Endocrine Flashcards Preview

DRUGS > Endocrine > Flashcards

Flashcards in Endocrine Deck (78):
1

DM 1 treatment plan

Low carbohydrates, insulin replacement

2

DM 2 treatment plan

Diet and exercise for weight loss; oral agents, non-insulin injectables, insulin replacement

3

Gestational diabetes treatment plan

Diet and excercise; insulin if these fail

4

Aspart Onset

Insulin rapid acting

5

Glulisine Onset

Insulin rapid acting

6

Lispro Onset

Insulin rapid acting

7

Regular insulin Onset

Insulin short acting

8

NPH Onset

Insulin intermediate acting

9

Determir Onset

Insulin long acting

10

Glargine Onset

Insulin long acting

11

Insulin Action: (liver, muscle, fat)

Liver: increase glucose --> glycogen
Muscle: increase glycogen, protein synthesis; K+ uptake
Fat: increased triglyceride stores

12

Insulin rapid acting: Use

DM T1, DM T2, GDM, post prandial glucose control

[Glulisine, Lispro, Aspart]

13

Insulin short acting: use

DM T1, DM T2, GDM, hyperkalemia (with glucose), DKA(IV), stress hyperglycemia

14

Insulin intermediate acting: Use

DM T1, DM T2, GDM

[NPH]

15

Insulin long acting: Use

DM T1, DM T2, GDM

[Determir, Glargine]

16

Insulin rapid acting: AE

Hypoglycemia / rare hypersensitivity

17

Biguanides: action
(metformin)

Decrease gluconeogenesis, increase glycolysis, increase peripheral glucose uptake (increase glucose sensitivity)

18

Biguanides: use
(metformin)

First line for DM T2, modest weight loss. Can be used in patients without islet function

19

Biguanides: AE
(metformin)

GI upset; LACTIC ACIDOSIS (contraindicated in renal insufficiency)

[no risk of hypoglycemia]

20

Sulfonylureas: Action
(1stG= chlorpropamide, Tolbutamide)
(2ndG= Glimepiride, glipizidine, Glyburide)

K+ channel blockade in beta cells --> increased insulin release

21

Sulfonylureas: Use
(1stG= chlorpropamide, Tolbutamide)
(2ndG= Glimepiride, glipizidine, Glyburide)

DM T2, (needs some islet function)

22

Sulfonylureas: AE
(1stG= chlorpropamide, Tolbutamide)
(2ndG= Glimepiride, glipizidine, Glyburide)

risk of hypoglycemia in renal failure
1st gen: disulfram like reactions
2nd gen: hypoglycemia

23

Glitazones / Thiazolidinediones: action
(Pioglitazone, Rosiglitazone)

PPAR-gamma nuclear transcription regulator (peripheral tissue) --> increased insulin sensitivity

24

Glitazones / Thiazolidinediones: use
(Pioglitazone, Rosiglitazone)

Used as monotherapy for DM T2, or in combination

25

Glitazones / Thiazolidinediones: AE
(Pioglitazone, Rosiglitazone)

weight gain, edema, hepatotoxicity, HF, increased risk of fractures

[no risk of hypoglycemia]

26

metformin

Oral hypoglycemic drug: Biguanides

27

chlorpropamide

Oral hypoglycemic drug: 1st Gen Sulfonylureas

28

Tolbutamide

Oral hypoglycemic drug: 1st Gen Sulfonylureas

29

Glimepiride

Oral hypoglycemic drug: 2nd Gen Sulfonylureas

30

glipizidine

Oral hypoglycemic drug: 2nd Gen Sulfonylureas

31

Glyburide

Oral hypoglycemic drug: 2nd Gen Sulfonylureas

32

Pioglitazone

Oral hypoglycemic drug: Glitazones / Thiazolidinediones

33

Rosiglitazone

Oral hypoglycemic drug: Glitazones / Thiazolidinediones

34

GLP-1 analogs: action
(exenatide, Liraglutide)

Increase insulin, decrease glucagon

35

GLP-1 analogs: use
(exenatide, Liraglutide)

DM T2

36

GLP-1 analogs: AE
(exenatide, Liraglutide)

Pancreatitis, N/V

[no risk of hypoglycemia]

37

DPP-4 inhibitors: Action
(linagliptin, Saxagliptin, sitagliptin)

