Endocrine Flashcards
(98 cards)
1
Q
what insulins are rapid-acting? (3)
A
- lispro
- aspart
- glulisine
2
Q
what is lispro?
A
rapid-acting insulin
3
Q
what is aspart?
A
rapid-acting insulin
4
Q
what is glulisine?
A
rapid-acting insulin
5
Q
mechanism of insulins
A
bind insulin receptor (tyrosine kinase)
liver: increase glycogen
muscle: increase glycogen, protein synthesis, increase K uptake
fat: increase triglyceride
6
Q
clinical use rapid-acting insulins
A
post-prandial control
7
Q
side effects of insulins (2)
A
- hypoglycemia
2. rare hypersensitivity
8
Q
what is a short-acting insulin?
A
regular
9
Q
what is regular?
A
short-acting insulin
10
Q
clinical use short-acting insulin
A
DKA, hyperkalemia (+ glucose), stress hyperglycemia
11
Q
what is an intermediate-acting insulin?
A
NPH
12
Q
what is NPH?
A
intermediate-acting insulin
13
Q
what are long-acting insulins? (2)
A
- glargine
2. detemir
14
Q
clinical use long-acting insulins
A
basal glucose control
15
Q
what is a biguanide?
A
metformin
16
Q
drug class metformin
A
biguanide
17
Q
what does metformin do?
A
increases insulin sensitivity
decrease gluconeogenesis
increase glycolysis
increase peripheral glucose uptake
18
Q
what drug is first line therapy in type 2 DM?
A
metformin
19
Q
side effects metformin (2)
A
- GI upset
2. lactic acidosis (DO NOT use in renal failure!)
20
Q
can you use metformin in renal failure?
A
NO!!
21
Q
what are two first generation sulfonylureas?
A
- tolbutamine
2. chlorpropamide
22
Q
what are three second generation sulfonylureas?
A
- glyburide
- glimepiride
- glipizide
23
Q
what is tolbutamine?
A
1st generation sulfonylurea
24
Q
what is chlorpropamide?
A
1st generation sulfonylurea
25
what is glyburide?
2nd generation sulfonylurea
26
what is glimepiride?
2nd generation sulfonylurea
27
what is glipizide?
2nd generation sulfonylurea
28
sulfonylurea mechanism
close K channel in beta cell --> depolarizes --> Ca influx --> insulin release
29
are sulfonylureas useful in type I diabetes?
NO!!
30
what type of DM are sulfonylureas useful in?
Type 2 (stimulates release of endogenous insulin)
31
side effects of sulfonylurea use in renal failure
hypoglycemia (risk increased)
32
side effects 1st generation sulfonylureas
disulfiram-like effects
33
side effects 2nd generation sulfonylureas
hypoglycemia
34
what are two glitazones/thiazolidinediones?
1. pioglitazone
| 2. rosiglitazone
35
what is pioglitazone?
glitazone/thiazolidinedione
36
what is rosiglitazone?
glitazone/thiazolidinedione
37
mechanism glitazone/thiazolidinedione
increase insulin sensitivity by binding PPAR-gamma nuclear transcription regulator
PPAR-gamma regulates fatty acid storage and glucose metabolism
38
side effects glitazone/thiazolidinedione
1. weight gain
2. edema
3. hepatotoxicity
4. heart failure
39
what are two alpha-glucosidase inhibitors?
1. acarbose
| 2. miglitol
40
what is acarbose?
alpha-glucosidase inhibitor
41
what is miglitol?
alpha-glucosidase inhibitor
42
mechanism alpha-glucosidase inhibitors
inhibit intestinal brush-border alpha-glucosidases
| dlays sugar hydrolysis and glucose absorption --> decrease postprandial hyperglycemia
43
side effect alpha-glucosidase inhibitors
GI disturbances
44
what is an amylin analog?
pramlintide
45
what is pramlintide?
amylin analog
46
mechanism amylin analogs
decrease gastric emptying
| decrease glucagon
47
clinical use amylin analog
type 1 and 2 DM
48
side effects amylin analogs (3)
1. hypoglycemia
2. nausea
3. diarrhea
49
what are two GLP-1 analogs?
1. exenatide
| 2. liraglutide
50
what is exenatide?
GLP-1 analog
51
what is liraglutide?
