Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacy > Endocrine > Flashcards

Endocrine Flashcards

(97 cards)

Start Studying
1
Q

what is the treatment choice for diabetes insipidus?

A

desmopressin - causes you to pee less but more concentrated

(can cause hyponatraemia, nausea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the treatment options for SIADH?

A

tolvaptan, demeclocycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens when you correct sodium too quickly?

A

osmotic demyelination syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the risk factors for osteoporosis?

A

postmenopausal women, men over 50, smoking, excess alcohol, vitamin D deficiency, low calcium intake, low BMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what treatments are first line for patients with osteoporosis?

A

-alendronic acid
-risedronate

** ibandronic acid may also be appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

for patients with osteoporosis who cannot tolerate oral bisphosphonates, what would be a suitable alternative?

A

-parenteral bisphosphonates (zolendronic acid)
-denosumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when would tibolone be recommended for treatment of osteoporosis?

A

younger postmenopausal women women with menopausal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how long after treatment with alendronic acid, should it be reviewed to possibly stop?

A

5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the three MHRA alerts for all bisphosphonates?

A

osteonecrosis of the jaw
osteonecrosis of the auditory canal
atypical femoral fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the counselling points for alendronic acid?

A

-take with a full glass of water
-swallowed whole
-taken on an empty stomach
-taken while sitting upright or standing - and continue for 30 minutes after
-taken once a week (women) - same day each week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how often is zolendronic acid given for osteoporosis?

A

IV - once yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how long is denosumab given for osteoporosis?

A

SC - every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the MHRA alerts for denosumab?

A

-osteonecrosis of the jaw
-osteonecrosis of the auditory canal
-atypical femoral fracture
-rebound hypercalcaemia
-multiple vertebral fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which corticosteroid has the highest mineralocorticoid (aldosterone) activity?

A

fludrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which corticosteroids have the highest glucocorticoid (cortisol) activity?

A

dexamethasone, betamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what effect do mineralocorticoids have on the body?

A

fluid retention, increase BP, hypokalaemia, hypocalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what effects do glucocorticoids have on the body?

A

anti-inflammatory, osteoporosis, diabetes, muscle wasting, gastric ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the side effects of corticosteroids?

A

chorioretinopathy, psychiatric reactions, adrenal suppression, immunosuppression, insomnia, stunted growth, skin thinning, cushingoid symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the causes of adrenal insufficiency?

A

addison’s disease, congenital adrenal hyperplasia, secondary causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

list the potency of topical corticosteroids?

A

Mild: hydrocortisone
Moderate: clobetasone
Potent: betamethasone
Very Potent: clobetasol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when should you do a reducing course of steroids?

A

40mg + prednisolone > 1 week
repeat evening doses
> 3 weeks treatment
repeated courses
short course within 1 year of stopping long term therapy
adrenal suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

patients who are diabetic and driving, should check their blood glucose levels how regularly?

A

2 hourly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

for patients with diabetes, blood glucose levels should always be above what to drive?

A

5

if between 4-5, a snack should be taken
if below 4, pull over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the sick day rules for type 1 diabetics?

A

monitor sugar levels regularly
continue insulin
eat and keep hydrated
test ketones regularly

