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Module 10: Mali: Endocrine > pharm chart > Flashcards

pharm chart Flashcards

1
Q

Sulfonylureas 2nd Generation

A

Glipizide [Glucotrol]

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2
Q

Glipizide [Glucotrol] MOA

A

Stimulates
pancreatic β-cell
release of insulin

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3
Q

Glipizide [Glucotrol] Indications

A

T2DM

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4
Q

Meglitinides
Non-Sulfonylurea
Secretagogue

A

Repaglinide

[Prandin]

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5
Q

MOA of Repaglinide

[Prandin]

A 
binds to
sulfonylurea
receptor on β-cell
to stimulate insulin
release
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6
Q

Indications of Repaglinide

[Prandin]

A

T2DM if sulfa allergy;
↓post-prandial glucose;
↓ A1c 0.6-1.9
↓ Gluc 65-75mg/Dl

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7
Q

Amylin (β-cell)–> released in response to ↑ blood glucose
o Inhibits gastric emptying
o Inhibits glucagon release

A

Amylin analog

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8
Q

Amylin analog

A

Pramlintide [Symlin]

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9
Q

MOA of Pramlintide

[Symlin]

A

Amylin analogue

↓gastric emptying, ↓glucagon secretion, ↓appetite

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10
Q

Indications of Pramlintide

[Symlin]

A

T1DM, T2DM ↓ postprandial glucose levels

↓ A1c 0.4-0.5

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11
Q

Incretin mimetic: Glucagon-Like Peptide-1 Agonist (GLP-1)
Synthetic analogue

What are the two drugs?

A

Exenatide [Byetta]

Liraglutide [Victoza]

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12
Q

MOA of Exenatide

[Byetta]

A

↑insulin release;
↓glucagon release;
↓gastric emptying;
↓appetite

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13
Q

Indications of Exenatide

[Byetta]

A

T2DM w/ metformin,
+/- sulfonylurea to lower postprandial glucose levels
↓ A1c 0.5 - 1.0%

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14
Q

MOA of Liraglutide

[Victoza]

A 
↑insulin release;
↓glucagon release;
↓gastric emptying;
↓appetite
↑ β-cell growth/replication
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15
Q

Indications of Liraglutide

[Victoza]

A

T2DM w/ metformin,
+/- sulfonylurea to
lower postprandial glucose levels

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16
Q

Dipeptidyl peptidase-4 inhibitors

DPP-4 Inhibitors

A

Sitagliptin

[Januvia]

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17
Q

MOA of Sitagliptin

[Januvia]

A

Inhibits DPP-4 to reduce degradation of GLP-1 –> incr levels of GLP-1; reduces postprandial glucose levels

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18
Q

Indications of Sitagliptin

[Januvia]

A

T2DM

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19
Q

Rapid Acting Insulin

A

Lispro

[Humalog]

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20
Q

MOA of Lispro

[Humalog]

A

insulin replacement,

supplement

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21
Q

Indications of Lispro

[Humalog]

A

T1DM

T2DM

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22
Q

Short-Acting

Insulin

A

Regular

[Humulin-R]

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23
Q

MOA of Regular

[Humulin-R]

A

insulin replacement,

supplement

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24
Q

Indications of Regular

[Humulin-R]

A

T1DM

T2DM

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25
Q

Intermediate- Acting Insulin

A

Neutral
Protamine
[Humulin-N]

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26
Q

MOA of Neutral Protamine

[Humulin-N]

A

insulin replacement,

supplement

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27
Q

Indications of Neutral Protamine

[Humulin-N]

A

T1DM,

T2DM

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28
Q

Long-Acting Insulin

100u/mL

A

Insulin Glargine

[Lantus]

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29
Q

MOA of Insulin Glargine

[Lantus]

A

insulin replacement,

supplement

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30
Q

Indications of Insulin Glargine

[Lantus]

A

T1DM,

T2DM

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31
Q

Long-Acting Insulin

300u/mL

A

Insulin Glargine

[Toujeo Solostar]

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32
Q

MOA Insulin Glargine

[Toujeo Solostar]

A

insulin replacement,

supplement

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33
Q

Indications of Insulin Glargine

[Toujeo Solostar]

A

T1DM,

T2DM

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34
Q

Oral Inhalation, Rapid Acting Insulin

A

Human rDNA Insulin

[Afrezza]

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35
Q

MOA of Human rDNA Insulin

[Afrezza]

A

Inhaled insulin

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36
Q

Indications of Human rDNA Insulin

[Afrezza]

