Week 12/13 - Endocrine Flashcards
hormones related to anterior lope of pituitary gland
- growth hormone (GH)
- luteinizing hormone (LH)
- follicle stimulating hormone (FSH)
- thyroid stimulating hormone (TSH)
- adrenocorticotropic hormone (ACTH)
- prolactin (Pr)
hormones related to the posterior lobe of pituitary gland
oxytocin and antidiuretic hormone (ADH)
growth hormone is also known as what?
somatropin
GH MOA
synthetic hormone that impacts bone, skeleton muscle, organs, and fat
GH AE
fluid retention/edema, muscle and joint pain
vasopressin is also known as what?
antidiuretic hormone (ADH) or arginine vasopressin (AVP)
what is the role of vasopressin?
decrease water excretion by causing increased urine concentration
DDAVP MOA
DDAVP binds to V2 receptor in collecting duct which increased aquaporin 2 on cell to make cell more permeable to water
what is the synthetic vasopressin?
desmopressin (DDAVP)
what can DDAVP be used for in kids?
nocturia - bed wetting at night
DDAVP AE
dry mouth, hyponatremia
what are the symptoms of diabetes? (10)
- always tired
- always hungry
- always thirsty
- sudden weight loss
- sexual problems
- vaginal infections
- numb/tingling hands or feet
- frequent urination
- wounds that won’t heal
- blurry vision
what is latent autoimmune diabetes (LADA) and how is it managed
slower beta-cell destruction and managed like T2DM
what are symptoms of hypoclycemia?
think about how you feel when you are hangry
- shaky
- sweaty
- dizzy
- confusion and difficulty speaking
- hungry
- weak or tired
- headache
- nervous or upset
what would you give a patient that is hypoglycemic?
sugary snack or drink like OJ
MOA of metformin
not fully known but inhibits production of glucose, inhibits instestinal absorption of glucose, and increases insulin sensitivity in muscle and fat
risk of hypoglycemia with metformin
low
AE of metformin
GI - diarrhea, nausea, abdominal cramping/bloating
what can develop over time with metformin?
vitamin B12 deficiency
MOA of sulfonylureas
binds to sulfonylurea receptor in pancreas and depolarization causes insulin release
sulfonylureas AE
hypoglycemia (especially in elderly and renal dysfunction) and weight gain
GLipizide is in what drug class
sulfonylureas - remember GL for prefix
when are sulfonylureas taken?
typically before breakfast; immediate release must be 30 minutes before meal otherwise you increase risk of hypoglycemia
Thiazolidinedione (TZD) MOA
increase insulin sensitivity by agonizing PPARgamma which increases glucose metabolism; insulin sensitizer
Thiazolidinedione (TZD) hypoglycemia risk
low
Thiazolidinedione (TZD) AE
edema, long term increase risk of bone fracture (especially in females)
What is boxed warning for Thiazolidinedione (TZD)?
can worsen heart failure after starting or increasing dose
DDP4 inhibitors suffix
-gliptin
DDP4 inhibitors MOA
inhibits DDP4 enzyme that breaks down incretin hormones; prolonged incretin hormone levels increases insulin synthesis and release and decreases glycogen secretion
DDP4 inhibitors hypoglycemia risk
low
DDP4 inhibitors AE
very well tolerated, new case reports show AE of arthralgia
SGLT2 inhibitor suffix
-flozin
SGLT2 inhibitor MOA
blocks glucose reabsorption in kidney at SGLT2 which increases urinary glucose excretion
SGLT2 inhibitor AE
volume-depletion related AE - dizziness/light-headed, genitourinary infections, renal insufficiency - leads to increased ketones which increases body pH
GLP1 receptor agonist MOA
- think GLP (gut, liver, pancreas)
increases insulin secretion in presence of elevated glucose, decreases glucagon secretion which decreases blood glucose, slows gastric emptying
GLP1 receptor agonist AE
GI - nausea, bloating, diarrhea
Insulin MOA
binds tyrosine kinase receptors which promotes increased expression of GLUT4 receptor to increase glucose uptake; inhibits production of glucose
Insulin AE
hypoglycemia and weight gain
what is basal insulin
- think “base” bc it is always working in the background
- 24 hour insulins given once per day
what is bolus insulin
- think “bowl” of food
- given before a meal; sliding-scale insulin
what blood glucose level is too high for PT
> 300 mg/dL