SEEK HELP IF:
pregnant
high BG levels
drowsy/ breathless
vomiting/ diarrhoea
abdo pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the advice for managing T1DM patients during surgery?
MINOR SURGERY: reduce long acting insulin by 20% MAJOR SURGERY: reduce long acting insulin by 20% and on day of surgery: stop until pt eating IV KCl + glucose + NaCl IV insulin in NaCl (soluble insulin) hourly BG measurements IV glucose 20% if > 6mmol/L POST SURGERY: SC insulin when eating restart with first meal long acting 20% reduced until patient discharged
26
what are the features of diagnosis in T1DM?
hyperglycaemia (>11mmol/L) ketosis weight loss BMI < 25 age < 50 family history
27
how often should blood glucose be monitored in T1DM?
4 times daily
28
what are the BG targets for T1DM?
waking (fasting) 5 -7 mmol/L before meals 4 - 7 mmol/L after eating 5 - 9 mmol/L driving > 5 mmol/L
29
what are first line options for insulin for a basal-bolus regime in T1DM?
1st detemir 2nd glargine
30
name the short acting insulin?
soluble insulin (human OR bovine/porcine) BRANDS: humulin S, insuman, hypurin soluble, actrapid
31
when should you administer short acting insulins?
15-30 minutes before food onset: 30-60 minutes peak: 1-4 hours duration: up to 9 hours
32
name the rapid acting insulins?
lispro aspart glulisine BRANDS: apidra, novorapid, lispro, aspart, fiasp
33
when should you administer rapid acting insulins?
immediately before meals onset: <15 mins duration: 2-5 hours
34
name the intermediate acting insulins?
isophane BRANDS: insulatard, humulin I, insuman basal, hypurin isophane
35
when should you administer intermediate acting insuin?
onset: 1-2 hours peak: 3-12 hours duration: 11-24 hours
36
name the long acting insulins?
detemir degludec glargine BRANDS: tresiba, lantus, toujeo, levemir
37
when should you administer long acting insulins?
once daily (twice daily for detemir) onset: 2-4 days for steady state duration: 36 hours
38
what are the symptoms of DKA?
polyurea thirst fruity breathe deep, fast breathing lethargy confusion
39
how is DKA diagnosed?
if BG > 11mmol/L test ketones: 0.6-1.5 retest in 24 hours 1.6-2.9 GP >3 medical emergency
40
how do you manage DKA?
BP < 90 restore volume (500ml NaCl) BP > 90 maintenance IV NaCl start IV insulin (soluble) in NaCl at rate so that: ketones fall at 0.5mmol/L/hr BG falls at 3mmol/L/hr when BG <14 start IV glucose 10% continue insulin until: ketones < 0.3 pH > 7.3 STOP treatment 1 hour after first meal
41
what are the symptoms of a hypo?
sweating lethargic dizziness hunger tremor palpitations pale extreme moods
42
how do you diagnose a hypo?
BG < 4 mmol/L
43
How do you treat a hypo in patients who can swallow?
fast-acting carbohydrate: 4-5 glucose tablets 3-4 teaspoons of sugar 200ml fruit juice glucose 40% gels Can repeat after 15 minutes up to 3 times Once BG > 4, give a longer acting carbohydrate
44
How do you manage a patient who has been treated 3 times with short acting carbohydrates and whose BG are still below 4?
IM glucagon IV glucose 10%
45
what are the medications for type 2 diabetes?
metformin (biguanides) sulfonylureas DPP-4 inhibitors SGLT 2 inhibitors GLP 1 agonists Pioglitazone
46
what is the mechanism of action of metformin?
reduced gluconeogenesis and increase the peripheral use of glucose
47
what is the max daily dose of metformin
2g
48
what are the side effects of metformin?
lactic acidosis GI reduced B12
49
what is the renal cut off for metformin?
30ml/min
50
what are the benefits of treatment with metformin?
weight loss and cardiovascular benefit
51
name the sulfonylureas?
glibenclamide, gliclazide, glimepiride, tolbutamide, glipizide
52
which of the sulfonylureas has the longest duration of action and is therefore associated with he greatest hypo risk?
glibenclamide
53
what is the mechanism of action of the sulfonylureas?
stimulate beta cell insulin secretion in the pancreas
54
what are the side effects of the sulfonylureas?
hypos acute porphryia
55
what are the side effects of the sulfonylureas?
hypos acute porphyria hepatic and renal failure
56
