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A - USMLE Step 1 Pharm > Endocrinology - Pharmacology > Flashcards

Endocrinology - Pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

Insulin - Mechanism (3) + Treatment Toxicities (3)

A

Mechanism - Binds Insulin Receptor 1

1) Increase liver glycogen production and glucose uptake
2) Increase muscle glycogen uptake
3) TG Storage

Toxicities

1) Hypogylcemia
2) Weight Gain
3) Lipodystrophy

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2
Q

4 Major Classes of Insulin Preparations (7 Names - 3,1,1,2)

A

1) Rapid Acting - Aspart + Glulisine + Lispro
2) Short Acting - Natural
3) Intermediate Acting - Neutral Protamine Hagedorn (NPH)
4) Long Acting - Detemir + Glargine

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3
Q

Sulfonylureas - Names (3) + Mechanism + Use + Toxicities (2)

A

Names - Glipizide + Glimepiride
Mechanism - Close B-Cell K+ Channels - Easier depolarization - Increased Ca2+ release - Increased Insulin release
Use - Type II DM (No DM i Use - needs functioning Beta-Cells
Toxicities - Hypoglycemia + Weight Gain + Renal Toxicity

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4
Q

Biguanindes - Names + Mechanism + Use + Toxicities (2)

A

Name - Metformin
Mechanism - Unknown - Increased Glycolosis + Reduces gluconeogenesis + Increased insulin sensitivity

Use - Type II DM
Toxicity - GI Disturbances + Risk of Lactic Acidosis (Anion Gap) - Don’t use in renal insufficiency + Alcoholics

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5
Q

Thizolinidediones - Names (2) + Mechanism + Use + Toxicities (5)

A

Names - Rosiglitazone + Pioglitazone
Mechanism - Binds PPAR-Gamma Nuclear Factor - Increases insulin sensitivity (esepcially in adipose tissue - Key for exam!)

Use - Type II DM
Toxicity - Weight Gain + Edema + Hepatotoxicity + Increased Bone Fxs + CHF/MI Warning (Especially in Rosiglitazone - Lower in Pioglizatone)

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6
Q

Alpha-Glucosidase Inhibitors - Name + Mechanism + Use + Toxicities (3)

A

Name - Acarbose
Mechanism - Inhibit intestinal brush border alpha-glucosiades - Delays carbohydrate absorption and decreases post-prandial hyperglycemia

Use - Type I and II DM
Toxicity - GI Disturbances (Diarrhea)

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7
Q

Glucagon Like Peptide 1 Therapy - Name + Mechanism + Use + Toxicities (3)

A

Name - Exenatide
Mechanism - Increased insulin with decreased glucagon release

Use - Type II DM
Toxicity - Nausea + Vomiting + Pancreatitis

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8
Q

DPP-4 Inhibitors - Name + Mechanism + Use + Toxicities (3)

A

Name - Sitagliptin
Mechanism - Increased insulin with decreased glucagon release

Use - Type II DM
Toxicity - Mild increase in UTI/Respiratory Infection - KEY FOR EXAM

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9
Q

Amylin Agonists - Name + Mechanism + Use + Toxicities (3)

A

Name - Pramlintide
Mechanism - Decrease gastric emptying and glucagon

Use - Type I and II DM
Toxicity - Hypoglyecemia + GI Disturbances + Headache

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10
Q

SGLT2 Inhibitors Name + Mechanism + Use + Toxicities (3)

A

Name - Canaglifozin
Mechanism - Reduce kidney glucose re absorption

Use - Type II DM
Toxicity - Glucosuria + UTIs + Vaginal Year Infections

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11
Q

Glulisine - Class + Use

A

Rapid Acting Insulin

Type I DM

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12
Q

Glipizide - Class + Use

A

Sulfonylurea

Type II DM

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13
Q

Acarbose - Class + Use

A

Alpha-Glucosidase Inhibitor

Type II DM

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14
Q

Glargine - Class + Use

A

Long Acting Insulin

Type I DM

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15
Q

Exenatide - Class + Use

A

GLP-1 Agonist

Type II DM

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16
Q

Aspart - Class + Use

A

Rapid Acting Insulin

Type I DM

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17
Q

Rosiglitazone - Class + Use

A

Thiazolidinediones

Type II DM - Increases Insulin Sensitivity in Adipose

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18
Q

Metformin - Class + Use

A

Biguanides

Type II DM

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19
Q

Detemir - Class + Use

A

Long Acting Insulin

Type I DM

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20
Q

Netrual Protamine Hagedorn - Class + Use

A

Intermediate Acting Insulin

Type I DM

21
Q

Glimepiride - Class + Use

A

Sulfonylurea

Type II DM

22
Q

Lispro - Class + Use

A

Short Acting Insulin

Type I DM

23
Q

Pioglitazone - Class + Use

A

Thiazolidinediones
Type II DM - Increases Insulin Sensitivity in Adipose
Less Cardiotoxic vs. Rsiglitazone

24
Q

Canaglifozin - Class + Use

A

SGLT-2 Inhibitor

Type II DM

25
Q

Pramlintide - Class + Use

A

Amylin Agonist

Type I and II DM Sitagliptin

26
Q

Sitagliptin - Class + Use

A

DPP-4 Inhibitor

Type II DM

27
Q

Somatropin - Uses (2,2) + Toxicities (3,3)

