Endocrine Flashcards
(24 cards)
Drug x replaces endogenous insulin in diabetes, i.e. it promotes cellular uptake of glucose, fatty acids, and amino acids and their conversion to glycogen, triglycerides, and proteins.
Glyburide
Insulin
Levothyroxine
Propylthiouracil
Insulin
Drug x closes ATP-sensitive K+ channels, preventing K+ efflux and depolarizing pancreatic B cells, causing influx of Ca2+ and releasing insulin; increases amount of insulin secreted
Metformin
Insulin
Propylthiouracil
Glyburide
Glyburide
Drug x is converted to T3 in peripheral tissues which binds thyroid nuclear receptors and incr gene transcription, thereby increasing metabolic rate, protein synthesis, gluconeogenesis, cell growth, and differentiation, and CNS development.
Propylthiouracil
Glyburide
Levothyroxine
Metformin
Levothyroxine
Drug x increases the number and affinity of insulin receptors in peripheral tissues; decreases hepatic output; decr glucose absorption from the gut; incr glucose uptake and utilization in skeletal muscle and adipose tissue; does not usually cause hypoglycemia.
Metformin
Insulin
Glyburide
Propylthiouracil
Metformin
Drug x binds to thyroid peroxidase and thereby inhibits the conversion of iodide to iodine. Normally thyroglobulin is degraded to produce T4 and T3 which are the main hormones produced by the thyroid gland. Therefore, drug x effectively inhibits the production of new thyroid hormones.
Levothyroxine
Glyburide
Propylthiouracil
Propylthiouracil
Clinical use: hyperthyroidism
Levothyroxine
Propylthiouracil
Glyburide
Iodine
Propylthiouracil
PROPerLY quench the burning THYROID with URINE
Clinical use: hypothyroidism
Glyburide
Levothyroxine
Propylthiouracil
Levothyroxine
Clinical use: type 2 diabetes mellitus
Metformin
Glyburide
Metformin, glyburide, insulin
Insulin
Metformin, glyburide, insulin
Clinical use: type 1 and type 2 diabetes mellitus
Glyburide
Insulin
Metformin
Propylthiouracil
Insulin
Usually a long acting insulin plus pre-meal and pre-snack injections of a rapid-acting insulin in type 1 DM
Adverse effects: Agranulocytosis, Alopecia, Arthralgia, Skin rash esp maculopapular rash, Hepatitis and cholestatic jaundice
Levothyroxine
Propylthiouracil
Glyburide
Metformin
Propylthiouracil
Mnemonic: Only ASH is left after burning (PROPerLY quench the burning THYROID with URINE)
Agranulocytosis-severe and dangerous leukopenia (lowered WBC count)
Adverse effects:
Lactic acidosis ( esp. in pts with hypoxia, renal and hepatic dysfunctions whom this drug is CI),
Agitated GI tract (diarrhea, cramps, nausea, vomiting, increased flatulence),
Blood glucose levels stable (no hypoglycemia unlike insulin and sulfonylureas),
B12 deficiency seen in higher doses and long-term users
Glyburide
Insulin
Metformin
Propylthiouracil
Metformin
*LAB
Adverse effects: hypoglycemia only and also contraindicated during episodes of hypoglycemia
Metformin
Glyburide
Insulin
Levothyroxine
Insulin
Adverse effects: Insomnia; irritability; tachycardia and anxiety; weight loss, decreased appetite; hyperthyroid symptoms
Levothyroxine
Propylthiouracil
Glyburide
Metformin
Levothyroxine
Adverse effects: hypoglycemia; photosensitivity reactions; can cause weight gain
Metformin
Insulin
Glyburide
Propylthiouracil
Glyburide
What drugs can mask signs of hypoglycemia and prolong recovery from hypoglycemia, thus interacting with insulin?
Beta-blockers
Thiazides
ACEi
CCBs
Beta-blockers
Which drug has these interactions: bile acid sequestrants decrease absorption; estrogens can increase thyroid requirement. Warfarin’s anticoagulant effect is increased when combined with this drug.
Glyburide
Metformin
Levothyroxine
Propylthiouracil
Levothyroxine
Which drug has these interactions: potentiated by alcohol, anti-inflammatory drugs, salicylates, and sulfonamides increase risk of hypoglycemia; effects decreased by diuretics, steroids, thyroid and phenytoin.
Metformin
Glyburide
Levothyroxine
Insulin
Glyburide
Contraindications: Type 1 DM, hypoglycemia, diabetic ketoacidosis, allergy to sulfonamide drugs
Metformin
Glyburide
Insulin
Propylthiouracil
Glyburide
Drug x Interactions: thiazides and steroids incr drug x requirements; alcohol, most nonsteroidal anti-inflammatory drugs, sulfonylureas, and warfarin can decrease drug x requirements. Psyllium may delay absorption of glucose from meals, leading to less postprandial hyperglycemia, which may allow for a reduced dosage of drug x.
Metformin
Glyburide
Insulin
Levothyroxine
Insulin
Contraindicated in pts with untreated subclinical (suppressed serum TSH level with normal T3 and T4 levels) or overt thyrotoxicosis of any etiology and in patients with acute myocardial infarction. CI in pts with uncorrected adrenal insufficiency bc drug x may precipitate an acute adrenal crisis by increasing metabolic clearance of glucocorticoids. Should not be used to treat obesity or weight loss.
Glyburide
Propylthiouracil
Levothyroxine
Metformin
Levothyroxine
Contraindications: renal failure, metabolic acidosis, type 1 diabetes
Insuline
Metformin
Glyburide
Levothyroxine
Metformin
Interaction: may increase the effect of oral blood thinners, eg warfarin. Warfarin dose changes and monitoring for the effects of warfarin on blood clotting are necessary.
Glyburide
Metformin
Propylthiouracil
Levothyroxine
Propylthiouracil
Contraindicated in hypothyroidism, pregnancy (crosses placenta and may cause harm to fetus), if need to use in pregnancy, should be used at lowest effective dose.
Glyburide
Metformin
Propylthiouracil
Levothyroxine
Propylthiouracil
Interactions: alcohol increases risk of lactic acidosis; cimetidine and furosemide compete for proximal renal tubule secretion that reduces clearance leading to increased effects. Beta blockers can alter glucose metabolism and increase risk of hypoglycemia. Psyllium may delay absorption of glucose from meals, leading to less postprandial hyperglycemia and may allow for a reduced dosage of drug x.
Metformin
Insulin
Glyburide
Levothyroxine
Metformin