A

T1DM,
T2DM
used w/longacting
insulin

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37
Q

Biguanides

A

Metformin

[Glucophage]

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38
Q

MOA of Metformin

[Glucophage]

A 
unknown mechanism
to 
decr hepatic glucose
production, 
decr renal
gluconeogenesis,
slow intestinal
absorption glucose,
incr glucose
conversion to lactate
by enterocytes,
stim tissue glycolysis,
incr glucose removal from blood (decr insulin resistance),
decr plasma glucagon levels
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39
Q

Indications of Metformin

[Glucophage]

A

T2DM

Initial DOC

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40
Q

Thiazolidinediones

TZD’s

A

Pioglitizone

[Actos]

41
Q

MOA of Pioglitizone

[Actos]

A

decr insulin resistance
by activation of nuclear PPAR-ϒ in myocytes, hepatocytes, adipocytes;
most potent insulin sensitizer;
pioglit also PPAR-α activity (incr trig metab)

42
Q

Indications of Pioglitizone

[Actos]

43
Q

α-glucosidase

Inhibitors

A

Acarbose

[Precose]

44
Q

MOA of Acarbose

[Precose]

A

reduces postprandial glucose levels by inhibition intestinal α-glucosidase conversion polysaccrides to monoscaccrides;
delays absorption & levels blood glucose

45
Q

Indications of Acarbose

[Precose]

A

T1DM,

T2DM

46
Q

SGLT2 Inhibitor Sodium-Glucose

CoTransportor 2

A

Canaglifloxin

[Invokana]

47
Q

MOA of Canaglifloxin

[Invokana]

A

inhibits glucose resorption in proximal renal tubule

48
Q

Indications of Canaglifloxin

[Invokana]

A

Adjunct therapy in T2DM

Not T1DM

49
Q

Bile Acid Sequestrant

A

Colesevelam

[Welchol]

50
Q

MOA of Colesevelam

[Welchol]

A

unknown in DM
(decrease intestinal
glucose absorption?)

51
Q

Indications Colesevelam

[Welchol]

A

hypercholest erolemia;
adjunct to metformin,
sulfonylurea, insulin in T2DM

52
Q

Vasopressin Receptor Agonists

A

Desmopressin

[DDAVP]

53
Q

MOA of Desmopressin

[DDAVP]

A

incr permeability of renal tubular cells to water
resorption→ decr urine volume;
incr vonW factor, VIII, t-PA levels

54
Q

Indication Desmopressin

[DDAVP]

A

diabetes insipidus;
primary nocturnal enuresis;
(off label) to control uremic bleeding; bleeding in hemophilia

55
Q

Adjunct Drugs:

A

ACEI / ARBs
HMGCoARI (‘statins’)
ASA

56
Q

Estrogens

A

Conjugated

estrogens

57
Q

Selective Estrogen
Receptor
Modulators
(SERMs)

A

Raloxifine

[Evista

58
Q

MOA of Raloxifine

[Evista

A

binds to selected estrogen
recepters and decr bone
resorption

59
Q

Indications of Raloxifine

[Evista

A

Px & Tx

osteoporosis

60
Q

Bisphosphenate:

Oral

A

Alendronate

[Fosamax]

61
Q

MOA of Alendronate

[Fosamax]

A

decreases rate bone

resorption

62
Q

indication Alendronate

[Fosamax]

A

Px & Tx of osteoporosis
in women; Tx in men;
Paget’s Disease

63
Q

Bisphosphenate:

IV

A

Zoledronic Acid

[Reclast]

64
Q

MOA of Zoledronic Acid

[Reclast]

A

Inhibits osteoclast activity
and skeletal calcium
release

65
Q

Indications of Zoledronic Acid

[Reclast]

A 
Px & Tx Osteoporosis;
Tx multiple myeloma,
metastatic bone lesions;
hypercalcemia of malignancy,
Paget’s Disease
66
Q

RANK Ligand Inhibitor

A

Denosumab

[Prolia]

67
Q

MOA of Denosumab

[Prolia]

A

Human monoclonal antibody which attaches to RANKL blocking
ability to bind to RANK receptor on surface of osteoclast thereby
inhibiting osteoclastogenesis &
increasing osteoclast apoptosis

68
Q

Indications of Denosumab

[Prolia]

A

Males and postmenopausal females at high fracture risk d/t osteoporosis; men on androgen deprivation rx and women
receiving aromatase inhibitor rx

69
Q

Calcitonin Hormone

A

Calcitonin Salmon

[Miacalcin]

