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ENDO 1 MOD > pharm > Flashcards

pharm Flashcards

1
Q

drugs that cause hyperprolactinemia (3)

A

antidepressant/antipsychotics
estrogen
h2-receptor blocker

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2
Q

treatment for prolactinoma

A

dopamine agonist
transphenoidal resection
radiation (rarely needed)

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3
Q

Bromocriptine MOA

A

dopamine agonist that suppresses synthesis and secretion of prolactin

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4
Q

ADR of bromocriptine and cabergoline

A

nausea
lightheadness
congestion

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5
Q

name the two meds that can be used to treat prolactinomas

A

bromocriptine and cabergoline
both are dopamine agonists

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6
Q

name the three phosphodiesterase inhibitors

A

end with “-afil”
sildenafil (viagra)
vardenafil
tadalafil

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7
Q

contraindication for phosphodiesterase inhibitors

A

taking nitrates

caution if taking alpha blockers (don’t take at same time)

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8
Q

contraindication for prostaglandin vasodilator

A
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9
Q

how do phosphodiesterase inhibitors work?

A

block effect of PDE5 to cause vasodilation

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10
Q

how do prostaglandin vasodilators work?

A

increases cAMP and causes smooth muscle relaxation/vasodilator
its a penile injection

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11
Q

two classes of meds used to treat ED

A

phosphodiesterase inhibitors
prostaglandin vasodilators

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12
Q

contraindication for SU & meglitinides

A

type 1 DM

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13
Q

SU MOA

A

closing Katp to stimulate insulin secretion

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14
Q

ADR of SU & meglitinides

A

hypoglycemia
wt gain

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15
Q

name the two meglitinides meds

A

nateglinide
repaglinide– safer in chronic renal dz

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16
Q

MOA of meglitinides

A

stimulate beta cell insulin secretion leading to increased postprandial insulin

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17
Q

when do you take meglitinides

A

before meals

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18
Q

what other condition can metformin be used to treat?

A

PCOS

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19
Q

MOA of biguanide

A

block gluconeogenesis to decrease hepatic glucose output
increase glucose uptake which decreases insulin resistance

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20
Q

ADR of biguanide

A

GI issues
VB12 deficiency
lactic acidosis

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21
Q

benefits of biguanide

A

decrease Tg & LDL & risk of cancer
wt loss
improves endothelial fx

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22
Q

contraindication for metformin

A

eGFR < 30
severe CHF
IV contrast
acidosis

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23
Q

when should you take metformin

A

with food

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24
Q

common end word with SGLT-2 inhibitors

A

”–gliflozin”

25
Q

contraindications for SGLT-2

A

eGFR <45
ESRD
dialysis (severe renal issues)

26
Q

MOA of SGLT2

A

block glucose reabsorption in proximal tubule to INCREASE GLUCOSE EXCR

27
Q

ADR of SGLT2

A

UTI
dehydration
ketoacidosis
genital mycotic infection
decreased bone density

28
Q

lowers BP, wt, progression to kidney dz
increases HDL

A

benefits of SGLT-2 inhibitors

29
Q

which medication must be used for wks-months for effect?

A

pioglitazone (actos)– a TZD

30
Q

MOA of actos

A

increase insulin sensitivity at peripheral receptor sites

31
Q

contra of TZD

A

Class 3 or 4 heart failure
preexisting liver disease
baseline liver transaminases >2.5x upper limit
Type 1 DM

32
Q

which condition should you show caution when prescribing TZDs?

A

CHF

33
Q

is actos safe in renal insufficiency and elderly?

A

yes

34
Q

which medication has ADR of edema, ALT/AST elevation and increased wt via subQ fat

A

pioglitazone/actos

35
Q

increases HDL, B-cell fx, NASH
decreases atherosclerotic dev, LDL and Tg

A

benefits of TZD

36
Q

name the alpha-glucosidase inhibitor

A

acarbose

37
Q

MOA of acarbose

A

blocks alpha-glucosidase at s. intestine which decreases glucose absorption causing decreased postprandial glucose
secondary effects on insulin sensitivity

38
Q

which medication has GI issues as the sole ADR

A

acarbose

39
Q

which medication has cirrhosis and IBS/malabsorption as contraindications?

A

acarbose

40
Q

which medication reduces risk of progression to DM, new MI and new HTN?

A

acarbose

41
Q

name your DPP4 inhibitor

A

sitagliptin

42
Q

which medication has hypersensitivity as the only contraindication? what class is this med?

A

sitagliptin– DPP4 inhibitor

43
Q

MOA of sitagliptin

A

block DPP4 which stops GLP1 and G1P breakdown to increase postprandial insulin and suppress glucagon

44
Q

when do you take acarbose

A

TID w/ meals

45
Q

which medication has pancreatitis and increased risk of hypoglycemia when taking w other meds? what class is it?

A

sitagliptin– DPP4 inhibitor

46
Q

which two GLP-1 analogs don’t need to be taken with food?

A

liraglutide & bydureon

47
Q

which GLP-1 analog med can be used as a stand alone wt loss drug?

A

liraglutide

48
Q

MOA of GLP-1 analogs

A

increased insulin secretion
delay gastric emptying
decrease glucagon secretion

49
Q

which class has severe renal impairment and gastroporesis as contraindication?

A

GLP-1 analogs

50
Q

why is severe renal impairment a contraindication for GLP-1 analogs?

A

risk of dehydration worsening renal fx

51
Q

ADR of GLP-1 analogs

A

GI issues
pancreatitis
hypoglycemia
mild increase in HR

52
Q

benefits of GLP-1 analogs

A

decreased appetite
decreased progression to diabetic kidney dz
possible beta cell fx improvement

53
Q

first line for GDM treatment

A

diet

54
Q

2nd line for GDM treatment

A

glyburide or metformin
insulin if not reaching goals

55
Q

treatment for pregnancy in preexisting DM

A

insulin therapy
refer to high risk OB and specialty care
stop ACE inhibitors and statins

56
Q

when is insulin pump therapy recommended with pregnancy?

A

if they have T1DM

57
Q

what do statins do?

A

decrease CV risk
used in all DM > age 40

58
Q

what do ACE/ARB do?

A

protective in microalbuminuria
enhance insulin sensitivity esp in ppl with high risk of developing DM

ENDO 1 MOD (4 decks)

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