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Step 1 Exam > Endocrine drugs > Flashcards

Endocrine drugs Flashcards

1
Q

Lispro, Aspart, Glulisine Action

A

-bind insulin receptor (tyrosine kinase activity) -increase glucose stored as glycogen in the liver -increase glyocgen, protein synthesis, and K+ uptake in muscle -increase TG storage in fat (rapid-acting)

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2
Q

Clinical use of lispro, aspart and glulisine

A

-DM1 -DM2 -GDM (postprandial glucose control)

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3
Q

Use of Inuslin, Regular

A

-DM1, DM2 -GDM -DKA -hyperkalemia -stress hyperglycemia (short acting)

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4
Q

NPH

A

intermediate acting insulin -DM1, DM2, GDM

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5
Q

Glargine and Detemir are…

A

long acting insulins for DM1, DM2, GDM (basal glucose control)

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6
Q

Metformin (a biguanide) acts to…

A

-decrease gluconeogenesis -increase glycolysis -increase peripheral glucose uptake (insulin sensitivity)

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7
Q

Use of Metformin

A

-first line therapy in type 2 DM

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8
Q

Toxicities of Metformin

A

lactic acidosis (thus contraindicated in renal failure)

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9
Q

First generation sulfonylureas

A

Tolbutamide Chlorpropamide

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10
Q

Second generation sulfonylureas

A

Glyburide Glimepiride Glipizide

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11
Q

MOA of Sulfonylureas

A

close K+ channel in beta-cell membrane so the cell depolarizes triggering insulin release via calcium influx

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12
Q

Use of sulfonylureas

A

type 2 DM (requires some islet function so useless in T1)

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13
Q

Toxicities of sufonlyureas

A

-1st gen: disulfiram-like effects -2nd gen: hypoglycemia (esp. in renal failure)

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14
Q

Pioglitazone and Rosiglitazone (glitazones/thiazolidinediones) MOA

A

increase insulin sensitivity in the peripheral tissues; binds PPAR-gamma nuclear transcription regulator

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15
Q

Use of Pioglitazone and Rosiglitazone

A

type 2 DM

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16
Q

Toxicities of Pioglitazone and Rosiglitazone

A

-weight gain -edema -hepatotoxicity -HEART FAILURE

17
Q

Acarbose and Miglitol (alpha-glucosidase inhibitors) MOA

A

-inhibit intestinal brush-border alpha-glucosidases -delayed sugar hydrolysis and glucose absorption leading to decreased postprandial hyperglycemia

18
Q

Acarbose and Miglitol uses

A

type 2 DM

19
Q

Pramlintide is an amylin analog that…

A

decreases gastric emptying and decreases glucagon. Used in T1 and T2 DM.

20
Q

Exenatide and Liraglutide are…

A

GLP-1 analogs that increase insulin and decrease glucagon release. Used in T2 diabetes.

21
Q

Toxicity of exenatide and liraglutide

A

pancreatitis

22
Q

Linagliptin, Saxagliptin and Sitagliptin are..

A

DPP-4 inhibitors that increase insulin and decrease glucagon release used in T2DM.

23
Q

Genes activated by PPAR-gamma regulate…

A

fatty acid storage and glucose metabolism. Activation of PPAR-gamma increase insulin sensitivty and levels of adiponectin.

24
Q

Propylthiouracil and Methimazole MOA

A

block thyroid peroxidase, inhibiting the oxidation of iodide and organification of iodine leading to inhibition of thyroid hormone synthesis.

25
Q

PTU also blocks…

A

5’-deiodinase which decreases peripheral conversion of T4 to T3. (used in pregnancy)

26
Q

Use of Methimazole and PTU

A

Hyperthyroidism

27
Q

Toxicity of PTU and Methimazole

A

-skin rash -agranulocytosis -aplastic anemia -teratogen (Methimazole can cause aplasia cutis)

28
Q

Levothryoxine and Triiodothyronine are used for…

A

hypothyroidism and myxedema.

29
Q

GH is used in…

A

GH deficiency and Turner syndrome.

30
Q

Somatostatin (octreotide) is used in…

A

acromegaly, carcinoid, gastinoma, glucagonoma and esophageal varices.

31
Q

Oxytocin stimulates…

A

labor, uterine contractions and milk letdown; it controls uterine hemorrhage too.

32
Q

ADH (DDAVP) is used for…

A

pituitary DI.

33
Q

Glucocorticoids (6)

A
  1. hydrocortisone 2. prednisone 3. triamcinolone 4. dexamethasone 5. beclomethasone 6. fludrocortisone
34
Q

Mechanism of glucocorticoids

A

metabolic, catabolic, anti-inflammatory, and immmunosuppressive effects are mediated by interactions with the glucocorticoid response elements and inhibition of transcription factors such as NF-kappaB.

35
Q

Use of glucocorticoids

A

-addison disease -inflammation -immune suppression -asthma

36
Q

Toxicity of Glucocorticoids

A

-iatrogenic Cushings -adrenal insufficiency when drugs are stopped abruptly after chronic use

Step 1 Exam (32 decks)

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