Endocrine drugs

Question 1

Patient advice for levothyroxine

Answer 1

Lifelong, take in morning 30mins-1 hour before food.

Question 2

Rapid acting insulin examples

Answer 2

Insulin lispor, aspart, novorapid

Question 3

Shortacting insulin example

Answer 3

Soluble insulin

Question 4

Intermediate acting insulin

Answer 4

Isophane insulin

Question 5

Long acting insulin

Answer 5

Glargine, determir

Question 6

Metformin monitoring, cautions, interactions

Answer 6

M- U&Es at least once a year
C- in AKI, renal impairment, lactic acidosis
I- IV contrast media, ACEi, NSAIDs, diuretics, prednisolone, insulin and sulphonyureas

Question 7

Metformin SE and counselling

Answer 7

SE- n,v, diarrhoea, anorexia, taste disturbance, weight loss, lactic acidosis, reduced vit B12, hepatitis
C- Should be taken with or after food

Question 8

Sulphonylurea examples

Answer 8

GliclazIDE, tolbutaimIDE, glibenclamIDE, glimepirIDE

Question 9

Sulphonylurea SE

Answer 9

WEIGHT GAIN HAPPENS
Weight gain
GI upset
Hypoglycaemia

Question 10

Thiazolidiones examples

Answer 10

ZONE

Pioglitazone, rosiglitazone

Question 11

Thiazolidiones CI, monitoring, SE

Answer 11

CI-HF, acitve bladder cancer, preg, BF, hepatic impairment, dialysis
M-LFTs every 2-6 months
SE- weight gain, hypoglycaemia, bladder cancer, dizziness, vertigo, visual disturbances, impotence

Question 12

DPP-4 inhibitors

Examples, Cautions, interactions, monitoring, SE

Answer 12

E- Sitagliptin, vidagliptin 
CI- pregnancy, BF
Cautions- renal impairment
I- Digoxin 
M- HBA1c and LFTs every 3 months 
SE- Gi distruabcnes, peripheral oedema, anorexia, pancreatitis, hepatotoxicity

Question 13

GLP-1 agonists

Examples, route, interactions, SE, Counselling

Answer 13

E- Exenatide, liraglutide
R- S/C
I- warfarin
SE- Weight loss, GI upset, severe pancreatitis, hypoglycaemia
C- dont take with food, if miss dose dont double up, stop immediately in acute pacnreatitis, need contraception up to 12 weeks after discontinuation