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Sam: Endocrine > Pharmy pharm pharm > Flashcards

Pharmy pharm pharm Flashcards

1
Q

L cells release?

A

Glucagon-like peptide-1 (GLP-1)

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2
Q

K cells release?

A

Glucose-dependent insulinotropic polypeptide (GIP)

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3
Q

DPP-4 inactivates what two hormones?

A

GLP-1 and GIP

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4
Q

Residual carbohydrates in the bowel leads to?

A

Flatulence and diarrhea

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5
Q

Alpha cells secrete?

A

Glucagon

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6
Q

Beta cells secrete?

A

Insulin and amylin

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7
Q

Delta cells release?

A

Somatostatin

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8
Q

What does somatostatin do?

A

Acts locally to decrease beta cell release

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9
Q

Insulin is cleared via the _______

A

kidneys

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10
Q

How many units of insulin are degraded by the kidney every 24 hours?

A

6-8 units

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11
Q

What promotes glucose uptake by tissue cells, promotes protein synthesis, and provides for glucose storage?

A

Insulin

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12
Q

What maintains blood glucose between meals and in fasting state?

A

Glucagon

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13
Q

What is released in response to increased blood glucose (besides insulin)?

A

Amylin

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14
Q

Growth hormone will have what effect on glucose levels?

A

Increases glucose levels

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15
Q

“Hypoglycemia begets hyperglycemia” refers to what?

A

Somogyi effect

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16
Q

What could you do before bed to reduce Somogyi effect?

A

Eat protein

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17
Q

How is Dawn phenomena different from Somogyi effect?

A

Dawn phenomena

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18
Q

What is our rapid acting insulin?

A

Lispro

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19
Q

What is our short acting insulin?

A

Regular insulin (Humulin-R)

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20
Q

What is our intermediate acting insulin?

A

Neutral Protamine Insulin (Humulin-N)

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21
Q

What is our long acting insulin?

A

Long-acting Glargine Insulin (Lantus)

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22
Q

What type of insulin can be given IV?

A

Regular Insulin

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23
Q

Where does Invokana work?

A

It inhibits glucose reabsorption in proximal renal tubule

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24
Q

T4 accounts for what percentage of thyroid hormone produced?

A

80-90%

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25
Q

T3 accounts for what percentage of total thyroid hormone produced?

A

10-20%

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26
Q

Calcitonin is released from??

A

Parafollicular C cells

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27
Q

What is Fludrocortisone prescribed for?

A

Addison’s disease and resistant orthostatic hypotension

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28
Q

Deficient mineralization of bone is called?

A

Osteomalacia

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29
Q

Early or mild bone thinning is called?

A

Osteopenia

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30
Q

Significant bone thinning with or without fracture is called?

A

Osteoporosis

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31
Q

How long does bone resorption take?

A

2 weeks

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32
Q

How long does bone formation take?

A

3 months

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33
Q

Parathyroid stimulates?

A

Bone resorption

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34
Q

Estrogen controls?

A

Osteoclast activation

35
Q

Calcitonin inhibits?

A

Osteoclast activity

36
Q

BMD > 2.5 SD below mean for same sex young adult on DEXA means what?

A

Osteoporosis

37
Q

Epinephrine _____ blood glucose levels secondary to stress, hypoglycemia

A

raises

38
Q

In fasting, strenuous exercise, and stress situations _____ levels increase

A

Growth hormone (and others) – but growth hormone filled in the blank based on his slides

39
Q

What drug stimulates pancreatic beta-cell release of insulin?

A

Glipizide

40
Q

This drug is a Meglitinide and is used in replacement of Glipizide when people have a sulfa allergy

A

Repaglinide

41
Q

Is insulin released in a continuous or pulsatile fashion?

A

Pulsatile

42
Q

What is the half life of insulin in the periphery?

A

15 minutes

43
Q

GLUT-1 transporters go where in the body?

A

All tissues including nervous system

44
Q

GLUT-2 transporters go where in the body?

A

Pancreatic beta-cells and liver cells

45
Q

GLUT-4 transporters go where in the body?

A

Skeletal muscle and adipose tissue

46
Q

What are macrovascular complications of diabetes?

A

CAD, CVA, and PVD

47
Q

What are microvascular complications of diabetes?