70
Q

MOa of Calcitonin
Salmon
[Miacalcin]

A 
protein sequence similar
to human calcitonin;
antagoizes impact of
parathyroid hormone &
inhibits osteoclast activity
71
Q

Indications of Calcitonin
Salmon
[Miacalcin]

A

osteoporosis,
Paget’s
disease,
hypercalcemia

72
Q

Recombinant Human Parathyroid
Hormone

Fragment Hormone

A

Teriparatide

[Forteo]

73
Q

MOA of Teriparatide

[Forteo]

A

recombinant form PTH (1-34);

stim new bone formation

74
Q

Indications of Teriparatide

[Forteo]

A

Tx severe,
treatment resistant osteoporosis
(max 2 years use)

75
Q

Thyroid Agents

synthetic T4 replacement

A

Levothyroxine (T4)

[Levothroid, Levoxyl, Synthroid]

76
Q

MOA of Levothyroxine (T4)

[Levothroid, Levoxyl, Synthroid]

A

replacement T4
converted to T3 in peripheral tissues–> nuclear receptors–>
protein synthesis, metabolic rate,
promotes gluconeogeesis

77
Q

Indications of Levothyroxine (T4)

[Levothroid, Levoxyl, Synthroid]

A

Hypothyroidism

Thyroid CA

78
Q

Thyroid Agents

synthetic T3 replacement

A

Liothyronine (T3)

[Cytomel]

79
Q

MOA of Liothyronine (T3)

[Cytomel]

A 
T3 in peripheral
tissues --> nuclear
receptors --> protein
synthesis, metabolic
rate, promotes
gluconeogenesis
80
Q

Indications of Liothyronine (T3)

[Cytomel]

A 
hypothyroidism
not responsive
to T4 Tx
Tx of myxedema
coma
81
Q

Thyroid

Ablation

A

Radioactive

iodine (131 I) RAI

82
Q

MOA of Radioactive

iodine (131 I) RAI

A 
radioactive iodine is
concentrated in
thyroid gland w/
death of gland cells
over 6-8wks
83
Q

Indications of Radioactive

iodine (131 I) RAI

A

thyroid ablation

w/o surgery

84
Q

Antithyroid Agents

A

Methimazole

[Tapazole]

85
Q

MOA of Methimazole

[Tapazole]

A 
Blocks oxidation of
iodine in thyroid
gland preventing
iodine combining w/
tyrosine to form T4,
T3
doesn't inactivate
circulating T4, T3
86
Q

Indications of Methimazole

[Tapazole]

A

hyperthyroidism

87
Q

Antithyroid Agents

Thiamine

A

Propylthiouracil

[PTU}

88
Q

MOA of Propylthiouracil

[PTU}

A 
interfere w/ thyroid
hormone synthesis;
inhibits conversion
T4 to T3;
has
immunosuppressive
effects (bone
marrow)
89
Q

Indications of Propylthiouracil

[PTU}

A 
Graves disease,
pre-thyroid
surgery or
RAI131 therapy;
thyrotoxic crisis
90
Q

Glucocorticoid
Intermediate acting
(T1/2= 12-36H)

2 drugs

A
  1. Prednisone

2. Prednisolone [Omnipred]

91
Q

MOA of Glucocorticoid

Intermediate acting

A 
suppresses adrenal
function at high dose;
decreased leukocyte
migration;
enters cell nucleus to
alters synthesis of
proteins
92
Q

Indications of Glucocorticoid

Intermediate acting

A

multiple
immunosuppress
ive fxns

93
Q

what is important to remember about Prednisolone [Omnipred]

A

Same as Prednisone

Active form of prednisone

94
Q

Glucocorticoid Long acting

T1/2 >48H

A

Dexamethasone

[Maxidex]

95
Q

what to know about Dexamethasone

[Maxidex]

A

Same as Prednisone
Much more potent than predniseon (~7-10x)
Equiv dosing —> prednisone 5mg = dexamethasone 0.75mg

96
Q

Mineralcorticoid

A

Fludrocortisone

[Florinef]

97
Q

MOA of Fludrocortisone

[Florinef]

A

promotes increase distal
renal tubule absorp
of Na+ & loss of K+

98
Q

Indications of Fludrocortisone

[Florinef]

A 
Addisons ds (adrenocotical insufficiency) 
resistant orothostatic hypotension
99
Q

Adjunct Drugs:

Beta Blockers

A

Propanolol

Metoprolol

Module 10: Mali: Endocrine (5 decks)

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