GLP-1 analog
52
mechanism GLP-1 analogs
increase insulin, decrease glucagon release
53
side effects GLP-1 analogs (2)
1. N/V
| 2. pancreatitis
54
what are three DPP-4 inhibitors?
1. linagliptin
2. saxagliptin
3. sitagliptin
55
what is linagliptin?
DPP-4 inhibitor
56
what is saxagliptin?
DPP-4 inhibitor
57
what is sitagliptin?
DPP-4 inhibitor
58
mechanism DPP-4 inhibitors
increase insulin, decrease glucagon release
59
side effects DPP-4 inhibitors
mild urinary or respiratory infections
60
what diabetes drug causes weight gain?
glitazones / thiazolidinediones
61
what diabetes drug causes hepatotoxicity?
glitazones / thiazolidinediones
62
what diabetes drug causes heart failure?
glitazones / thiazolidinediones
63
what diabetes drug causes lactic acidosis and shouldn't be used in renal failure?
metformin
64
what diabetes drug causes pancreatitis?
GLP-1 analogs
65
what is propylthiouracil?
thyroid peroxidase inhibitor for hyperthyroidism
66
what is methimazole?
thyroid peroxidase inhibitor for hyperthyroidism
67
propylthiouracil mechanism
blocks thyroid peroxidase --> inhibits oxidation of iodide and organification (coupling) of iodine --> inhibits thyroid hormone synthesis
inhibits 5'-deiodinase --> decreases peripheral conversion of T4 to T3
68
methimazole mechanism
blocks thyroid peroxidase --> inhibits oxidation of iodide and organification (coupling) of iodine --> inhibits thyroid hormone synthesis
69
clinical use propylthiouracil
hyperthyroidism
70
clinical use methimazole
hyperthyroidism
71
which drug do you use for hyperthyroidism in pregnancy?
propylthiouracil (PTU)
72
side effects propylthiouracil
1. rash
2. agranulocytosis / aplastic anemia
3. hepatotoxicity
73
side effects methimazole
1. rash
2. agranulocytosis / aplastic anemia
3. teratogen (aplasia cutis)
74
what is levothyroxine?
thyroxine replacement
75
what is triiodothyronine?
thyroxine replacement
76
clinical use levothyroxine
hypothyroidism, myxedema
77
clinical use triiodothyronine
hypothyroidism, myxedema
78
side effects levothyroxine (4)
1. tachycardia
2. heat intolerance
3. tremors
4. arrhythmias
79
side effects triiodothyronine (4)
1. tachycardia
2. heat intolerance
3. tremors
4. arrhythmias
80
clinical use GH
GH deficiency
| Turner syndrome
81
clinical use somatostatin (octreotide)
```
acromegaly
carcinoid
gastrinoma
glucagonoma
esophageal varices
```
82
clinical use oxytocin
stimulates labor
uterine contractions
milk let-down
uterine hemorrhage
83
clinical use ADH (DDAVP)
pituitary (central) DI
84
what is demeclocycline?
ADH antagonist
85
clinical use demeclocycline
SIADH
86
what drug treats SIADH?
demeclocycline
87
side effects demeclocycline
1. nephrogenic DI
2. photosensitivity
3. bone and teeth abnormalities
88
drug class hydrocortisone
glucocorticoid
89
drug class prednisone
glucocorticoid
90
drug class triamcinolone
glucocorticoid
91
drug class dexamethasone
glucocorticoid
92
drug class beclomethasone
glucocorticoid
93
drug class fludrocortisone
glucocorticoid
94
mechanism glucocorticoids
metabolic, catabolic, anti-inflammatory, and immunosuppressive
inhibits transcription factors (i.e. NF-KB)
95
clinical use glucocorticoids (4)
1. Addison disease
2. inflammation
3. immune suppression
4. asthma
96
side effects glucocorticoids (2)
1. Cushing syndrome
| 2. adrenal insufficiency if stopped abruptly
97
sx of Cushing syndrome (10)
1. buffalo hump
2. moon facies
3. truncal obesity
4. muscle wasting
5. thin skin
6. easy bruisability
7. osteoporosis
8. adrenocortical atrophy
9. peptic ulcers
10. diabetes (if chronic)
98
treatment osteoporosis
bisphosphenates
