7 - Endocrine, Genitourinary Flashcards
Insulin
- MOA
- clinical indications
Binds to cell surf receptors -> activation of tyrosine kinase receptors -> phosphorylation cascade -> promotes formation/storage of glycogen, proteins, triglycerides within liver/muscle/fat
DM1, also DM2 pts no longer controlled by oral meds
Primary signal for release is presence of glucose in blood
List DM meds
- biguanides (1)
- sulfonylureas (3)
- thiazolidinediones (2)
B: metformin
S: glipizide, glyburide, chlorpropamide
T: pioglitazone, rosiglitazone
Metformin
- MOA
- clinical indications
- adverse effects
Decr gluconeogenesis in liver
Incr glucose uptake
1st oral rxd for DM bc doesn’t cause hypoglycemia
Diarrhea
Lactic acidosis: esp pts with renal insufficiency or hepatic impairment
Glipizide, Glyburide, Chlorpropamide
- MOA
- clinical indications
- adverse effects
Incr secr of insulin by beta cells in pancreas
Incr sensitivity of cells to insulin
Decr glucagon release
DM
Hypoglycemia
Sulfa moieties = allergies
Pioglitazone, Rosiglitazone
- MOA
- clinical indications
- adverse effects
Activate peroxisome proliferator-activated receptor gamma (PPAR-gamma) -> incr glucose uptake in muscle/fat
Combat insulin resistance
Pio: decr VA from new/worsening macular edema, rx with caution in pts with diabetic ret/macular edema
Peripheral tissue edema, heart failure, hypoglycemia
Levothyroxine
- MOA
- clinical indications
- adverse effects
Synthetic T4 hormone
Hypothyroidism (Hashimotos)
Symptoms of hyperthyroidism
PSEUDOTUMOR CEREBRI in children (incr ICP)
Estrogens, Progestins
-MOA
Estrogen primarily found as estradiol-17, promote growth of endometrium
Progestins promotes gestation, primarily found as progesterone, withdrawal leads to menstruation
Estrogens, Progestins
- clinical indications
- adverse effects
Oral contraceptives, hypogonadism, hypopituitarism, post-menopausal/PMS symp, osteoporosis, dysmenorrhea
Ocular:
- dry eye
- optic neuritis (rare)
- papilledema due to pseudotumor cerebri (rare)
- incr risk of venous clots -> B/CRVO, DVT, PE
Erectile dysfunction
-usually results from __ and is considered a form of __
Endothelial dysfunction, PVD
Sildenafil, Vardenafil
- MOA
- adverse effects
Inhibits PDE5
- cGMP relaxes vascular smooth muscle during an erection, is broken down by PDE5
- inhibiting PDE5 incr blood flow/vasodilates by prolonging effects of cGMP
Systemic: flushing, HA
Ocular: color changes (cyanopsia (blue tint)), blur, photosensitivity
-due to minor PDE6 inhibition = rods/cones
-possible link to NAION, not proof to be definitive, but should advise pts about
List
-BPH drugs
Alpha1 blockers: praZOSIN, teraZOSIN, tasuLOSIN
Prazosin, Terazosin, Tamsulosin
- MOA
- clinical indications
- adverse effects
Alpha1 blockers -> relax smooth muscle in bladder neck/prostate -> decr outflow obstruction
-prazosin and terazosin also block a1 in BVs = prevent peripheral vasoconstriction
BPH
First dose orthostatic hypotension -> dizziness, HA
Tamsulosin: intraoperative floppy iris syndrome (ra1dial)
