Endocrinology

Question 1

What drug class is Insulin?

Answer 1

Insulin

Question 2

What are the indications for Insulin?

Answer 2

Type 1 DM
Type 2 DM
Diabetic emergency - DKA
Hyperkalaemia

Question 3

How does insulin work?

Answer 3

Insulin stimulate glycogen, lipid and protein synthesis
Inhibits ketogenesis, gluconeogenesis
Insulin pushes potassium into cells

Question 4

What are the side effects of insulin?

Answer 4

Hypoglycaemia
Lipohypertrophy at injection sites
Weight gain

Question 5

What are the contraindications of insulin?

Answer 5

Renal impairment

Question 6

Important drug interactions of insulin?

Answer 6

Corticosteroids increases insulin requirements

Question 7

What drug class is Glicazide?

Answer 7

Sulphonylureas

Question 8

What are the indications for Sulphonylureas?

Answer 8

Type 2 DM (second line)

Question 9

How do Sulphonylureas work?

Answer 9

Decrease blood glucose

Stimulate pancreas to secrete insulin

Question 10

What are the side effects of Sulphonylureas?

Answer 10

Hypoglycaemia

Weight gain

Question 11

What are the contraindications of Sulphonylureas?

Answer 11

Type 1 DM
Renal impairment
Hepatic impairment

Question 12

Important drug interactions of Sulphonylureas?

Answer 12

Other anti-diabetic drugs - hypos

Question 13

What drug class is Metformin?

Answer 13

Biguanides

Question 14

What are the indications for Biguanides?

Answer 14

DM 2

Question 15

How do Biguanides work?

Answer 15

Increasing the response (sensitivity) to insulin

Reduces weight gain

Question 16

What are the side effects of Biguanides?

Answer 16

GI upset
Lactic acidosis (rare)

Question 17

What are the contraindications of Biguanides?

Answer 17

Renal impairment
AKI
Severe tissue hypoxia
Acute alcohol intoxication

Question 18

Important drug interactions of Biguanides?

Answer 18

Witheld before and after for 48 hours with IV contrast media
Drugs that impair renal function

Question 19

What drug class is Thyroxine?

Answer 19

Thyroid hormones

Question 20

What are the indications for Thyroid hormones?

Answer 20

Primary Hypothyroidism

Hypothyroidism secondary to hypopituitarism

Question 21

How do Thyroid hormones work?

Answer 21

Levothyroxine is T4
Liothyronine is T3 (shorter half life)
Thyroid hormones regulate metabolism and growth

Question 22

What are the side effects of Thyroid hormones?

Answer 22

Usually due to excessive doses - hyperthyroidism

Question 23

What are the contraindications of Thyroid hormones?

Answer 23

Precipitate cardiac ischaemia in coronary artery disease

Must give with a corticosteroid in thyroid hormone replacement to avoid Addisonian crisis

Question 24

Important drug interactions of Thyroid hormones?

Answer 24

Increased dose needed in patients taking P450 inducers

Question 25

What drug class is Carbimazole?

Answer 25

Anti-thyroid drugs

Question 26

What are the indications for Anti-thyroid drugs?

Answer 26

Hyperthyroidism

Question 27

How do Anti-thyroid drugs work?

Answer 27

Converted to active form after absorption | P

Question 28

What are the side effects of Anti-thyroid drugs?

Answer 28

``` GI Headache Muscle, joint pain Skin rash Changes to the way things taste Mouth ulcers (rare) ```

Question 29

What are the contraindications of Anti-thyroid drugs?

Answer 29

Severe blood disorders Hepatic impairment Pregnancy Breast feeding

Question 30

What are the contraindications of Bisphosphonates?

Answer 30

Severe renal impairment Hypocalcaemia Not allowed oral in Upper GI disorders Care in giving to patients that smoke or have dental disease

Question 31

Important drug interactions of Bisphosphonates?

Answer 31

Don't take with calcium - absorption of it will be reduced

Question 32

What drug class is Colecalciferol and Calcium Carbonate?

Answer 32

Vitamin D (colecalciferol) and Calcium

Question 33

What drug class is Colecalciferol and Calcium Carbonate?

Answer 33

Vitamin D (colecalciferol) and Calcium

Question 34

What are the indications for Vit D and Calcium?

Answer 34

``` Osteoporosis CKD Severe hyperkalaemia (calcium gluconate) Hypocalcaemia Vit D deficiency - Rickets (children), osteomalacia (vit D) ```

Question 35

How does Vit D and Calcium work?

Answer 35

Osteoporosis - (positive calcium balance) when sunlight and diet are insufficient CKD - secondary hyperparathryoidism leading to renal osteodystrophy Calcium raises myocardial threshold potential

Question 36

What are the side effects of Vit D and Calcium?

Answer 36

Calcium - dyspepsia, constipation | IV calcium gluconate can cause cardiovascular collapse if given too fast

Question 37

What are the contraindications of Vit D and Calcium?

Answer 37

Hypercalcaemia

Question 38

Important drug interactions of Vit D and Calcium?

Answer 38

Oral calcium reduces absorption of iron, bisphosphonates, tetracyclines and levothyroxine

Question 39

What drug class is Fludrocortisone?

Answer 39

Mineralocorticoids

Question 40

What are the indications for Mineralocorticoids?

Answer 40

Addison's disease | Adrenal cortical insufficiency

Question 41

What are the side effects of Mineralocorticoids?

Answer 41

``` Muscle weakness Oedema Hypertension Impaired wound healing Hirsutism Raised intracranial pressure ```

Question 42

How do Mineralocorticoids work?

Answer 42

Cause kidneys to retain sodium Reabsorb water Binds to aldosterone receptor (I am chatting shit)

Question 43

What are the contraindications of Mineralocorticoids?

Answer 43

``` Children (growth restriction) Elderly Patients with TB Hepatic Failure Renal Failure ```

Question 44

Important drug interactions of Mineralocorticoids?

Answer 44

Loads