Extra Clinical in Endocrine Flashcards
What is the action of sulfonylureas?
displacing the binding of ADP-Mg2+ from the SUR subunit (closing the KATP channel)
Give some examples of sulfonylureas.
Tolbutamide, glibenclamide, glipizide
Undesirable effects of sulfonylureas?
weight gain
may cause hypoglycaemia
How do glinides work?
bind to SUR at distinct site close to Katp channel
Which two hormones are released from the small intestine causing enhanced insulin resistance?
GLP-1 and GIP
Which cells are GIP1 and GIP released from?
L cells in ileum and colon
K cells in jejenum/duodenum
Mechanism of incretin analogues?
mimic action of GLP-1 but are longer lasting
Desirable effects in incretin analogues?
reduce hepatic fat accumulation
weight loss
How are incretin analogyes administered?
subcutaneously, twice a day
Adverse effects of incretin analogues?
hypoglycaemia
nausea
pancreatitis (rare)
What are gliptins?
Competitive DPP 4 inhibitors
Do gliptins/DPP4 inhibitors cause hypoglycaemia?
no
What is DPP-4?
an enzyme that terminated the actions of GLP-1 and GIP
What is acarbose?
alpha-glucosidase inhibitor
What is alpha-glucosidase?
an enzyme that breaks down starch and disaccharides into glucose
In who is acarbose used?
T2DM patients inadequately controlled by other drugs
Where do the adverse effects of acarbose occur?
GI tract
What is metformin?
biguanine
What is the mechanism of metformin?
reduced hepatic gluconeogenesis, increases glucose uptake by skeletal muscle, reduces carb absorption, increased fatty acid oxidation
What do glitazones do?
Enhance action of insulin at target tissues
What is dapagliflozin
Sodium-glucose cotransporter inhibitor
Who is tertiary hyperparathyroidism most commonly seen in?
patients with chronic renal failure
How do steroids cause osteoporosis?
by blocking production of interleukin
Name two antithyroid drugs.
carbimazole and PTU
