Lecture 05_Spring Flashcards
Where is Insulin synthesized?
pancreatic beta cells
Which drug is given to induce uterine contractions but is contraindicated in patients with asthma?
Carboprost tromethamine (Hemabate)
____ is a synthetic thyroid hormone replacement that increases basal metabolic rate by __-___%
Levothyroxine (Synthroid), 60-100%
____ is secreted from alpha cells of the pancreas
glucagon
Normal insulin secretion is __ unit/hr at rest but __-__units/day in response to food, stress, corticosteroids, other stimuli
~1 unit at rest, 40-50 units/day in response to food, stress, corticosteroids, other stimuli
How does stimulation of alpha adrenergic receptors effect secretion of insulin? What about beta stimulation? What about parasympathetic stimulation?
Alpha-stimulation decreases insulin
Beta-stimulation and parasympathetic stimulation increase insulin
Which class of oral hypoglycemics decrease insulin resistance at skeletal muscle / adipose tissue and makes the body more sensitive to insulin?
Thiazolidinediones (TZDs): Rosiglitazone (Avandia*), Pioglitazone (Actos)
Even though ___ is not a catecholamine, it increases cAMP just like catecholamines do and increases myocardial contractility, stroke volume, heart rate
Glucagon
Which oral hypoglycemic is associated with risk of lactic acidosis and has been classically been held on day of surgery?
metformin
1 unit regular insulin will lower plasma glucose by ___ mg/dL in a normal adult
25-30 mg/dL
What are the 3 Sulfonylureas listed in this lecture? How do they work?
Glipizide (Glucotrol)
Glyburide (Micronase)
Glimepiride (Amaryl)
Increase beta cell activity which leads to more insulin secretion
How does metformin (glucophage) work to decrease blood glucose levels?
Inhibits hepatic gluconeogenesis (lactate glucose)
What drug increases myocardial contractility, stroke volume, and heart rate even in the presence of beta-blockade?
Glucagon
Where is insulin metabolized? What is the half-time? What is the duration of it’s sustained effect?
Metabolism: kidneys + liver
Half-time is 5-10 minutes
Sustained effect is 30-60 minutes because insulin is tightly bound to receptors
Onset of IV insulin is __ minutes, Peak in ___minutes, Duration is ___ minutes
onset = 10 min
Peak in 15-30 minutes
Duration 30-60 minutes
What is Propylthiouracil (PTU)?
inhibit thyroperoxidase and blocks peripheral conversion of T4-> T3
Used to treat chronic hyperthyroidism as well as acute thyroid storm (thyrotoxicosis) however, it is no longer recommended as first-line treatment due to severe hepatic failure
Beta-blockade (usually propranolol or esmolol) is also used to prevent symptoms of hyperthyroidism
_____ also blocks peripheral conversion of T4 -> T3 (but ____ does NOT)
Propranolol also blocks peripheral conversion of T4T3 (but esmolol does NOT)
What directions are given to diabetic patients regarding medications in the pre-op period?
No short-acting insulin on day of surgery, and partial (half) dose of long-acting insulin
List the 5 primary stimuli of glucagon secretion
- hypoglycemia
- stress
- trauma
- cortisol
- sepsis
What oral hypoglycemic inhibits DPP-4,increasing insulin release and decreasing hepatic glucose production?
Sitagliptin (Januvia)
What is the target blood glucose levels?
80-120 mg/dL
____ can be used to induce labor or for post-partum uterine atony.
Oxytocin (Pitocin)
What are the side effects of Pitocin?
hypotension, flushing, tachycardia, nausea
0.2 mg of ____ can be given IM for uterine atony, but is contraindicated in patients with severe pre-eclampsia
methylergonovine (methergine)
What are the side effects associated with methylergonovine (methergine)?
Side effects: HTN, N/V, cramping, pulmonary HTN.
N/V and bronchoconstriction are associated with which OB drug?
Carboprost tromethamine (Hemabate)
