osteonecrosis of the jaw.
34
Q

Teriparatide

A
  • Inc. bone density/mass.
  • Mech:PTH analog. Stimulates osteoblast activity, inc. GI absorption of Ca., inc. renal resorption of Ca.
  • Use: osteoporosis
  • Tox: never use more than 2 yrs due to inc. risk of osteosarcoma (cancer of osteoblasts).

*intermittent PTH stimulates bone formation whereas continuous PTH stimulates bone resorption.

35
Q

pegvisomant

A

GH receptor antagonist

Pharm (12 decks)

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