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Endo pharm Flashcards

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1
Q

Rapid acting insulins

A

Lispro, aspart, glulisine

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2
Q

Short acting insulin

A

Regular

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3
Q

Intermediate acting insulin

A

NPH

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4
Q

Long acting insulin

A

Detemir, glargine

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5
Q

Effects of insulin

A

Liver – increase glucose stored as glycogen
Muscle – increase glycogen, protein synth, K uptake
Fat – increase trig storage

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6
Q

Risks w/ insulin

A

Hypoglycemia, lipodystrophy

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7
Q

Biguanides example

A

Metformin

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8
Q

Clinical use of biguanides

A

T2DM (can cause some wt loss)

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9
Q

MOA of biguanides

A

Inhibit hepatic gluconeogenesis and action of glucagon via mitochondrial glycerophosphate DHase –> less gluconeogenesis, increased glycolysis, increased peripheral glc uptake, increased insulin sensitivity

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10
Q

ADE w/ biguanides

A

GI upset, lactic acidosis (rare – but cautin in renal insufficiency)

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11
Q

Sulfonylureas 1st gen examples

A

Chlorpropamide, tolbutamide

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12
Q

Sulfonylureas 2nd gen examples

A

Glimepiride, glipizide, glyburide

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13
Q

Shortest half life of SU 2nd gen

A

Glipizide

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14
Q

Clinical use of SUs

A

Stimulate release of endogenous insulin in T2DM (req some islet fxn)

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15
Q

MOA of SUs

A

Close K channel in B cell membrane –> depolarization –> insulin release due to Ca influx

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16
Q

ADE in SUs

A

Hypoglycemia (worse in renal failure), wt gain
1st gen: disulfiram life rxn
2nd gen: hypoglycemia

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17
Q

Thiazolidinediones examples

A

Pioglitazone, rosiglitazone

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18
Q

Clinical use of TZDs

A

Monotherapy in T2DM or combined

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19
Q

Pro to TZDs

A

Safe in renal impairment

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20
Q

TZD MOA

A

Regulates PPAR-gamma –> Increased insulin sensitivity in peripheral tissue (upreg of Glut4)

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21
Q

ADE of TZDs

A

Wt gain (adipocyte maturation), edema, HF, increased risk of fractures

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22
Q

Meglitinides examples

A

Nateglinide, repaglinide

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23
Q

Clinical use of meglinitides

A

T2DM

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24
Q

MOA of meglinitides

A

Stimulate postprandial insulin release by binding K channels on B cell membranes (diff site from SUs)

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25
ADEs of meglinities
Hypoglycemia (worse risk w/ renal failure), wt gain
26
GLP1 analog examples
Exanatide, liraglutide (SQ)
27
Clinical use of GLP1 analogs
T2DM
28
MOA of GLP1 analogs
Increases glucose dependent insulin release, less glucagon release, less gastric emptying, increased satiety (can cause wt loss)
29
ADE in GLP1 analogs
NV, pancreatitis
30
DPP4 inhibitors examples
Linagliptin, saxagliptin, sitagliptin
31
Clinical use of DPP4 inhib
T2DM
32
DPP4 inhib MOA
Inhibits DPP4 that deactivates GLP1 --> increased glucose dependent insulin release, lower glucagon release, less gastric emptying, increase satiety
33
ADE in DPP4 inhib
Mild urinary or respiratory infxns
34
Amylin analog example
Pramlintide (SQ)
35
Amylin analog clinical use
T1/T2DM
36
Amylin analog MOA
Less gastric emptying, less glucagon
37
Amylin analog ADE
Hypoglycemia (mistime prandial insulin), nausea
38
SGLT2 inhibitor examples
Canagliflozin, dapagliflozin, empaglifozin
39
SGLT2 inhibitor clinical use
T2DM
40
SGLT2 inhibitor MOA
Blocks resorption of glc in PCT
41
ADE of SGLT2 inhibs
Glocusria, UTIs, vaginal yeast infxns, hyperkalemia, dehydration (-->othostatic hypotension), wt loss
42
alpha glucosidase inhib exmaples
Acarbose, miglitol
43
alpha glucosidase clinical use
T2DM
44
alpha glucosidase MOA
Inhibit intestinal brush border alpha glucosidases -- delated carb hydrolysis and glc absorption --> lower post prandial hyperglycemia
45
ADE w/ alpha glucosidase
GI disturbances (short chain carbs fermented by bacteria in colon)
46
Thioamide examples
PTU, MMI
47
MOA of thioamides
Block TPO --> no oxidation/organification/coupling in thyroid hormone synth PTU also blocks peripheral 5' deiodinase T4-->T3
48
Clinical use of thioamides
Hyperthyroidism PTU in 1st tri of pregnancy MMI in 2-3rd (risk of PTU hepatotox)
49
ADE w/ thioamides
Skin rash, agranulocytosis (rare), aplastic anemia, hepatotox (PTU), MMI is a possible teratogen (aplasia cutis), drug induced lupus/ANCA vasculitis (PTU)
50
Levothyroxine, triiodothyronine MOA
thyroid hormone replacement
51
Clinical use of thyroid hormones
Hypothyroidism, myxedema (beware people using as wt loss supplements)
52
ADE of thyroid hormones
tachycardia, heat intolerance, tremors, arrhythmias
53
ADH antagonist exmaples
Conivaptan, tolvaptan
54
Clinical use of ADH antagonists
SIADH, block actin of ADH at V2
55
Desmopressin acetate clinical use
Central (NOT NEPHRO) DI, von Willebrand disease (extra renal V2 receptors regulate clotting factors), sleep enuresis
56
GH clinical use
GH deficiency, Turner
57
Oxytocin clinical use
Stimulates labor, uterine contractions, mile let-down, controls uterine hemorrhage
58
Somatostatin (octreotide) clinical uses
Acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices, somatostatinoma
59
Demeclocycline MOA
ADH antagonist (member of tetracyclines)
60
Demeclocyline clinical use
SIADH
61
Demeclocycline adverse effects
Nephrogenic DI, photosens, abnormalities of bone/teeth
62
Fludrocortisone MOA
synthetic analog of aldo w/ some glucocorticoid effects
63
CLinical use of fludrocortisone
Mineralocorticoid replacement in 1o adrenal insuff
64
Adverse effects of fludrocortisone
Similar to glucocorticoids but also edema, exacerbation of heart failure, hyperpigmentation
65
Cinacalcet MOA
Sensitizes Ca sensing receptor (CaSR) in parathyroid to circulating Ca --> lower PTH
66
Clinical use of cinacalcet
1o or 2o hyperparathyroidism
67
ADE of cinacalcet
Hypocalcemia

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