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Pharmacology > Unit 10: Endocrine > Flashcards

Unit 10: Endocrine Flashcards

1
Q

Normal fasting glucose

A

<100

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2
Q

Normal 2 hour post load glucose

A

<140

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3
Q

Normal HbA1C

A

<5.7%

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4
Q

Normal random plasma glucose

A

<200

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5
Q

Sulfonylureas

A

Oral hypoglycemics for type 2 DM
Bind to beta cell receptors causing ATP dependent K+ channels to close; Ca channels then open causing release of insulin
Second generation more potent

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6
Q

1st generation sulfonylureas

A

Tolbutamide, chlorpropamide, tolazamide

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7
Q

2nd generation sulfonylureas

A

glyburide, glipizide, glimepiride

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8
Q

Most important SE of sulfonylureas

A

Hypoglycemia

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9
Q

Biguanides

A

Metformin
Not considered hypoglycemic as it does not increase insulin secretion
Inhibits glucose production and improves sensitivity to insulin
Used in conjunction with diet as first line therapy
Does not cause hypoglycemia

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10
Q

Metformin CI in

A

renal issues, HF, pregnancy, alcoholics, >80 years old, children

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11
Q

Most common SE of metformin

A

GI upset

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12
Q

Thiazolidinediones

A

Rosiglitazone + Pioglitazone
Decrease insulin resistance at sites of insulin action
Bind to nuclear steroid hormone receptor and increase insulin sensitivity in skeletal muscle and fat

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13
Q

Alpha glucosidase inhibitors

A

Acarbose + Miglitol
Slows absorption of carbs from intestines, minimizing postprandial rise in blood sugar
Most useful in patients with post prandial hyperglycemia, very high HbA1c and poor diet adherence

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14
Q

Meglitinide analogs

A

Repaglinide + Nateglinide
Rapid acting insulin secretagogues that stimulate release of insulin from pancreas in response to a meal
Effective in patients who become hypoglycemic with sulfonylureas and have acceptable fpg levels but high postprandial blood glucose

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15
Q

Meglitinide analogs CI in

A

Type 1 DM, DKA, severe infection, surgery, trauma, pregnancy, BF

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16
Q

Dipeptidyl peptidase 4 inhibitors

A

-Gliptin

DPP4 usually inactivates GLP-1 so by inhibiting DPP4 there is an increase in amount of circulating GLP1

17
Q

GLP-1 receptor agonists

A

-glutide
Used as adjunct therapy
Stimulates glucose dependent secretion of insulin from pancreatic beta cells while decreasing inappropriate release of glucagon from alpha cells
Also slows gastric emptying
Decreased postprandial and fasting glucose and avoids hypoglycemia

18
Q

Dopamine receptor agonists

A

Bromcocriptine mesylate

Postprandial glucose levels are improved without increasing insulin concentrations

19
Q

Amylin analog

A

Pramlintide

Delays gastric emptying, alters release of additional inappropriate glucagon by alpha cells, increases satiety

20
Q

Sodium-glucose co-transporter 2 inhibitors

A

-gliflozin
Induces glycosuria through kidneys independent of insulin by inhibiting SGLT-2 transport system
Causes 60% excretion of glucose in urine

21
Q

Roles of insulin

A

Rapid transport of glucose and amino acids intracellularly, promotes uptake and storage of glucose in liver, inhibits gluconeogenesis, and promotes conversion of excess glucose into fat

22
Q

Very rapid acting insulin

A

Insulin analog

23
Q

Short acting insulin

A

Regular insulin

24
Q

Intermediate acting insulin

A

NPH

25
Q

Long acting insulin

A

Glargine + Detemir

26
Q

Recommended treatment for type 2 DM If entry HbA1C <7.5%

A

Monotherapy with oral agents– metformin, GLP-1, DPP4I, AGI

Second line–SGLT-2, TZD, SU/GLN

27
Q

Recommended treatment for type 2 DM If entry HbA1C >7.5%

A

First line: metformin

Second line: combo of sulfonylureas + metformin, TZD or alpha glucosidase inhibitors

28
Q

Recommended treatment for type 2 DM If entry HbA1C >9%

A

Consider insulin therapy

29
Q

Drug therapy for hypothyroidism

A

Replacement with thyroid hormone in form of T4

Levothyroxine, liothyronine

30
Q

3 main treatment options for hyperthyroidism

A

Antithyroid drugs, radioactive iodine, surgery

31
Q

Antithyroid drugs

A

Methimazol + Propylthiouracil

Inhibits iodine organification, blocks conversion of T4 to T3 in periphery

32
Q

Adjunct therapy for hyperthyroidism

A

Beta blockers (propranolol or atenolol), iodine containing compounds, lithium, glucocorticoids

33
Q

Sulfonylureas should not be used in

A

Pregnant or breastfeeding women as it can cause severe hypoglycemia in fetus or infant

34
Q

SE of biguanides

A

GI distress; lactic acidosis can occur with metformin

35
Q

Biguanides CI in

A

patients with renal insufficiency of creatininine clearance, heart failure, pregnancy, children, alcoholics, those with dehydration

36
Q

What needs to be monitored with thiazolidinediones

A

Liver function tests–may cause hepatic dysfunction

May exacerbate heart failure

37
Q

Alpha glucosidase inhibitors CI in

A

patients with IBD, colon ulceration, obstructive bowel disorders, chronic intestinal disorders, liver disease, breastfeeding

Pharmacology (56 decks)

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