MOA SPECIFICS Flashcards
MOA of metformin
Suppression of hepatic glucose production & absorption
Increase insulin sensitivity by peripheral tissues & GLP-1 synthesis
Unusual adverse effects of metformin
VIT B12 deficiency
Lactic Acidosis
Sulfonylureas end in
IDE
Sulfonylureas require
Beta cell function so ineffective in Type 1
Unusual side effects of Sulfonylureas
Therapy failure
HYPOGLYCEMIA, which is more severe
Higher risk with malnutrition, greater than 60, abx
MOA of Sulfonylureas
Inhibits K+ ATP on BETA CELLS
Ca+ enters, Insulin leaves
TZDs end in
GLITAZONE
MOA of TZDs
Increases insulin sensitivity at skeletal muscle, hepatic & adipose tissue & glucose use
Decreases insulin resistance & hepatic glucose production
TZDs decrease
Triglycerides
GLP-1 receptor agonists ends in
TIDE
MOA of GLP-1 receptor agonist
Increases beta cell insulin secretion & satiety
Decreases alpha cell glucagon production & appetite
Unusual side effects of GLP-1 receptor agonist
Acute pancreatitis & renal insufficiency
Injection site reaction
Gallbladder & biliary disease risk
Sodium glucose co transporter inhibitors end in
GLIFLOZIN
MOA of Sodium glucose co transporter inhibitors
Inhibits SGLT2 in the proximal tubule
Sodium glucose co transporter inhibitors cause
A decrease in BP & decrease CV EVENTS
What to consider with SGLT2 inhibitors
Ketoacidosis & dehydration
Unusual side effects of SGLT2 inhibitors
Osmotic diuresis
Higher risk in ACEI & ARBs
Ketoacidosis
UTI & genital infections
Decrease bone density
Dipeptidyl-peptidase inhibitors end in
GLIPTIN
MOA of dipeptidyl-peptidase 4 inhibitors
Inhibits DPP4 enzyme which breaks down incretin hormones
Increase insulin secretion
Decrease glucagon secretion
DPP4 Inhibitors cause
Musculoskeletal pain
MOA of thionamides
Inhibits thyroid peroxidase & formation of TH
Decrease concentrations of antithyrotropin- receptor antibodies
PTU inhibits deiodination of T4-T3
Adverse effects of Thionamides
Urticaria
Skin rash
Arthralgia
GI discomfort
Agranulocytosis & granulocytopenia
Hepatic toxicity
MOA of potassium iodides
Decreases iodine uptake by thyroid, TH synthesis & release, thyroid size & thyroid vascularity
Side effects of potassium iodides
Allergic reaction
Angioedema
Laryngeal edema
Bleeding disorders
MOA of radioactive iodine
Uptake by thyroid cells
Iodine isotopes trapped in thyroid
Beta rays destroy cells w/minimal to no damage to surrounding tissues
Risks of radioactive iodine
Hypothyroidism
Contraindicated in pregnancy
Radiation toxicity
Infertility
Special consideration with radioactive iodine
Definitive tx for Graves
Arrhythmias, ischemia & HF controlled with Propranolol, which inhibits T4-T3 conversion
Controls HR, HTN, & fever
Dose 0.5-1mg over 10min
MOA of corticosteroids
Cytoplasmic receptors
DNA transcription
Regulates protein synthesis
Which drugs have mineralocorticoid activity
Fludrocortisone
Aldosterone
Which medications have no mineralocorticoid activity
Betameth
Triamcinolone
When should dexamethasone be avoided
In severe head injury or hemorrhage
A glucocorticoid acts as an analgesic by
Peripheral inhibition along COX & lipoxygenase
Unusual symptoms of long term steroid use
Fluid resistant HOTN
Change in consciousness & cognitive decline
N/V/ABD pain
Low BS
low Na & increased K
Persistent fever
Do not give decadron with
Benadryl
Decadron has minimal
To no mineralocorticoid activity
Corticoidsteroid adverse effects
HPA suppression
Low K
Alkalosis
Increased HCT
Cataracts
Skeletal muscle myopathy due to K LOSS
Osteoporosis
Large doses of opioids will
Alter cortisol response to surgical stress
Etomidate inhibits
Cortisol synthesis (adrenal insufficiency)
Volatile anesthetics have
Minimal suppression of stress induced endocrine response
Regional anesthesia
Will decrease cortisol release & may decrease periop complications
Inhibiting ACh will cause
Dilation
Gq-
Gs-
Gq- constriction
Gs-dilation
Inhaled corticosteroids can cause an
Increase in IOP
Ketamine can cause direct
Bronchodilation & increases secretion, so give anticholinergic
Propofol can possibly
Cause dilation due to a decrease in vagal tone
Etomidate decreases
SVR & PAP
Why should you give propofol with caution in the PH patient
Decreases SVR & coronary perfusion
RV dysfunction
May vasoconstrict in PAH
Nitrous oxide causes
Pulmonary vasoconstriction
An epidural will cause
HOTN & RV dysfunction
Prostaglandins inhibits
Smooth muscle cell growth
PLT Aggregation
Remodeling will
Decrease systemic & pulm artery pressure
Indomethacin MOA
Non specific inhibition of COX 1 & 2 enzymes
Decrease production of prostaglandins
Side effects of Indomethacin
Gastritis
Nausea
Oligohydraminas
Premature closure of PDA
Side effects of CCB
Vasodilation
Dizzy
HA
Palpitations
MOA of beta agonists
Binds beta 2 receptor
Stimulates adenyl cyclase
Increases formation of camp
Causing inhibition of MLCK
MOA of oxytocin receptor antagonists (Atosiban)
Competitive inhibition of oxytocin binding to oxytocin receptors
Prevents IP3 formation & Ca release from SR
Mg effects on endothelium
Decreased PLT aggregation & vasodilation
