Endocrine Flashcards Preview

STEP 1 Pharm > Endocrine > Flashcards

Flashcards in Endocrine Deck (30):
1

How to treat DMI

Low sugar diet, insulin replacement

2

How to treat DM II

Weight loss, then metformin, then other agents

3

How to treat gestational diabetes

Diet modifications, exercise, insulin. NOT metformin

4

Three short acting insulins

Insulin aspart, insulin glulisine, insulin lispro

Bind insulin receptor (tyrosine kinase). Increase glucose stored as glycogen, increase synthesis of glycogen in muscle, protein synthesis and K intake.

Increases triglyceride storage in fat cells.

5

Short acting insulin

Given IV for DM I II and gestational. Can also be given for hyperkalemia. Causes hypoglycemia and weight gain.

6

Intermediate acting insulin

NPH

7

Long acting insulin

Glargine and detemir. Glargine is more stable

8

Metformin

A biguanide that increases glycolysis and decreases gluconeogenesis. Increases peripheral glucose uptake in states of insulin insensitivity.

Can be used in patients without islet function.

9

Metformin side effects

GI upset. Does not cause hypoglycemia. Can cause some weight loss

Most important side effect is lactic acidosis because it blocks the breakdown of lactate in liver. DO NOT USE in renal patients.

10

When not to use metformin

In renal patients

11

Sulfonylureas

and Mechanism

First generation: Tolbutamide, chlorpromamide
Second generation: Glyburide, Glimepiride, Glipizide

Close the ATP dependent K channel to depolarize the cell . Leads to Ca influx and release of insulin.

Requires some islet function so can't use for DM1.

12

Sulfonylureas side effects

Risk of hypoglycemia increases with renal failure.

Disulfiram like reaction with tolbutamide/chlorpromamide.

13

Glitazones

Pioglitazone, rosiglitazone. Increase insulin sensitivity by binding to PPAR gamma.

14

Pioglitasone, rosiglitazone side effects

Hepatotoxicity, bone loss, heart failure.

15

Alpha glucosidase inhibitors

Acarbose, miglitol. Prevent breakdown of disaccharides. Side effects are basically like lactose intolerance.

16

Pramlintide (amylin analog)

Decreases gastric emptying and decreases glucagon. PRevents huge glucose spike. Good for T1Dm and T2.

Can cause hypoglycemia and pancreatitis.

17

GLP-1 Analogs (exenatide, liraglutide)

Exenatide, liraglutide. Increase insulin and decrease glucagon release. Treat for T2 DM. Can cause pancreatitis.

18

DPP4 inhibitors (Gliptins)

Gliptins Increase insulin, decrease glucagon release. Used for T2. Can cause urinary or respiratory treact infections

19

SGLT2 inhibitors (canagliflozin)

leads to increased glucose in tubules. Can lead to yeast infections and utis.

20

Propylthiouracil, methimazole

Block thyroid peroxidase, inhibits oxidation of iodide and the organification of iodine. Inhibits thyroid hormone synthesis. Propylthiouracil also decreases peripheral conversion of T4 to T3. Used in hyperthyroidism.

21

Which drug to treat hyperthyroidism is used in pregnancy?

Propylthiouracil, because methimazole can cause aplastica cutis in babies.

22

Side effects of propylthiouracil and methimazole

Agranulocytosis, aplastic anemia, hepatotoxicity

23

Levothyroxine

Thyroid replacment. Can be abused as a weight loss aid. Used for hypothyroidism/myexedema.

24

Levothyroxine side effects

Tachy cardia, heat intolerance, tremors arrhythmias.

25

Growth hormone used for

turner syndrome

26

Somatostatin used for

Gastrinoma, glucagonoma, carcinoid, acromegaly

27

Oxytocin

Stimulates labor, uterine contractions, milk let down. Controls uterine hemorrhage

28

DDAVP

ADH analog used for central DI

29

Vaptans

ADH antagonists used for SIADH. Can cause nephrogenic DI. Also demeclocycline

30

Cinacalcet

Sensitizes calcium receptors on the parathyroid to decrease PTH. Used in 1 or 2 hyperparathyroidism.