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Adv. Pharm > Endocrine > Flashcards

Endocrine Flashcards

Exam2 (58 cards)

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1
Q

S/Sx of Hyperglycemia?

A

Dry mouth
Increased thirst
Weakness
Headache
Blurred vision
Frequent Urination

Tx: insulin administration

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2
Q

S/Sx of Hypoglycemia?

A

Fatigue
Shakiness
Dizziness
Tachycardia
Excess hunger
Profuse sweating
Numbness of extremities
Severe -> ketoacidosis

Tx: consuming carbs (15g/15min ex. 1/2 banana) or glucagon

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3
Q

Normal blood sugar range?

A

Pre-meal: 80-130mg/dL

Post-meal: <180mg/dL

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4
Q

What drug is a biguanide?

A

Metformin

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5
Q

What drug class is metformin in?

A

Biguanides

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6
Q

Metformin- indication?

A

T2DM (paired w/ diet & exercise

(Biguanides)

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7
Q

Metformin- MOA?

A

Activates AMPK enzyme in liver -> decreases glucose production
decreases GI glucose absorption
increases insulin sensitivity

Decreases A1C 1-2%

(Biguanides)

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8
Q

Metformin- side effects?

A

Lactic acidosis- higher risk in renal dysfunction

Contraindicated for eGFR<30 AKA kidney disease

Contraindicated for metabolic acidosis

GI upset- take w/ food to avoid

Hold 48hrs for iodinated contrast studies

(Biguanides)

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9
Q

What drug is a sodium glucose co-transporter 2 inhibitor?

A

Dapagliflozin

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10
Q

What drug class is dapagliflozin in?

A

Sodium glucose co-transporter 2 inhibitor

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11
Q

Dapagliflozin- MOA?

A

Inhibits SGLT-2 in kidneys -> decreased reabsorption of glucose -> increases urinary excretion of glucose -> decreases glucose in blood -> lowers blood sugar

Decreases A1C 0.7-1%

(SGLT2i)

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12
Q

Dapagliflozin- indications?

A

T2DM
HF
CKD

(SGLT2i)

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13
Q

Dapagliflozin- side effects?

A

Glucosuria- risk of UTIs - counsel on urinary hygiene

Increased urination/thirst

Euglycemic ketoacidosis d/t NPO

Necrotizing fasciitis risk

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14
Q

What drug is a glucagon-like peptide 1 agonist (GLP-1)?

A

Liraglutide

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15
Q

What drug class is liraglutide in?

A

Glucagon-like peptide 1 agonists

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16
Q

Liraglutide- indications?

A

T2DM
Weight loss

(GLP-1 agonist)

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17
Q

Tiers of A1C lowering drugs?

A

Metformin (biguanine): 1-2%

Glipizide (sulfonylureas): 1-2%

Insulin: 0.9-1.2%

Dapagliflozin (SGLT2i): 0.7-1%

Liraglutide (GLP-1 agonist): 0.5-1.5%

Pioglitazone (TZDS): 0.5-1.4%

Sitagliptin (DPP-4i): 0.5-0.8%

The lower A1C effect, the less the risk of hypoglycemia

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18
Q

Liraglutide- MOA?

A

Like GLP-1 hormone (released from GI in response to ingestion of food) -> increase glucose-dependent insulin secretion / decreases glucagon decrease -> lowers blood sugar

Slows gastric emptying -> decreased appetite

Decreases A1C 0.5-1.5%

(GLP-1)

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19
Q

Insulin function?

A

Insulin allows transport of glucose from blood into cells to be used as energy

Opposite of glucagon

Regulates blood sugar levels

Energy storage of glucose in liver when there is excess

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20
Q

Glucagon function?

A

Glucagon stimulates the release of glucose stored in the liver - raises blood sugar levels

Opposite of insulin

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21
Q

Liraglutide- side effects?

A

Weight loss/decreased appetite
Rebound weight gain w/ d/c

GI discomfort- occurs w/ increased dosing

Pancreatitis

(GLP-1 agonist)

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22
Q

What drug is a sulfonylureas?

A

Glipizide

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23
Q

What drug class is glipizide in?

A

Sulfonylureas

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24
Q

Glipizide- indications?

