Endocrinology Pharmacology Flashcards
What does Thyroid Peroxidase (TPO) and Thymosin do?
Help T-cells mature
What does vasoactive intestinal peptide (VIP) do?
Inhibits secretin, motilin, and CCK, and opens Sphincters
NOT SURE
How does a VIPoma present?
non-beta pancreatic islet cell tumor
Watery diarrhea, hypokalemia, and achlorhydria (absence of hydrochloric acid in the gastric secretions)
How does a Somatostatinoma present?
Constipation
What are the hormones with disulfide bonds?
“PIIG”: Prolactin, Insulin, Inhibin, GH (growth hormone)
Which hormones have the same Alpha Subunits?
LH, FSH, TSH, and B-HCG
What hormones produce Acidophilus?
“GAP”: GH, Acidophilus, and Prolactin
What hormones produce Basophila?
“B FLAT”: Basophils, FSH, LH, ACTH, and TSH
What hormones are released from the posterior pituitary?
ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins
What is seen in Hashimoto’s Thyroiditis?
Antimicrosomal antibody and Anti-TPO antibody
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
What are the Indications for Insulin?
DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes
What is the Adverse Effect of Insulin?
Hypoglycemia
What are the Rapid Acting Insulin drugs?
Aspart and Lispro
What is the Short Acting Insulin drug?
Regular Insulin
What is the Intermediate Acting Insulin drug?
NPH and Lente
What are the Long Acting Insulin drugs?
Ultralente, Glargine, and Protamine
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
What are the indications for Sulfonylureas?
NIDDM (Type 2)
noninsulin-dependent diabetes mellitus
What is the Adverse Effect of Sulfonylureas?
Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy
Function of what cells is necessary for the action of Sulfonylureas?
Requires some islet cell function, so drugs is USELESS in Type 1 DM
What is the first generation Sulfonylureas?
Chlorpropamide and Tolbutamide
What is the Adverse Effect for first generation Sulfonylureas?
Disulfiram like effects (example: hypersensitivity to alcohol)
What is the second generation Sulfonylureas?
Glyburide, Glimepiride, and Glipizide
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