Endocrinology Pharmacology COPY Flashcards

1
Q

What does Thyroid Peroxidase (TPO) and Thymosin do?

A

Help T-cells mature

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2
Q

What does vasoactive intestinal peptide (VIP) do?

A

Inhibits secretin, motilin, and CCK, and opens Sphincters

NOT SURE

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3
Q

How does a VIPoma present?

A

non-beta pancreatic islet cell tumor

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

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4
Q

How does a Somatostatinoma present?

A

Constipation

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5
Q

What are the hormones with disulfide bonds?

A

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

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6
Q

Which hormones have the same Alpha Subunits?

A

LH, FSH, TSH, and B-HCG

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7
Q

What hormones produce Acidophilus?

A

“GAP”: GH, Acidophilus, and Prolactin

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8
Q

What hormones produce Basophila?

A

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

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9
Q

What hormones are released from the posterior pituitary?

A

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

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10
Q

What is seen in Hashimoto’s Thyroiditis?

A

Antimicrosomal antibody and Anti-TPO antibody

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11
Q

What is the Mechanism of Action of Insulin?

A

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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12
Q

What are the Indications for Insulin?

A

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

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13
Q

What is the Adverse Effect of Insulin?

A

Hypoglycemia

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14
Q

What are the Rapid Acting Insulin drugs?

A

Aspart and Lispro

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15
Q

What is the Short Acting Insulin drug?

A

Regular Insulin

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16
Q

What is the Intermediate Acting Insulin drug?

A

NPH and Lente

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17
Q

What are the Long Acting Insulin drugs?

A

Ultralente, Glargine, and Protamine

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18
Q

What is the Mechanism of Action of Sulfonylureas?

A

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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19
Q

What are the indications for Sulfonylureas?

A

NIDDM (Type 2)

noninsulin-dependent diabetes mellitus

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20
Q

What is the Adverse Effect of Sulfonylureas?

A

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

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21
Q

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

A

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

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22
Q

What is the first generation Sulfonylureas?

A

Chlorpropamide and Tolbutamide

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23
Q

What is the Adverse Effect for first generation Sulfonylureas?

A

Disulfiram like effects (example: hypersensitivity to alcohol)

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24
Q

What is the second generation Sulfonylureas?

A

Glyburide, Glimepiride, and Glipizide

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25
Q

What is the MOA of Biguanides?

A

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

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26
Q

What are the Indications for Biguanides?

A

First line therapy in Type 2 DM

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27
Q

What is the Adverse effect of Biguanides?

A

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

2% of patients develop anemia each year
MUST CHECK CBC for anemia, B12 deficiency, GFR before prescribing

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28
Q

What are the Biguanides drugs?

A

Metformin

29
Q

What is the MOA of Glitazones/Thiazolidinedione’s?

A

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

30
Q

What are the Indications and contraindications for Glitazones/Thiazolidinedione’s?

A

indications: NIDDM. (Type 2)
noninsulin-dependent diabetes mellitus

Contraindications: heart failure

31
Q

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

A

Weight gain, edema, hepatotoxicity, bone loss

increases LDL and triglycerides

Contraindicated in patients with HF

32
Q

What are the Glitazones/Thiazolidinedione’s drugs?

A

Pioglitazone and rosiglitazone

33
Q

What is the MOA of Alpha-Glucosidase Inhibitors?

A

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

34
Q

What are the Indications for Alpha-Glucosidase inhibitors?

A

NIDDM. (Type 2)

noninsulin-dependent diabetes mellitus

35
Q

What is the Adverse Effect of Alpha-Glucosidase Inhibitors?

A

GI disturbances and may reduce absorption of iron

36
Q

What are the Alpha-Glucosidase Inhibitors?

A

Acarbose and Miglitol

37
Q

What is the MOA of Mimetics?

A

Decreases Glucagon

38
Q

What is the Indication for Mimetics?

A

NIDDM. (Type 2)

noninsulin-dependent diabetes mellitus

39
Q

What are the Adverse Effects of Mimetics?

A

Hypoglycemia, Nausea, Diarrhea

40
Q

What are the Mimetic drugs?

A

Pramlintide

41
Q

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

A

Increase Insulin
Decrease Glucagon release
delays absorption of food

42
Q

What is the Indication for GLP-1 Analogs?

A

NIDDM. (Type 2)
noninsulin-dependent diabetes mellitus

ALSO REDUCES CARDIOVASCULAR MORBIDITY AND MORTALITY

43
Q

What are the Adverse Effects of GLP-1 Analogs?

A

Nausea/Vomiting, weight gain, RARELY Pancreatitis

44
Q

What are the GLP-1 Analog drugs?

A

Exenatide and Liraglutide

45
Q

What is an SGLT2 inhibitor?

A

Inhibits the sodium-glucose transporter in the proximal tubule to decrease glucose reabsorption

46
Q

What are the indications/contraindications for SGLT2 inhibitors?

A

Type 2 DM

Also known to reduce cardiovascular morbidity and mortality

47
Q

Adverse effects of SGLT2 inhibitors

A

UTIs, vulvovaginal candidiasis. Can cause weight gain and decrease blood pressure

48
Q

What is the MOA of a Growth Hormone?

A

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

49
Q

What are the Indications for GH?

A

GH deficiency in children, Turner syndrome, and Burn victims

50
Q

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

A

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

51
Q

What are the Indications for Octreotide?

A

Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome

52
Q

What are the Indications for Oxytocin?

A

Induces labor and Controls uterine hemorrhage

53
Q

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

A

Recruits water channels to Luminal Membrane in collecting duct

54
Q

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

A

Antidiuresis and Central (pituitary) DI

55
Q

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

A

Over hydration and allergic reaction

56
Q

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

A

Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones

57
Q

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

A

Hyperthyroidism

58
Q

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

A

Agranulocytosis, skin rash and Aplastic Anemia

59
Q

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

A

Thyroxine replacement

60
Q

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

A

Hypothyroidism and Myxedema

61
Q

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

A

Tachycardia, heat intolerance, tremors and Arrhythmias

62
Q

What is the MOA of Demeclocycline?

A

ADH antagonist

63
Q

What is the Indication for Demeclocycline?

A

SIADH

64
Q

What are the Adverse Effects of Demeclocycline?

A

Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth

65
Q

What is the MOA of Glucocorticoids?

A

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

66
Q

What are the Indications for Glucocorticoids?

A

Addison’s disease; inflammation; immune suppression; asthma

67
Q

What are the Adverse Effects of Glucocorticoids?

A

Iatrogenic Cushing’s syndrome.

Adrenal insufficiency when drug stopped after chronic use

68
Q

What are the Glucocorticoid drugs?

A

Hydrocortisone, Triamcinolone, Dexamethasone, Prednisone, Beclomethasone