A

Retinopathy, Nephropathy, Neuropathy

48
Q

Almost all type 2 diabetic patients will end up on what types of drugs?

A

ACE-inhibitors, statins, and aspirin

49
Q

What classes of drugs decrease insulin resistance?

A

Biguanides, TZD’s

50
Q

What classes of drugs decrease hepatic gluconeogenesis?

A

Biguanides, amylin analogue

51
Q

What classes of drugs decrease glucose absorption?

A

Alpha-glucosidase inhibitors and bile acid sequestrants

52
Q

True or False

Sulfonylureas can cause weight gain and hypoglycemia concerns

A

TRUE

53
Q

Is Glipizide a first or second generation sulfonylurea?

A

Second

54
Q

What is our amylin analogue?

A

Pramlintide (Symlin)

55
Q

What are our GLP-1 agonists?

A

Exenatide (Byetta) and Liraglutide (Victoza)

56
Q

What is the difference between Exenatide and Liraglutide?

A

Not much…

Exenatide can increase warfarin effect

57
Q

What is our DDP-4 inhibitor?

A

Sitagliptin (Januvia)

58
Q

Breaking it down,

  1. GLP-1 and GIP do what to blood sugar?
  2. DDP-4 does what do GLP-1 and GIP?
  3. DDP-4 inhibitors have what effect on blood sugar?
A
  1. Decrease
  2. Inhibits
  3. Decrease

Good job team.

59
Q

Is hypoglycemia seen clinically with metformin?

A

Nope

60
Q

What do we have to do with someone’s Metformin if they need to use IV iodinated contrast agent?

A

hold that puppy for 48 hours.

61
Q

What is our TZD?

A

Pioglitzone (Actos)

62
Q

MoA for Pioglitazone?

A

Decrease insulin resistance by activating of nuclear PPAR-gamma in myocytes, hepatocytes, and adipocytes.

Basically look for PPAR-gamma

63
Q

What is our Alpha-glucosidase inhibitor?

A

Acarbose (Precose)

64
Q

What is our SGLT2 inhibitor and how does it work?

A

Canaglifloxin (Invokana)

inhibits glucose reabsorption in proximal renal tubule

65
Q

What drug do we initially prescribe for hypothyroidism and thyroid cancer?

A

Levothyroxine

66
Q

What is the MoA of Levothyroxine?

A

Replacement T4 converted to T3 in peripheral tissues

67
Q

When would we prescribe Liothyronine?

A

When hypothyroidism is not responsive to T4 therapy.

68
Q

Besides hypothyroidism, when else would we use Liothyronine?

A

Myxedema coma

69
Q

What do we put people at risk for if we over-treat thyroid supplement?

A

A fib, depression, post-menopausal osteoporosis

70
Q

When do we use Radioactive Iodine?

A

To ablate the thyroid

-can be an exacerbation of Grave’s opthalmology

71
Q

How do we treat hyperthyroidism?

A

Methimazole and Propylthiouracil

PTU for pregnant women

72
Q

How does prednisone affect adrenal function?

A

Suppresses

73
Q

What drug is also a glucocorticoid but is much more potent than prednisone?

A

Dexamethasone

74
Q

What drug do we prescribe for resistant orthostatic hypotension?

A

Fludrocortisone

75
Q

What else is Fludrocortisone prescribed for?

A

Addison’s

76
Q

What type of calcium supplementation should be used with PPI’s?

A

Calcium citrate

77
Q

What drug is our Selective Estrogen Receptor Modulators?

A

Raloxifene (Evista)

78
Q

Dx-Dx interaction with Raloxifene?

A

Thyroid supplementations

79
Q

So Fosamax decreases rate bone resorption, how does Zolidronic acid (Reclast) work?

A

Inhibits osteoclast activity and skeletal calcium release

80
Q

How is Denosumab (Prolia) administered?

A

Injection every 6 months

81
Q

How is Calcitonin administered?

A

IM or nasal spray formulation

82
Q

What is Teriparatide (Forteo)?

A

Recombinant Human Parathyroid Hormone

83
Q

What is the longest amount of time someone can be on Teriparatide?

A

2 years

84
Q

Can you use Teriparatide with bisphosphonates?

A

No

Sam: Endocrine (3 decks)

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