A

Recombinant GH for Low GH

Children - GH Deficiency + Genetic Disorders (Turner’s + Prader Willi)
Adults - Anabolics + Reduce Generalized Obesity

Childhood AEs

1) Psuedotumor
2) Edema
3) Hyperglycemia

Adult AEs

1) Peripheral Edema
2) Arthralgias
3) Carpal tunnel

28
Q

Mecasermin - Mechanism + Use + Toxicity

A

Recombinant IGF-1

IGF-1 Deficiency with no response to GH

Hypoglycemia - Take before a meal

29
Q

Growth Hormone Antagonist - Name + Mechanism + Use + Toxicity

A

Pegvisomant

Blocks GH Receptor Signalling

Used for Acromegaly

AE = Increased Liver Enzymes

30
Q

Somatonstatin Analog - Name + Mechanism + Uses (2) + Toxicities (3)

A

Octerotide

Mechanism - Inhibits GH Release via the dopamine pathway

Use - Acromegaly + Pituitary Tumors

AEs - GI Disturbances + Gallstones + Bradycardia/Conduction Abnormalities

31
Q

Gonadotropin Analogs - Names (3) + Use + Toxicities (2)

A

Urofollitropin = FSH
Lutropin = LH
Choriogonadotropin Alpha = Recombinant hCG

Use - IVF with ovulatory hyperstimulation

AEs - Ovarian Hyperstimulation Syndrome (Ascites + Ovarian Enlargement + Hypovolumic Shock) + Multiple Pregnancies

32
Q

GnRH Agonist - Names (3) + Mechanism + Uses (4)

A

Leuprolide + Gonadorelin + Goserelin

Increased GnRH reduces the Pulse –> No pulse results in less FSH/LH (need to pulse to produce)

Uses

1) Endometriosis (reduce LH = reduce E2)
2) Uterine Lieomyoma (reudce LH = reduce E2)
3) Prostate Cancer (reduce testosterone = reduce dihydro-testosterone = less prostate growth)
4) Central Precocious Puberty

33
Q

GnRH Agonist Toxicities - Male (2) + Female (4)

A

Male

1) Decreased Libido
2) Reduced Bone Density

Female

1) Osteoporosis
2) Vaginal Dryness
3) Menopause S/Sx
4) Depression

34
Q

Pegvisomant - Class + Use

A

Growth Hormone Antagonist

Acromegaly

35
Q

Octerotide - Class + Use

A

Somatostatin Analog

Inhibit GH Release = Acromegaly + Pituitary Tumor

36
Q

Leuprolide - Class + Use

A

GnRH Agonist

1) Endometriosis (reduce LH = reduce E2)
2) Uterine Lieomyoma (reudce LH = reduce E2)
3) Prostate Cancer (reduce testosterone = reduce dihydro-testosterone = less prostate growth)
4) Central Precocious Puberty

37
Q

Dopamine (D2) Agonist - Names (2) + Uses + Mechanism + Toxicities (3)

A

Bromocriptine + Cabergoline

Prolactinemia

Dopamine inhibits prolactin production (normal function is to prevent premature lactation in female)

AEs

1) Nausea (Less with Cabergoline)
2) Headache
3) Orthostatic HTN

38
Q

Oxytocin - Use (2) + Toxicity (3)

A

Used to induce + control uterine hemorrhage after delivery

Toxicity - Super Rare

1) Fetal Distress
2) Placental Abruption
3) Uterine Rupture (massive contractions)

39
Q

Goserelin - Class + Use

A

GnRH Agonist

1) Endometriosis (reduce LH = reduce E2)
2) Uterine Lieomyoma (reudce LH = reduce E2)
3) Prostate Cancer (reduce testosterone = reduce dihydro-testosterone = less prostate growth)
4) Central Precocious Puberty

40
Q

Bromocriptine - Class + Use

A

D2 Agonist

Prolactinoma

41
Q

Cabergoline - Class + Use

A

D2 Agonist

Prolactinoma (less nausea)

42
Q

Glucocoritcoids - Uses + Toxicities (3)

A

Uses - Inflammatory Disease + Organ Transplant

Toxicity - Cushingoid - Hyperglycemia + Purple Striae + Protein Catabolism

43
Q

Primary Adrenal Insufficiency - Treatments (2)

A

1) Corticosteroid

2) Fludrocortisone (Aldosterone Mimic)

44
Q

Acute Adrenal Insufficiency - Treatments (3)

A

1) Cortisol
2) Fluids
3) Potassium - Must give because even though hyperkalemic all the intracellular K+ has been depleted

45
Q

Glucocorticoid that crosses the placenta?

A

Dexamethasone

46
Q

Mifepristone - Class + Use + Mechanism

A

Glucocorticoid Receptor Antagonist

Used for Cushing Syndrome

47
Q

Pasireotide - Class + Use + Mechanism

A

Somatostain Receptor Agonist

Increases somatostain which inhibits ACTH release and thus cortisol

48
Q

Spironlactone - Treatment Uses (2) + Mechanism + Toxicities

A

Conn Syndrome (to reduce aldosterone)

Antagonizes aldosterone

AEs

1) Gynecomastia
2) Decreased Libido
3) Menstrual Irregularities

A - USMLE Step 1 Pharm (11 decks)

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