Endocrinology Pharmacology Flashcards by Doc JdP

What does Thyroid Peroxidase (TPO) and Thymosin do?

Help T-cells mature

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What does vasoactive intestinal peptide (VIP) do?

Inhibits secretin, motilin, and CCK, and opens Sphincters

NOT SURE

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How does a VIPoma present?

non-beta pancreatic islet cell tumor

Watery diarrhea, hypokalemia, and achlorhydria (absence of hydrochloric acid in the gastric secretions)

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How does a Somatostatinoma present?

Constipation

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What are the hormones with disulfide bonds?

“PIIG”: Prolactin, Insulin, Inhibin, GH (growth hormone)

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Which hormones have the same Alpha Subunits?

LH, FSH, TSH, and B-HCG

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What hormones produce Acidophilus?

“GAP”: GH, Acidophilus, and Prolactin

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What hormones produce Basophila?

“B FLAT”: Basophils, FSH, LH, ACTH, and TSH

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What hormones are released from the posterior pituitary?

ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins

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What is seen in Hashimoto’s Thyroiditis?

Antimicrosomal antibody and Anti-TPO antibody

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What is the Mechanism of Action of Insulin?

Pushes K+ into the cell,
Liver: Increases Glucose storage as Glycogen, Increases Triglyceride synthesis.
Muscle: Increases protein and glycogen synthesis.
Adipose Tissue: Improves Triglycerde storage by activating Lipoprotein Lipase, Decrease circulating Free Fatty Acids

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What are the Indications for Insulin?

DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes

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What is the Adverse Effect of Insulin?

Hypoglycemia

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What are the Rapid Acting Insulin drugs?

Aspart and Lispro

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What is the Short Acting Insulin drug?

Regular Insulin

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What is the Intermediate Acting Insulin drug?

NPH and Lente

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What are the Long Acting Insulin drugs?

Ultralente, Glargine, and Protamine

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What is the Mechanism of Action of Sulfonylureas?

Closes K+ channel in the pancreatic Beta cell membrane,

Reduces K+ efflux & increases Ca (2+) influx, and cell depolarize to increase secretion of insulin

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What are the indications for Sulfonylureas?

NIDDM (Type 2)

noninsulin-dependent diabetes mellitus

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What is the Adverse Effect of Sulfonylureas?

Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy

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Function of what cells is necessary for the action of Sulfonylureas?

Requires some islet cell function, so drugs is USELESS in Type 1 DM

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What is the first generation Sulfonylureas?

Chlorpropamide and Tolbutamide

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What is the Adverse Effect for first generation Sulfonylureas?

Disulfiram like effects (example: hypersensitivity to alcohol)

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What is the second generation Sulfonylureas?

Glyburide, Glimepiride, and Glipizide

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What is the MOA of Biguanides?

Decrease Gluconeogenesis, Increase Glycolysis, and Increase peripheral Glucose uptake. (Insulin sensitivity)

What are the Indications for Biguanides?

First line therapy in Type 2 DM

What is the Adverse effect of Biguanides?

Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast Do not prescribe any NSAID/painmeds focused on kidney filtration => kidney failure

What are the Biguanides drugs?

Metformin

What is the MOA of Glitazones/Thiazolidinedione's?

Increases Insulin sensitivity in peripheral tissues. Transaction modulation by Peroxisome Proliferator Activated Receptor Gamma in Nucleus (PPAR-gamma)

What are the Indications for Glitazones/Thiazolidinedione's?

NIDDM. (Type 2) | noninsulin-dependent diabetes mellitus

What is the Adverse Effect of Glitazones/Thiazolidinedione's?

Weight gain, edema, hepatotoxicity, increases LDL and triglycerides, CHF and Contraindicated

What are the Glitazones/Thiazolidinedione's drugs?

Pioglitazone and rosiglitazone

What is the MOA of Alpha-Glucosidase Inhibitors?

Inhibits intestinal brush border Alpha-Glucosidases, Delays sugar hydrolysis and Glucose absorption from the gut, Decreases postprandial hyperglycemia

What are the Indications for Alpha-Glucosidase inhibitors?

NIDDM. (Type 2) | noninsulin-dependent diabetes mellitus

What is the Adverse Effect of Alpha-Glucosidase Inhibitors?

GI disturbances and may reduce absorption of iron

What are the Alpha-Glucosidase Inhibitors?

Acarbose and Miglitol

What is the MOA of Mimetics?

Decreases Glucagon

What is the Indication for Mimetics?

NIDDM. (Type 2) | noninsulin-dependent diabetes mellitus

What are the Adverse Effects of Mimetics?

Hypoglycemia, Nausea, Diarrhea

What are the Mimetic drugs?

Pramlintide

What is the MOA of GLP-1 Analogs (glucagon like peptides)?

Increase Insulin and Decrease Glucagon release

What is the Indication for GLP-1 Analogs?

NIDDM. (Type 2) | noninsulin-dependent diabetes mellitus

What are the Adverse Effects of GLP-1 Analogs?

Nausea, Vomiting and Pancreatitis

What are the GLP-1 Analog drugs?

Exenatide and Liraglutide

What is the MOA of a Growth Hormone?

Stimulates liver production of insulin-like growth factors and gastric emptying

What are the Indications for GH?

GH deficiency in children, Turner syndrome, and Burn victims

What is the MOA of Octreotide (Synthetic analog of Somatostatin)?

Decreases release of GH, Gastrin, CCK, Carcinoid, VIP, Glucagon and Insulin

What are the Indications for Octreotide?

Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome

What are the Indications for Oxytocin?

Induces labor and Controls uterine hemorrhage

What is the MOA of Desmopressin (DDAVP)/ADH?

Recruits water channels to Luminal Membrane in collecting duct

What are the Indications for Desmopressin (DDAVP)/ADH?

Antidiuresis and Central (pituitary) DI

What are the Adverse Effects of Desmopressin (DDAVP)/ADH?

Over hydration and allergic reaction

What is the MOA of PTU(Propylthiouracil) and Methimazole?

Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones

What is the Indication for PTU(Propylthiouracil) and Methimazole?

Hyperthyroidism

What are the Adverse Effects of PTU(Propylthiouracil) and Methimazole?

Agranulocytosis, skin rash and Aplastic Anemia

What is the MOA of Levothyroxine (T4)/Triiodothyronine (T3)?

Thyroxine replacement

What are the indications for Levothyroxine (T4)/Triiodothyronine (T3)?

Hypothyroidism and Myxedema

What are the Adverse Effects of Levothyroxine (T4)/Triiodothyronine (T3)?

Tachycardia, heat intolerance, tremors and Arrhythmias

What is the MOA of Demeclocycline?

ADH antagonist

What is the Indication for Demeclocycline?

SIADH

What are the Adverse Effects of Demeclocycline?

Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth

What is the MOA of Glucocorticoids?

Decrease production of Leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2

What are the Indications for Glucocorticoids?

Addison's disease; inflammation; immune suppression; asthma

What are the Adverse Effects of Glucocorticoids?

Iatrogenic Cushing's syndrome. | Adrenal insufficiency when drug stopped after chronic use

What are the Glucocorticoid drugs?

Hydrocortisone, Triamcinolone, Dexamethasone, Prednisone, Beclomethasone