what effect do sulfonylureas have on weight?
weight gain
57
name the DPP-4 inhibitors?
alogliptin, linagliptin, sitagliptin, saxagliptin, vildagliptin
58
which of the DPP-4 inhibitors is associated with hepatotoxicity?
vildagliptin
59
what is the mechanism of action of the DPP-4 inhibitors?
increase insulin secretion, and decrease glucagon
60
what effect do DPP-4 inhibitors have on weight?
weight neutral
61
which DPP-4 inhibitors do not need dose reductions in renal impairment?
linagliptin
62
what are the side effects of he DPP-4 inhibitors?
pancreatitis
63
name the SGLT-2 inhibitors?
canagliflozin dapagliflozin empagliflozin
64
what is the mechanism of action of the SGLT-2 inhibitors?
inhibits SGLT-2 in renal proximal convoluted tubule (excrete more glucose in urine)
65
what is the renal cut off for the SGLT-2 inhibitors?
60 (when used for diabetes)
66
what effect does SGLT-2 inhibitors have on weight?
weight loss
67
what is the MHRA alert specific to canagliflozin?
lower limb amputation
68
what are the MHRA alerts for all SGLT-2 inhibitors?
DKA risk Fourniers gangrene
69
name the GLP-1 agonists?
dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide
70
what is the mechanism of action of the GLP-1 agonists?
increase insulin secretion and reduced glucagon secretion, slows gastric emptying
71
what effect for the GLP-1 agonists have on weight?
weight loss
72
what is the mechanism of action of pioglitazone?
reduces peripheral insulin resistance
73
what effect does pioglitazone have on weight?
weight gain
74
what are the MHRA alerts for pioglitazone?
bladder cancer heart failure
75
what should pioglitazone not be used alongside in triple therapy?
dapagliflozin
76
how do you manage diabetes in pregnancy?
stop oral antidiabetics except metformin replace with insulin folic acid 5mg daily aim for HbA1c < 48
77
what is defined as pre-diabetic?
HbA1c 42-47 mmol/mol
78
what is defined as diabetic?
HbA1c > 48 mmol/mol
79
what is the HbA1c target for a patient who is at risk of a hypo?
53mmol/L
80
define a hypo?
< 4mmol/L
81
what type of HRT has an increased risk of breast cancer?
combined HRT (oestrogen and progesterone) greater than oestrogen alone
82
why is progesterone given alongside oestrogen in HRT?
reduces the risk of endometrial cancer when given cyclically (eg 10 days out of 28 day cycle)
83
which HRT is not suitable for women in the perimenopausal period or up to 1 year after their last period?
combined and tibolone
84
what options are available for patients with menorrhagia?
levonorgestrel releasing IUD tranexamic acid NSAID cyclical progesterone
85
what are the symptoms oh hyperthyroidism?
goitre hyperactivity disturbed sleep fatigue palpitations anxiety heat intolerance increased appetite weight loss diarrhoea
86
what is the main cause of primary hyperthyroidism?
graves disease
87
define hyperthyroidism?
Low TSH High T4 Subclinical hyperthyroidism: Low TSH Normal T4
88
what is first line for hyperthyroidism?
carbimazole
89
what is second line for hyperthyroidism?
propylthiouracil when carbimazole not tolerated
90
what are the three MHRA alerts for carbimazole?
neutropenia and agranulocytosis congenital malformations acute pancreatitis
91
which anti-thyroid medication is not suitable for the block and replace regime?
propylthiouracil
92
what are the symptoms of hypothyroidism?
fatigue weight gain constipation menstrual irregularities depression dry skin cold intolerance reduced body and scalp hair
93
define hypothyroidism?
High TSH Low T4 Subclinical hypothyroidism: High TSH Normal T4
94
what is the drug of choice for hypothyroidism?
levothyroxine
95
how regularly should TSH levels be monitored in hypothyroidism?
3 monthly until stable annually thereafter
96
what is the MHRA alert for levothyroxine?
some patients experience symptoms when switching between levothyroxine products
97
what are the counselling points for administration of levothyroxine?
take in the morning 30-60 minutes before food, caffeine containing liquids and other medications

Pharmacy (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions