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STEP 3 Uworld > IM endo medications > Flashcards

IM endo medications Flashcards

1
Q

Major drug interactions of levothyroxine - decreased absorption

A
  1. bile acid binding agents
  2. iron, calcium, alum hydroxide
  3. PP, sucralfate
    always 30-60 hour before brekfast (4 hours seperated from iron)
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2
Q

Major drug interactions of levothyroxine - increased TBG

A
  1. Estrogens

2. Tamoxifen

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3
Q

Major drug interactions of levothyroxine - decreased TBG

A
  1. androgens

2. steroids

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4
Q

Major drug interactions of levothyroxine - increased metabolism

A
  1. rifampin
  2. phenytoin
  3. carbamazepine
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5
Q

insulin preparations - rapid-acting - drugs? peak and duration

A
  1. aspart
  2. Lispro
  3. Glulisine
    1-3h / 4-6h
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6
Q

insulin preparations - short acting - drugs?peak and duration

A

regular

1.4-3.5 / 8

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7
Q

insulin preparations - intermediate acting - drugs? peak and duration

A

NPH

4-6 / 12

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8
Q

insulin preparations - long acting - drugs? peak and duration

A

detemir 3-9/6-24
glargine none / 24
Degludec none / more than 24

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9
Q

regular insulin charachteristics: regular vs short acting

A

regular peak does not coincident with food peak

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10
Q

long - acting - which does not cause hypoglycemia

A

the peakless (glargine and degludec)

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11
Q

5 steps of management of hyperglycemia + DM in inpatients

A
  1. classify type (1 vs 2 vs stressed induced hypergl)
  2. determine dietary status
  3. determine preadmission glycemic control
  4. stop all oral drugs
  5. determine insulin regimen
    MAINTAIN 140-180
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12
Q

5 steps of management of hyperglycemia + DM in inpatients - step 5 (insulin regimen) options

A
  1. Basal bolus regimen
  2. Insulin sliding scale only
  3. insulin infusion
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13
Q

Basal bolus regimen - who

A
  1. DM1
  2. DM2 treated with basal before admission
  3. DM3 inadequately controlled with sliding scale
  4. New diafgnosed or high gl
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14
Q

Insulin sliding scale only - who

A

DM2 well control with diet or oral medication before admission
- addition of basal if suboptimal with sliding

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15
Q

insulin infusion - who

A
  1. hypergl emergencies
  2. DM1 perioperative or during labor
  3. DM1 who do not eating + glucose suboptimal with SC
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16
Q

Insulin sliding scale?

A

varies the dose of insulin based on blood glucose level.

17
Q

metoformin - side effects

A
  1. GI upset

2. lactic acidosis (in renal failure)

18
Q

sulfonylureas - drugs?

A

first generation: chlorpropamide, tolbutamine

seond generation: glimepiride, glipizide, glypuride

19
Q

sulfonylureas toxicities

A
  1. increased risk of hypoglycemia in renal failure
  2. first generation: disulfiram like reaction
  3. second generation: hypoglycemia
  4. Weight gain
20
Q

Glitazone/thiazolidinediones - drugs

A
  1. pioglitazone

2. rosiglitazone

21
Q

Glitazone/thiazolidinediones - toxicity

A
  1. weight gain
  2. edema
  3. hepatotoxicity
  4. Heart failure
  5. increased risk for FRUCTURES
22
Q

GLP-1 analogs - drugs

A
  1. exenatide

2. Liraglutide

23
Q

GLP-1 analogs - toxicities

A
  1. nausea
  2. vomiting
  3. pancreatitis
  4. modest weight loss
24
Q

DDP-4 inhibitors - drugs

A
  • GLIPTIN
    1. Linagliptin
    2. Saxagliptin
    3. Sitagliptin
25
DDP-4 inhibitors - toxicities
Mild urinary or respiratory infections | wight neutral
26
SGLT-2 inhibitors - drugs
- GLIFLOZIN | 1. Canagliflozin 2. dapagliflozin 3. empagliflozin
27
SGLT-2 inhibitors - side effects
1. Glucosuria 2. UTIs 3. vaginal yeast infection 4. hyperkalemia 5. dehydration (orthostatic hypertension) 6. EUGLYCEMIC DKA
28
α-glcosidase inhibitors - drugs
1. acarbose | 2. Miglitol
29
Meglitinides - drugs
- Glinide 1. Nateglinide 2. Repaglinide
30
Meglitinides - side effects
1. weight gain | 2. increased risk for hypoglycemia in renal failure
31
treatment of severe hypoglycemia
IM glucagon in nonmedical setting (if glucagon is not available --> buccal or sublingual glucose IV dextrose in medical setting if mild hypoglycemia -->oral glucose (eg. juice)
32
thyroid effects of amiodarone (and treatment)
1. Decreased T4-3 conversion (none) 2. inhibition of synthesis (levo) 3. iodine induced increased of hormones (antithyr) 4. destructive thyroiditis (steroids)
33
primary ovarian insuf - treatment
estrogen + progestin
34
Anti-thyroid meds during pregn
PTU in 1st trimester | Methimazol in 2nd and 3rd
35
treatment of chronic hypoparathyroidism
1. Vitamin D (over calcitriol the active form because cheaper) 2. Ca2+ 3. thiazide (if low serum and high urine
36
ADH antagonists
conivaptan, tolvaptan
37
Cinacalcet
sensitizes CA2+ SENSING RECEPTORS | for 1ry and 2ry hyperparath

STEP 3 Uworld (14 decks)

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