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Endocrinology Flashcards

1
Q

Insulin

A

Peptide Hormone

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2
Q

Mechanisms of Insulin

A

Lowers plasma glucose concentration by:
stimulating glucose transport into fat and muscle cells
Stimulating glycogen synthesis in the liver
Inhibiting gluconeogenesis and lipolysis
Increasing protein synthesis and decreases protein breakdown

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3
Q

Indications for Insulin

A 
Type 1 Diabetes (Essential)
Type 2 Diabetes (if islet cells are damaged)
Diabetic Ketoacidosis
Hyperosmolar non-ketotic coma (HONK)
Gestational Diabetes
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4
Q

Side effects for Insulin

A

Hypoglycaemia: dizziness, sweating, weakness, confusion

Weight gain

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5
Q

Interactions for Insulin

A
  • Beta blockers may ask signs of low blood sugar

- Don’t combine with Sulfonylureas

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6
Q

Patient Information for Insulin

A

Notify DVLA if taking anti-diabetic drugs or insulin

Insulin doesn’t cross placenta so no risk to baby but poor control of diabetes increases risk of birth defects

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7
Q

Glicazide

A

Sulphonylureas

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8
Q

Mechanism of Sulphonylureas

A

Stimulates production and secretion of insulin from the islet cells in the pancreas. Promoting uptake of sugar into cells lowering blood sugar levels.

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9
Q

Indications for Sulphonylureas

A

Type 2 Diabetes (2nd line)

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10
Q

Contraindications for Sulphonylureas

A 
Pregnancy 
Hepatic and renal insufficiency 
Ketoacidosis
Allergic to Sulphonylureas
Thyroid problems 
Porphyria
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11
Q

Side effects of Sulphonylureas

A 
Hypoglycaemia 
Weight gain 
Nausea and vomiting, diarrhoea, constipation 
Hepatotoxicity 
Hypersensitivity 
Anaemia
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12
Q

Interactions of Sulphonylureas

A

Drugs that can reduce effect of Sulphonylureas: corticosteroids, oestrogens,NSAIDS, diuretics and rifampicin

Drugs that increase the effect of Sulphonylureas: warfarin, sulphonamides, antibacterials, aspirin, beta blockers, ACE inhibitors and antifungals

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13
Q

Metformin

A

Biguanide

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14
Q

Mechanism of Metformin

A

Delays absorption of glucose, reducing glucose production in the liver.
Improves body’s sensitivity toward insulin and reduces amount of sugar absorbed by the intestines. Used in conjunction with good diet and exercise

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15
Q

Indications of Metformin

A

Type 2 Diabetes (1st line)

Polycystic Ovarian Syndrome

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16
Q

Contraindications of Metformin

A

Pregnancy and breastfeeding

Hepatic and renal insufficiency

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17
Q

Side effects of Metformin

A

Nausea and vomiting
Diarrhoea
Lactic acidosis (rare)
Prolonged treatment ca deplete reserves of Vitamin B12 causing anaemia

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18
Q

Interactions of Metformin

A

Warfarin can be more effective with Metformin

Drugs that reduce effect of metformin: corticosteroids, oestrogens and diuretics

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19
Q

Levothyroxine

A

Thyroid Hormone

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20
Q

Mechanism of Levothyroxine

A

Levothyroxine is the main hormone produced by thyroid glands. Increases oxygen consumption of active tissues

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21
Q

Indications of Levothyroxine

A

Hypothyroidism
Thyroid Cancer
Overactive Thyroid Gland

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22
Q

What is Levothyroxine given with when treating an Overactive Thyroid Gland

A

Carbimazole or Prophylthiouracil

23
Q

Contraindications for Levothyroxine

A

Pregnancy
Diabetes
Heart problems
High blood pressure

24
Q

Side effects of Levothyroxine

A

Hyperthyroidism

25
Interactions of Levothyroxine
``` Oral Anticoagulants Colestyramine Amiodarone Antidiabetic agents Antiepileptic agents Sucralfate Antidepressants Oral contraceptives ```
26
Carbimazole
Anti-thyroid drugs
27
Mechanism of Carbimazole
Suppresses formation of thyroid hormones and used to manage overactive thyroid glands
28
Indications of Carbimazole
Hyperthyroidism (1st line)
29
Contra-indications of Carbimazole
Liver problem | Pregnant
30
Side effects of Carbimazole
Agranulocytosis: reduction in white blood cells, increasing risk of infection indicate by sore throat, fever or mouth ulcer
31
Interactions of Carbimazole
Theophylline blood levels may increase with Carbimazole
32
Alendronate (Fosamax)
Bisphosphonates
33
Mechanism of Bisphosphonates
Inhibit bone resorption (breakdown of bone).
34
Indications of Alendronate
Corticosteroid-induced Osteoporosis Post-menopausal Osteoporosis Paget's disease of bone Hypercalcaemia of malignancy
35
How to optimise effect of Alendronate
Calcium and Vitamin D should be prescribed with the drug if amounts are not adequate. But calcium should not be taken at the same time as Aledronate as calcium reduces its absorption
36
Contraindications of Alendronate
Pain or difficult swallowing as risk of ulcer formation Peptic ulcers or stomach problems Kidney problems Low calcium blood levels Pregnant Unable to sit or stand upright for at least 30mins
37
Side effects of Alendronate
Abdominal pain Gastric and oesophageal ulceration Renal toxicity
38
Interactions of Alendronate
Antacids, calcium and iron salts prevent absorption of Alendronic acid and should be taken at a different time
39
Patient information for Alendronate
Once daily first thing in the morning with TAP water. After taking tablet remain upright for at lesat 30mins.
40
Calcium
Mineral/ Essential Ion
41
Indications for Calcium
Hypocalcaemia Hyperkalaemia Prevention of Osteoporosis (with Vitamin D)
42
Side effects of Calcium
GI problems Bradycardia Arrhythmias Hypercalcaemia
43
Interactions of Calcium
Digoxin effects enhanced
44
Calciferol
Vitamin D
45
Indications of Calciferol
``` Vitamin D deficiency Osteoporosis Hypoparathyroidism Renal Osteodystrophy Anti-convulsant-induced osteomalacia Congenital rickets Plaque psoriasis topical treatment ```
46
Contraindications of Calciferol
Hypercalcaemia Metastatic calcification Breastfeeding
47
Side effects of Calciferol
Hypercalcaemia causing nausea and vomiting, anorexia, thirst Local itching, erythema, dermatitis
48
Calcipotriol (Devonex)
Vitamin D derivative used to treat plaque Psoriasis by reducing production of skin cells that cause thickening.
49
Fludrocortisone Acetetate
Mineralocorticoid
50
Mechanism of Fludrocortisone Acetate
Controls amount of sodium and fluid in the body by decreasing amount of sodium that is excreted in the urine
51
Indications of Fludrocortisione
Addison's disease | Postural Hypotension
52
Contraindications for Fludrocortisone
``` Tuberculosis Infection due to a fungus Low thyroid hormone levels Diabetes Cushing's Syndrome Myasthenia Gravis Glaucoma ```
53
Side effects of Fludrocortisone
``` Anxiety, fatigue, headache Cushing's Syndrome Electrolyte imblance Fluid retention Adrenal suppression ```

Y3 Drugs (9 decks)

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