Increase insulin, decrease glucagon

38

DPP-4 inhibitors: Use
(linagliptin, Saxagliptin, sitagliptin)

DM T2

39

DPP-4 inhibitors: AE
(linagliptin, Saxagliptin, sitagliptin)

Mild urinary or resp infections

[no risk of hypoglycemia]

40

Amylin analogs: action
(Pramlintide)

decrease gastric emptying, decrease glucagon

41

Amylin analogs: Use
(Pramlintide)

DM T1, DM T2

42

Amylin analogs: AE
(Pramlintide)

Hypoglycemia, N/D

43

SGLT-2 inhibitors: Action
(canagliflozin)

block reabsorption of glucose in PCT

44

SGLT-2 inhibitors: use
(canagliflozin)

DM T2

45

SGLT-2 inhibitors: AE
(canagliflozin)

Glucosuria, UTIs, vaginal yeast infections

[no risk of hypoglycemia]

46

alpha-glucosidase inhibitors: Action
(Acarbose, miglitol)

inhibit Brush border glucosidase. Delayed carbohydrate hydrolysis and glucose absorption --> decreased postprandial hyperglycemia

47

alpha-glucosidase inhibitors: Use
(Acarbose, miglitol)

monotherapy in DM T2, or in combination

48

alpha-glucosidase inhibitors: AE
(Acarbose, miglitol)

GI disturbances

[no risk of hypoglycemia]

49

exenatide

Oral hypoglycemic drug: GLP-1 analogs:

50

Liraglutide

Oral hypoglycemic drug: GLP-1 analogs:

51

linagliptin

Oral hypoglycemic drug: DPP-4 inhibitors:

52

Saxagliptin

Oral hypoglycemic drug: DPP-4 inhibitors:

53

sitagliptin

Oral hypoglycemic drug: DPP-4 inhibitors:

54

Pramlintide

Oral hypoglycemic drug: Amylin analogs:

55

canagliflozin

Oral hypoglycemic drug: SGLT-2 inhibitors:

56

Acarbose

Oral hypoglycemic drug: alpha-glucosidase inhibitors

57

miglitol

Oral hypoglycemic drug: alpha-glucosidase inhibitors

58

Propylthiouracil: mechanism

Block thyroid peroxidase (also methimazole). Propylthiouracil also blocks 5' deiodinase --> decreased peripheral conversion of T4-->T3

59

Propylthiouracil: Use

Hyperthyroidism, pregnancy

60

Propylthiouracil: Adverse effects

Skin rash, agranulocytosis, aplastic anemia, (also methimazole)
hepatotoxicity (only propylthiouracil)

61

Methimazole: Mechanism

Block thyroid peroxidase (also propylthiouracil)

62

Methimazole: use

Hyperthyroidism

63

Methimazole: AE

Skin rash, agranulocytosis, aplastic anemia, (also propylthiouracil)
possible teratogen(only methimazole)

64

Levothyroxine (T4), Triiodothyronine (T3): Use

hypothyroid, myxedema, weight loss suppliments (off-label)

65

Conivaptan

ADH antagonist
(conivaptan, tolvaptan)

66

Desmopressin acetate: use

Central DI

67

Tolvaptan

ADH antagonist
(conivaptan, tolvaptan)

68

GH: use

GH def., turner syndrome

69

Oxytocin: use

Contractions, milk letdown, controls uterine hemorrhage

70

Somatostatin (ocreotide): Use

Acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

71

Demeclocyline: action

ADH antagonist

72

Demeclocyline: AE

N DI, photosenstiivity, abnormalities of bone and teeth

73

Glucocorticoids: action
(beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)

catabolic, anti-inflammatory and immunosuppresive (inhibit PLA2), inhibit NF-kB

74

Glucocorticoids: use
(beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)

Addisons, inflammation, immunosuppression, asthma

75

Glucocorticoids: AE
(beclomethason, dexamethasone, fludrocortisone (mineralocorticoid also), hydrocortisone, methylprednisolone, prednisolone, triamcinolone)

Iatrogenic cushings, adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis. Adrenal insufficiency if drug stopped prematurely

76

Cinacalcet: mechanism

sensitizes Ca++ sensing receptor in parathyroid gland to circulating Ca++ --> decrease PTH

77

Cinacalcet: use

hypercalcemia due to hyperparathyroidism

78

Cinacalcet: AE

Hypocalcemia