Lecture 6: Endocrine

Question 0

What is the adverse effect of insulin?

Answer 0

Hypoglycemia

Question 1

Regular insulin is given to a patient through what route?

Answer 1

Intravenously

Question 2

What are the 5 different types of insulin?

Answer 2

(1) rapid acting
(2) short acting
(3) intermediate acting
(4) long acting
(5) combo short/intermediate acting

Question 3

How long does it take for rapid acting insulin to take effect?

Answer 3

15-20 minutes

Question 4

When is the best time (most ideal) to give a patient rapid acting insulin?

Answer 4

Best given after the first bite of meal

Question 5

What is the onset of the short acting insulins?

Answer 5

0.5 to 1 hour

Question 6

Is short acting insulin given intravenously?

Answer 6

Yes. It’s the only one recommended intravenously

Question 7

What is the onset of the intermediate acting insulins?

Answer 7

Onset is 1 to 1.5 hours

Question 8

How long does intermediate acting insulin last?

Answer 8

24 hours

Question 9

What is special about long acting insulin?

Answer 9

It is peak less and lasts 24 hours

Question 10

Insulin glargine (lantus) is a peak less insulin that lasts 24 hours, but you should avoid…

Answer 10

Mixing it with other insulins

Question 11

Insulin detemir (Levemir) has an onset of 3-4 hours and peaks at 6-8 hours, however you should avoid…

Answer 11

Mixing with other insulins

Question 12

What are the two benefits of insulin mixtures?

Answer 12

(1) fewer injections needed daily

(2) useful for patients who have trouble mixing insulins

Question 13

If you have hypoglycemia (less than 50 mg/dL of blood glucose) then what needs to happen?

Answer 13

Treat QUICKLY with 10-20 grams of simple sugar

Question 14

Give an example of a biguanide?

Answer 14

Metformin (glucophage)

Question 15

Who should not take biguanides (like metformin)?

Answer 15

Do not give to patients with kidney failure (they will develop lactic acidosis)

Question 16

What is the 1st line agent for type 2 diabetes?

Answer 16

Biguanides (metformin)

Question 17

What are the 2nd generation Sulfonylureas? (3)

Answer 17

(1) glimepiride (amaryl)
(2) glipizide
(3) glyburide

Question 18

There are 5 facts we need to know about Sulfonylureas …

Answer 18

(1) can cause severe hypoglycemia
(2) insulin releasers from the pancreas
(3) insulin release can cause weight gain
(4) efficacy reduces over time
(5) second line agents added on to metformin

Question 19

Who should avoid thiazolinediones?

Answer 19

CHF patients

Question 20

What are the two drugs that are glucosidase inhibitors?

Answer 20

(1) miglitol (glyset)

2) acarbose (precose

Question 21

Can type I diabetes go without insulin?

Answer 21

No

Question 22

Can type ii diabetes go without insulin?

Answer 22

Possibly… They may be able to control with diet and exercise

Question 23

Uncontrolled diabetes over a long time may …

Answer 23

Cause damage to organs

Question 24

Which thyroid hormone is more active? T3 or T4?

Answer 24

T3 is much more active than T4

Question 25

What are some of the preparations available for thyroid hormone replacement therapy?

Answer 25

Levothyroxine, T4

Question 26

What is a common mistake for hypothyroidism drug treatments (such as levothyroxine)?

Answer 26

It is Easily overdosed because it was written incorrectly

Question 27

What are glucocorticoids?

Answer 27

Have effects on metabolism - generally takes hours to days to have full effects due to cellular changes and protein turnover

Question 28

What are mineralocorticoids?

Answer 28

A steroid that has effects on salt (aldosterone)

Question 29

What is the tablet form of prednisone?

Answer 29

Orasone and deltasone

Question 30

What is the oral liquid form of prednisone?

Answer 30

Liquid pred (1 mg/dL)

Question 31

What is the oral concentrate of prednisone?

Answer 31

Prednisone intensol

Question 32

What are the two side effects of prednisone?

Answer 32

Adrenal suppression and osteoporosis

Question 33

What are the four oral liquid forms of prednisone sodium phosphate?

Answer 33

(1) millipred (10mg/5mL)
(2) Pedipred (5mg/5mL)
(3) Orapred (15mg/mL)
(4) Veripred 20 (20mg/mL)

Question 34

What is the oral disintigrating tablet of prednisone sodium phosphate?

Answer 34

Orapred ODT 10mg, 15mg, 30mg

Question 35

What are the different forms of prednisone acetate?

Answer 35

(1) oral liquid–> flopred suspension 5mg/5mL
(2) prelone syrup: 15mg/5mL
(3) tablet: millipred :5mg

Question 36

What is triamcinolone used for?

Answer 36

Primarily used for tendon and joint issues

Question 37

How is Triamcinolone administered? What can it cause?

Answer 37

Injected intraarticularly

Can cause weakening of tendons

Question 38

What is the major use of mineralocorticoids?

Answer 38

Chronic hypotension (especially in the elderly)