Endocrinology Drugs Flashcards
what does insulin do
lowers plasma glucose concentration by:
stimulating glucose transport into fat and muscle
glycogen synthesis
inhibits gluconeogenesis and lipolysis
what effect does insulin have on K+ levels
drives K+ into cells, lowering plasma concentration
used in treatment of hyperkalaemia alongside glucose
what is Gliclazide and how does it work?
Sulphonylurea
lowers blood glucose by stimulating insulin secretion
only effective in pts with residual pancreatic function
How does Metformin work?
Biguanide
lowers blood glucose by increasing sensitivity to insulin
suppresses glycogenolysis and gluconeogenesis
suppresses intestinal glucose absorption
why doesn’t metformin cause hypoglycaemia
doesn’t stimulate insulin secretion
contraindications of metformin
excreted unchanged by the kidney, so cannot give in severe renal impairment
can causes lactic acidosis in alcoholics
IV contrast media
what beneficial side effects does metformin have
reduces appetite, reduces weight gain, can even induce weight loss
what is thyroxine and levothyroxine
T4 - produced by thyroid gland, converted to active form T3 in target tissues
synthetic T4
indications for levothyroxine
primary hypothyroidism
hypothyroidism secondary to hypopituitarism
what must be started before giving thyroxine in hypopituitarism
corticosteroid therapy, to avoid precipitating an Addisonian Crisis
How does Carbimazole work?
inhibits thyroid peroxidase, reducing production of T3/T4
important contraindication of Carbimazole
can disrupt oestrogen production, risk of congenital defects in pregnancy
side effects of Carbimazole?
rashes and pruritus common (antihistamines)
bone marrow suppression (rare)
what kind of drug is Alendronic acid, and how does it work?
Bisphosphonate
inhibits osteoclasts = increase in bone mass
what are the potential side effects of alendronate?
oesophagitis
Hypophosphataemia, hypocalcaemia
osteonecrosis of the jaw
what kind of drug is fludrocortisone and how does it work?
mineralocorticoid
mostly made up to aldosterone
what does cortisol do
increases blood sugar through gluconeogenesis
suppresses the immune system
aids metabolism of fat, protein and carbs
indications for fludrocortisone
andrenogenital syndrome
postural hypotension
adrenal insufficiency - i.e. Addison’s disease
side effects of fludrocortisone
oedema, hypertension, hirsutism, decreased bone density, headache, dizziness, GI disturbance
briefly summarise the drugs to learn for diabetes
Insulin - increases absorption
Gliclazide (sulphonylurea) - stimulates pancreatic production of insulin
Metformin (biguanide) - increases sensitivity to insulin
