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Pharmacology > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What type of medication are Actrapid, Humulin S? What is their duration action?

A

Short acting insulin
Onset 30-60 mins
Peak action 2-3hrs
Duration of action 5-8hrs

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2
Q

What type of medication is novorapid? What is its duration of action?

A

Rapid acting insulin
Onset of action 5-15 mins
Peak action 30-90mins
Duration of action 3-5hrs

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3
Q

What type of medication are isophane insulin, Humulin I?

A

Intermediate acting insulin
Onset of action 2-4hrs
Peak action 4-8hrs
Duration of action 14-16hrs

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4
Q

What type of medication is insulin glargine?

A

Long acting insulin
Onset of action 2-4hrs
Peak action - none
Duration of action 20-24hrs

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5
Q

What type of medication are gliclazide and glimepiride?

A

Sulphonylurea

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6
Q

What are the indication for prescribing gliclazide?

A

Type 2 diabetes mellitus.

Where metformin is contraindicated, or in addition to metformin whee blood glucose is still inadequately controlled

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7
Q

What is the mechanism of action of sulphonylureas?

A

Lowers blood glucose by stimulating pancreatic insulin secretion.
Block ATP dependant potassium channels in pancreatic beta cell membranes, causing depolarisation and opening voltage gated calcium channels, raising Intracellular calcium levels which causes insulin secretion .
Associated with weight gain.

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8
Q

What are the indications for prescribing metformin?

A

Type 2 diabetes mellitus
First choice for blood glucose control. Can be used alone or in combination with other oral hypoglycaemic agents e.g. sulphonylureas

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9
Q

What is the mechanism of action of metformin?

A

Lowers blood glucose by increasing the response (sensitivity) to insulin. Suppresses hepatic glucose production (glycolysis and gluconeogenesis), increases glucose uptake and utilisation by skeletal muscle and suppresses intestinal glucose absorption. Reduces weight gain.

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10
Q

What class of medication are repaglinide and nateglinide?

A

Meglitinides

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11
Q

What is the mechanism of action of meglitinides such as repaglinide and nateglinide?

A

Promotes insulin release from beta islet cells of pancreas. Blocks potassium channels, leading to increase of Intracellular calcium and therefore stimulating insulin release

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12
Q

What is the indication for prescribing meglitinides such as repaglinide and nateglinide?

A

Type 2 diabetes mellitus

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13
Q

What class of medication are rosiglatazone and pioglatizone?

A

Thiazolidinediones

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14
Q

What would be the indication for prescribing thiazolidinediones such as rosiglatazone or pioglatizone?

A

Type 2 diabetes mellitus

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15
Q

What is the mechanism of action of thiazolidinediones such as rosiglatazone or pioglatizone?

A

Insulin sensitisers. Binds to PPAR receptor in fat cells, making them more responsive to insulin. Often used alongside metformin and other oral hypoglycaemic agents.

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16
Q

What is the mechanism of action of alpha glucosidase inhibitors, such as acarbose, miglitol?

A

Competitive inhibitors of enzymes which are needed to digest carbohydrates, decreasing their absorption as glucose.

17
Q

What is the use of alpha glucosidase inhibitors, such as acarbose, miglitol?

A

Oral hypoglycaemic agents in diabetes mellitus type 2

18
Q

What is the use of glucagon like peptide 1 receptor antagonists such as liraglutide, exenatide?

A

Treatment of type 2diabetes mellitus

19
Q

What is the mechanism of action of glucagon like peptide 1 receptor antagonists such as liraglutide, exenatide?

A

Agonists of GLP 1 receptor, found on beta cells of pancreas, enhancing insulin secretion

20
Q

What may sodium glucose cotransporter 2 (SGLT2) inhibitors, such as dapagliflozin and canagliflozin be prescribed for?

A

Type 2 diabetes mellitus

21
Q

What is the mechanism of action of sodium glucose cotransporter 2 (SGLT2) inhibitors, such as dapagliflozin and canagliflozin?

A

Prevent kidneys from reabsorbing glucose back into blood, causing excretion of excess glucose into urine.

22
Q

What is the mechanism of action of dipeptyl peptidase 4 (DPP4) inhibitors such as sitagliptin, saxagliptin, linagliptin?

A

Block action of DPP4, preventing break down of incretins, which help stimulate insulin and reduce production of glucagon. Also slow down digestion and decreases appetite so can aid weight loss

23
Q

What are dipeptyl peptidase 4 (DPP4) inhibitors such as sitagliptin, saxagliptin, linagliptin prescribed for?

A

Third line treatment of diabetes mellitus behind metformin and sulphanylureas

24
Q

What might levothyroxine, liothyronine be used for?

A

Primary hypothyroidism

Hypothyroidism secondary to hypopituitarism

25
Q

What is the mechanism of action of levothyroxine, liothyronine?

A

Levothyroxine (synthetic T4)
Liothyronine (synthetic T3, quicker duration of use, reserved for hypothyroid emergencies)
Replacement of thyroid hormones

26
Q

What may carbimazole be used for?

A

Hyperthyroidism

27
Q

What is the mechanism of action of carbimazole?

A

Prevents thyroid peroxidase from iodinating tyrosine residues on thyroglobulin, thereby reducing production of thyroid hormones T3 and T4

28
Q

What might systemic steroids be given for?

A

Allergic or inflammatory disorders
Suppression of autoimmune disease
Treatment of some cancers, as part of chemotherapy or to reduce tumour associated swelling
Hormonal replacement of adrenal insufficiency or hypopituitarism

29
Q

What is the mechanism of action of systemic corticosteroids?

A

Bind to cytosolic receptors which then translocation to nuclear and alter gene expression. Unregulated anti inflammatory genes as down regulate pro inflammatory genes (e.g. cytokines, TNF alpha). Suppression of circulating monocytes and eosinophils.

30
Q

What type of medications are fludrocortisone, betamethasone, dexamethasone?

A

Systemic corticosteroids

31
Q

What is medroxyprogesterone acetate used for?

A

HRT in menopause
Contraception (depot injection), endometriosis, abnormal uterine bleeding
Progestin type

32
Q

Wha this oestradiol used for?

A

HRT

33
Q

What is clomifene used for?

A

To treat infertility in woman who do not ovulate

34
Q

What is the mechanism of action of clomiphene?

A

Given early in menstrual cycle (days 3-5), reducing negative feedback of oestrogen and thereby increasing FSH and LH levels and increased growth and release of ovarian follicles
Nonsteroidal SERM. Inhibits oestrogen receptors in the hypothalamus, inhibiting negative feedback of oestrogen on gonadotropin release, resulting in upregulation of hypothalamic pituitary gonadal axis.

35
Q

What is tamoxifen used to treat?

A

Breast cancer
Also used for its prevention in high risk patients
Has been used for anovulatory infertility and also in men
Gynaecomastia

36
Q

What is the mechanism of action of tamoxifen?

A

Competitive inhibitor of oestrogen

Pharmacology (9 decks)

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