Study These Flashcards
A

T2DM

(Sulfonylureas)

25
Glipizide- MOA?
Blocks potassium channels -> increases insulin secretion -> decreases blood sugar
26
Glipizide- side effects?
Weight gain Hypoglycemia - counsel, esp. if w/ beta blockers Contraindicated for T1DM Must be taken WITH first meal (if IR, 30min prior)- hold if NPO (Sulfonylureas)
27
What drug is a dipeptidyl peptidase 4 inhibitor (DPP-4i)?
Sitagliptin
28
What drug class is sitagliptin in?
Dipeptidyl peptidase 4 inhibitor (DPP-4i)
29
Sitagliptin- indications?
T2DM (DPP-4i)
30
Sitagliptin- MOA?
Inhibits DPP-4 -> prolonged activity of incretin (GLP-1/GIP) -> increases insulin secretion / decreases glucagon secretion -> decreases blood sugar (DPP-4i)
31
Sitagliptin- side effects?
Pancreatitis Arthralgia (joint pain) AKI Dermatologic hypersensitivity reactions - serious reactions HF Not taken with GLP-1 Liraglutide- similar MOA Avoid grapefruit juice d/t accumulative effect (DPP-4i)
32
What drug is a thiazolidinedione (TZDS)?
Pioglitazone
33
What drug class is pioglitazone?
Thiazolidinediones (TZDS)
34
Pioglitazone- indications?
T2DM
35
Pioglitazone- MOA?
Increases insulin sensitivity Increases glucose uptake Decreases hepatic glucose production -> lowers blood sugar (TZDS)
36
Pioglitazone- side effects?
HF Peripheral edema Weight gain Contraindicated in HF Avoid grapefruit d/t accumulation effect (TZDS)
37
Insulin types and onset?
Lispro- Rapid acting Regular- short acting NPH- intermediate Glargine- long acting Basal (long-acting) Bolus (short-acting/ meal-time)
38
Insulin- side effects?
Hypoglycemia Hypokalemia Weight gain
39
Rapid insulin name, onset and duration?
Lispro Onset: 15min Peak: 1-2hours Duration: 3-5hours Bolus dose Can be used in pumps Clear & colorless
40
What type of insulin is Lispro?
Rapid acting Onset: 15min Peak: 1-2hours Duration: 3-5hours
41
Short acting insulin name, onset, peak and duration?
Regular insulin Onset: 30min Peak: 2hours Duration: 6-10hours Preferred for IV and parenteral nutrition Bolus dose Taken 30min before meals
42
What type of insulin is regular insulin?
Short acting Onset: 30min (take 30min prior to eating) Peak: 2hours Duration: 6-10hours Bolus/IV/parenteral
43
Intermediate acting insulin name, onset, peak and duration?
NPH Onset: 1-2hours Peak: 4-12hours Duration: 14-24hours (unpredictable) SubQ only, basal insulin BID Cloudy Mixing: draw LAST
44
What type of insulin is NPH?
Intermediate acting insulin Onset: 1-2hours Peak: 4-12hours Duration: 14-24hours (unpredictable) SubQ only, basal BID Cloudy Mixing: draw LAST
45
Long acting insulin name, onset, peak and duration?
Insulin Glargine Onset: 3-4hours Peak: none Duration: >24hours SubQ 1/day Not to be mixed
46
What type of insulin is glargine?
Long acting insulin Onset: 3-4hours Peak: none Duration: > 24hours SubQ only, 1/day
47
Premixed insulin- what is the mix?
70/30 NPH / short or rapid acting
48
What drugs can affect blood glucose?
Increased: Beta blockers (metoprolol) Thiazide/loop diuretics (hydrochlorothiazide/furosemide) Decreased: Beta blockers (can mask hypoglycemia)
49
Main effect of thyroid hormones?
Main determinant of basal metabolic rate
50
Sx of hypothyroidism?
Weight gain Increased fatigue Hair loss, dry skin Cold intolerance Increased BP/cholesterol Constipation/nausea Decreased T4 -> elevated TSH Hashimoto's disease- autoimmune attacks thyroid
51
What hormone does levothyroxine target?
Increases T4
52
Levothyroxine- indication?
Thyroid hormone replacement (T4)
53
Levothyroxine- side effects?
High doses have life threatening toxic effects- not to be used for weight loss Decrease dose in CAD May decrease bone mineral density If dose too high- hyperthyroid Sx Taken w/ water at same time each day, 60min before breakfast or 3 hours after last meal Can increase effects of warfarin- increased INR Beta blockers can decrease effects
54
Sx of Hyperthyroidism?
Overproduction of thyroid hormone (low TSH) Grave's disease- autoimmune, stimulates thyroid -> increased T4 Heart arrythmias thirst increased urination weight loss
55
Propylthiouracil- MOA?
Blocks oxygenation of iodine in thyroid gland -> Inhibits synthesis of thyroid hormones Inhibits conversion of T4 to T3
56
Propylthiouracil- indication?
Hyperthyroidism
57
Propylthiouracil- side effects?
Preferred in 1st tri of pregnancy May cause severe liver injury/acute liver failure - hepatotoxicity
58

Adv. Pharm (9 decks)

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