PHARM: GI/Endocrine

Question 1

Metformin

Answer 1

Biguanide (Lowers liver production + release)

For T2DM
- Hold for 24-48 hrs prior to iodine contrast

S/e
= N/V; diarrhea
= Vit. B12 deficiency (chronic use)
= LACTIC ACIDOSIS (esp for pts w/ kidney disease + high ETOH consumption!!!)

Question 2

Repaglinide or the “-glinides”

Answer 2

Meglitinide (stimulates beta cells)
For T2DM

Works super fast so take with food!!
= Monitor for hypoglycemia

S/e
= WEIGHT GAIN

Question 3

Sitagliptin

Answer 3

Incretin enhancers (stimulates beta cells)
For T2DM

Question 4

“-gliFLOzins”

Answer 4

Sodium-Glucose (SGLT-2 Inhibitors) = increase glucose (+Na) excretion via urine
For T2DM

S/e
= UTI
= Fungal infections @genitals
= Intravascular depletion (volume loss) - are they taking any diuretics?

Question 5

“Gli/Gly - ide”

Glimepiride / Glipizide / Glyburide

Answer 5

Sulfonylureas (stimulates beta cells)
For T2DM

S/e: WEIGHT GAIN + Hyperglycemia risk!!

Question 6

“-glitazones”

Pioglitazone / Rosiglitazone

• Contraindicated in who?

Answer 6

Thiazolidinedione (increases insulin receptor sensitivity)

S/e = FLUID RETENTION - avoid for pts w/ CHF

Question 7

Glucagon (alpha cells)

Answer 7

Increases blood glucose

= Used for SEVERE HYPOglycemia
= No S/E!!

Question 8

Levothyroxine

Answer 8

Synthetic thyroid hormone for HYPOthyroidism

DO NOT D/C = myxedema coma

Question 9

Methimazole**; PTU

Answer 9

Anti-thyroid for HYPERthyroidism and Grave’s Disease

S/e: Hepatotoxicity + Agranulocytosis (big risk of infection)

Methimazole can cause FETAL TOXICITY d/t thyroid changes during pregnancy!!!