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Flashcards in Endocrine pharm - first aid Deck (22)
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1
Q

Insulin rapid acting

A

LAG - lispro, aspart, glulisine

2
Q

Insulin short acting

A

regular insulin

3
Q

intermediate acting insulin

A

NPH

4
Q

insulin long acting

A

determir, glargine

5
Q

Oral hypoglycemic agents

A

biguanides (metformin), sulfonylureas, glitazones/thiazolidinediones, meglitinides, GLP-analogs, DPP-4 inhibitors, amylin analogs, sodium glucose co-transporter 2 inhibitors, alpha glucosidase inhibitors.

6
Q

Biguianides (metformin) - mechanism of action

A

exact mechanism is unknown. this medication decreases gluconeogenesis, increases glycolysis, increase peripheral glucose uptake by increasing insulin sensitivity.

7
Q

Biguianides (metformin) - clinical use

A

FIRST line therapy in T2DM, can cause modest weight loss.

8
Q

Biguianides (metformin) - adverse effects

A

Gi upset, most serious is lactic acidosis (thus contraindicated in renal insufficiency).

9
Q

sulfonylureas - mechanism

A

chlorpropamide, tolbutamide, glimepiride, glipizide, glyburide

close beta cell potassium channel, cell depolarizes, calcium influx, insulin released.

10
Q

sulfonylureas - mechanism

A

Type2DM only as they stimulate endogenous insulin release. Requires some islet cell function.

11
Q

sulfonylureas - adverse effects

A

risk of hypoglycemia, weight gain,

12
Q

glitazones/thiazolidinediones - mechanism

A

pioglitazone, rosiglitazone

increase insulin sensitivity in peripheral tissue, binds to PPAR-gamma nuclear transcription regulator.

13
Q

glitazones/thiazolidinediones - clinical use

A

monotherapy in T2DM or with metformin of sulfonylurea. can be used safely in patients with renal impairment. Weight gain, edema, hepatotoxicity.

14
Q

Meglitinides - mechanism

A

nateglinide, repaglinide.

stimulate postprandial insulin release by binding to potassium channels on beta-cell membranes. NOTE that the binding site differs from sulfonylurea.

15
Q

Meglitinides - clinical use

A

montherapy or combined with metformin in T2DM.

16
Q

GLP-1 analogs - mechanism

A

exenatide, liraglutide

increase GLUCOSE DEPENDENT insulin release. decrease glucagon release, decrease gastric emptying, increase satiety.

17
Q

GLP-1 analogs - adverse effects

A

nausea, vomiting, pancreatitis

–> note can cause modest weight loss.

18
Q

DPP-4 inhibitors - mechanism

A

linagliptin, saxagliptin, sitagliptin
- INHIBITS DPP-4 enzyme that DEACTIVATES GLP-1 thereby increasing glucose dependent insulin release. decrease glucagon release, decrease gastric emptying, increase satiety.

19
Q

DPP-4 inhibitors - adverse effects

A

mild urinary or respiratory infections, weight neutral.

20
Q

SGLT-2 inhibitors - mechanism

A

canagliflozin, dapagliflozin, empagliflozin

block reabsoprtion of glucose in the PCT.

21
Q

SGLT-2 inhibitors - adverse effects

A

glucosuria, UTIs, vaginal yeast infections, hyperkalemia, dehydration

22
Q

Thionamides - mechanism

A

Propylthiouracil (PTU), methinazole

–> block thyroid peroxidase, this inhibits the oxidation of iodide and the organification (coupling), of iodine –> decreased thyroid hormone synthesis.

NOTE PTU also blocks 5-deiodinase, which blocks peripheral conversion of T4 to active T3.
PTU is also the drug of choice during pregnancy