Endocrine Drugs

Question 1

What does Insulin do in the body?

Answer 1

Stimulates glucose uptake from circulation into tissues

Stimulates glycogen and lipid/protein synthesis
Inhibits gluconeogenesis and ketogenesis

Question 2

What can Insulin drive into cells?

Answer 2

K+

Question 3

Insulin Indications

Answer 3

Type I Diabetes (Type II if other medication ineffective), Diabetic ketoacidosis (given IV)

Question 4

What drug class can increase Insulin requirement?

Answer 4

Systemic Corticosteroids

Question 5

What drug class does Gliclazide belong to?

Answer 5

Sulphonylureas

Question 6

How do Sulphonylureas’s Work?

Answer 6

Block K+ channels in pancreatic B-cell membrane = Increases Ca2+ concentration (and therefore insulin secretion)

Question 7

Sulphonylureas Indications

Answer 7

Type II Diabetes (in combination with or instead of Metformin)

Question 8

Who is at risk of Hypoglycaemia?

Answer 8

Hepatic impairment, Malnutrition, Adrenal/Pituitary insufficiency, Elderly

Question 9

What drug class is Metformin?

Answer 9

Biguanide

Question 10

What does Metformin do?

Answer 10

Supresses hepatic glucose production, Increases glucose uptake, Suppresses intestinal absorption

Question 11

Metformin Indications

Answer 11

Type II Diabetes (first-line)

Question 12

When should Metformin be withheld?

Answer 12

Acute Alcohol Intoxication ( = lactic acidosis)

Question 13

Metformin Side Effects

Answer 13

Nausea, Vomiting, Taste disturbance, Anorexia, Diarrhoea

Question 14

Metformin Interactions

Answer 14

IV Contrast media, Drugs that can impair renal function (ACE, NSAIDs, Diuretics)

Question 15

Thyroxine Indications

Answer 15

Hypothyroidism

Question 16

What must you do when administering Thyroxine in Hypopituitarism?

Answer 16

Give Corticosteroid therapy before (avoid Addisonian crisis)

Question 17

Thyroxine Side Effects

Answer 17

Similar to Hyperthyroidism symptoms

Question 18

What is Levothyroxine?

Answer 18

Synthetic T4 (most commonly used)

Question 19

What is Liothyronine and when is it used?

Answer 19

Synthetic T3 (used in emergencies - quicker onset)

Question 20

What is levothyroxine metabolised by?

Answer 20

CYP450 system

Question 21

Levothyroxine Interactions

Answer 21

Increase insulin requirement

Enhance effects of warfarin

Question 22

Anti-Thyroid drug examples?

Answer 22

Carbimazole, Methimazole, PTU

Question 23

Anti-Thyroid Drugs Indications

Answer 23

Hyperthyroidism/Graves

Question 24

Anti-Thyroid Drugs Side Effects

Answer 24

Agranulocytosis, Granulocytopenia, Aplastic Anaemia

Question 25

Which Bisphosphonate is used for Osteoporosis?

Answer 25

Alendronic Acid

Question 26

Which Bisphosphonates are used for Hypercalcaemia and Cance Bone Metastases?

Answer 26

Pamidronate and Zoledronic acid

Question 27

Bisphosphonate Contra-indications

Answer 27

Renal Impairment, Hypocalcaemia

Question 28

Bisphosphonate Side Effects

Answer 28

Oesophagitis, Osteonecrosis of Jaw, Femoral Fracture

Question 29

Bisphosphonate Interactions

Answer 29

Bind calcium so absorption reduced with Calcium salts (milk), Antacids, Iron salts

Question 30

Calcium and Vitamin D Indications

Answer 30

Osteoporosis, CKD, Hyperkalaemia, Hypocalcaemia, Vitamin D deficiency

Question 31

What drug is used IV in Hyperkalaemia and how is it administered?

Answer 31

Calcium Gluconate, Administered slowly

Question 32

Fludrocortisone Indication

Answer 32

Addison’s / Adrenal Insufficiency, Low BP

Question 33

How does Fludrocortisone work?

Answer 33

Decreases amount of sodium lost in urine (derivative of cortisol)