FA Endo Pharm

Question 1

Exact mechanism is unknown.
Dec gluconeogenesis, inc glycolysis, inc peripheral glucose uptake (insulin sensitivity); first line in type 2 DM.
SE: lactic acidosis (CI in RF, LF, CHF, check BUN/Cr before starting)

Answer 1

Metformin

Question 2

Close K+ channel in beta cell membrane, so cell depolarizes –> insulin release via Ca2+ influx.

Answer 2

Sulfonylureas (2G: glyburide, glimepiride, glipizide)

Question 3

Inc insulin sensitivity in peripheral tissue. Binds to PPAR-gamma nuclear transcription regulator –> increased insulin sensitivity and adiponectin.
SE: fluid retention, hepatox, hear failure

Answer 3

TZDs ( -glitazones)

Question 4

Inhibit intestinal brush border alpha glucosidases.

SE: GI disturbances

Answer 4

Acarbose and miglitol

Question 5

Decrease gastric emptying, decrease glucagon.

SE: hyoglycemia, nausea, diarrhea

Answer 5

Amylin analogs (Pramlintide)

Question 6

Increase insulin, decrease glucagon release.

Answer 6

GLP-1 analogs (Exenatide, Liraglutide)
- SE: N/V, pancreatitis
DPP-4 inhibitors (-gliptans)
- SE mild UTI or URTI

Question 7

Insulin - Lispro, Aspart, Glulisine

Answer 7

Rapid acting

Question 8

Insulin - Regular

Answer 8

Short acting

Question 9

Insulin - NPH

Answer 9

Intermediate acting

Question 10

Insulin - Glargine, Detemir

Answer 10

Long acting

Question 11

Ex: Glyburide, Glimepiride, Glipizide

Answer 11

Sulfonylureas

Question 12

Ex: Pioglitazone, Rosiglitazone

Answer 12

TZDs

Question 13

Ex: Acarbose, Miglitol

Answer 13

alpha-glucosidase inhibitors

Question 14

Ex: Pramlintide

Answer 14

amylin analog

Question 15

Ex: Exenatide, Liraglutide

Answer 15

GLP-1 analog

Question 16

Ex: Linagliptin, Saxagliptin, Sitagliptin

Answer 16

DPP-4 inhibitors

Question 17

Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine –> inhibition of thyroid hormone synthesis; ALSO blocks peripheral conversion of T4 to T3

Answer 17

PTU

Question 18

Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine –> inhibition of thyroid hormone synthesis; does NOT block peripheral conversion of T4 to T3

Answer 18

Methimazole

Question 19

Thyroxine replacement

Answer 19

Levothyroxine, triiodothyonine

Question 20

ADH antagonist (member of the tetracycline family).
SE: nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Answer 20

Demeclocycline

Question 21

Metabolic, catabolic, anti-inflammatory, and immunosuppressive effects mediated by interactions with glucocorticoid response elements and inhibition of transcription factors such as NF-kappaB.
SE: iatrogenic cushings - osteoporosis, diabetes, adrenal crisis if stopped

Answer 21

Glucocorticoids