7.1 - Endocrine System Flashcards
What does insulin do?
–> Stimulates glucose uptake in skeletal muscle and adipose tissue
–> Increase glycogen, triglyceride, and protein synthesis (anabolic hormone)
–> Inhibits gluconeogenesis and lipolysis
What kid of insulin is lispro, aspart, and glulisine?
Rapid - onset 10-30 mins
What kind of insulin is Toronto? When is it in tmax?
Regular
–> 2-4 hours max
Name an intermediate insulin and how long it lasts?
NPH - 12-18 hours
How long does detemir act?
Long acting - 16-24 hrs
How long does glargine act?
Long acting - 20-26 hrs
How long does degludec work?
Long acting - 36-42 hours.
What are the clinical uses for insulin?
Treatment of DM 1/Later stage 2
–> Also hyperkalemia (given w glucose)
What are the adverse effects of insulin?
Hypoglycemia
–> Tachycardia/palpitations, sweating, nervousness, headaches, confusion, drowsiness, convulsions, coma
Lipohypertrophy at injection site
What kinds of drugs are gliclazide and glyburide? What is their mechanism of action?
Sulfonylureas (p.o.)
–> Promote insulin secretion by the pancreas
What kind of drug is metformin? What is its route? Mechanism of Action?
Biguanide (p.o.)
–> Decreased production of glucose
–> Increased uptake of glucose in skeletal muscles and adipose tissue
Rosiglitazone
–> Class
–> Route
–> Mech of action
–> Adverse effects
Glitazone
–> p.o
–> Decreased insulin resistance
Adverse effects:
Retention of fluid, not great for people with heart failure
Liraglutide and Semaglutide
–> Route
–> Mech of action
–> Side/adverse effects
GLP-1 Receptor Agonist (s.c)
–> Increases effects of incretins, increasing glucose-dependent release of insulin; Enterogastrone effect: results in reduced gastric motility and emptying
Side Effects:
–> Decreased appetite
–> Risk of thyroid cancer
What are the incretins? What do they do?
Glucagon Like Peptide & Glucose-dependent Insulinotropic peptide/gastric inhibitory peptide
–> Stimulate gluose-dependent release of insulin
–> Suppress postprandial release of glucagon
Sitagliptin, Saxagliptin, Linagliptin
–> Route
–> Mechanism of action
Dipeptide peptidase-4 (DPP-4) Inhibitors (p.o.)
–> Increases incretin levels by inhibiting enzyme that inactivates them (DPP-4); Increased incretins signal for increased release of insulin
What percentage of glucose reabsorption takes place via the SGLT cotransporter in the proximal tubule?
90%
What kinds of drugs are atorvastatin and rosuvastatin?
HMG-CoA Reductase Inhibitors
–> Lower LDLs and triglycerides
What are the adverse effects of ator/rosuvastatin?
–> Gastro-intestinal disturbances
–> Elevation of liver enzyme tests
Can cause myopathies
Myalgia
–> Muscle pain; normal creatine kinase plasma levels
Myositis
–> Muscle inflammation (pain + elevated CK, >10x normal)
Rhabdomyolysis
–> Muscle pain + CK 10X > normal
–> Elevated myoglobin (Blood, urine)
Avoid During Pregnancy
What is myalgia?
Muscle pain with normal creatine kinase levels
What is myositis?
Muscle Inflammation:
Muscle pain + elevated creatine kinase (< 10X normal)
What is rhabdomyolysis?
Muscle pain
Creatine kinase 10x > normal
Elevated myoglobin (blood, urine)
What kind of medication is ezetimide?
A cholesterol absorption inhibitor
–> Lowers LDLs and triglycerides
What kind of drugs are evolocumab and alircumab? Adverse effects?
PCSK9 Inhibitors
–> monoclonal antibodies that target proprotein convertase subtilisin/kexin type 9, resulting in more LDL receptors and less circulating in the blood
Adverse Effects:
Injection site reactions
What kind of drug is cholestyramine? Adverse Effects?
Bile Acid Sequestrant (resin)
–> nonabsorbable resin that binds to bile acids in the GI tract and promote their excretion; body will begin using cholesterol to replace lost bile
Can cause constipation and often administered with a laxative
