Endocrine Drugs Flashcards

(31 cards)

1
Q

What are 2 examples of Sulphonylureas?

A

Gliclazide

Glimepiride

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2
Q

What is the MoA of sulphonylureas?

A

Stimulates B cells of the pancreas to produce more insulin
Increase cellular glucose uptake and glycogenesis; reduces gluconeogenesis
Glicazide is short acting (12 hours approx)

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3
Q

what are the indications for sulphonyulereas?

A

T2DM with diet and exercise

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4
Q

list some side effects of sulphonyuleras?

A
Hypoglycaemia
Rashes
Nausea
Vomiting
Stomach pain
Indigestion
Weight gain
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5
Q

What is important clinically regarding pharmacokinetics/dynamics for sulphonyulereas?

A

Renally excreted so accumulate in renal failure

Glimepiride is long acting sulphonylureas

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6
Q

What info should be given to patient before starting a sulphonyulerea?

A

Compliance important
Maintain consistent diet
Avoid alcohol

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7
Q

What is an example of a biguanide?

A

Metformin

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8
Q

what is the MoA of metformin?

A

Increase the activity of AMP-dependent protein kinase (AMPK)
This inhibits gluconeogenesis
Reduces insulin resistance

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9
Q

What are the indications for a biguanide?

A

Type 2 diabetes mellitus along with diet and exercise

Metabolic and reproductive abnormalities associated with Polycystic ovarian syndrome

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10
Q

List some side effects of metformin:

A
Diarrhoea
Nausea
Vomiting
Taste disturbances
Lack of apetite
Risk of lactic acidosis in patients with renal failure
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11
Q

What is important clinically regarding pharmacokinetics/dynamics for metformin?

A

Not recommended in pregnancy and renal failure (eGFR <30 mls/min)
Absorption reduces when taken with food

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12
Q

What info should be given to patient before starting metformin?

A

take at same time every day

avoid alcohol

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13
Q

What is metformin’s affect on weight?

A

It does not increase weight (may loose some due to side effects)

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14
Q

What are 2 examples of GLP-1 (glucagon like peptide) Agonists?

A

Exanatide

Liraglutide

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15
Q

What is the MoA for a GLP-1 Agonist?

A

GLP-1 is a hormone that is released after meals to increase insulin secretion
These drugs are a GLP-1 agonist - it increases insulin secretion, decreases glucagon secretion and reduces hunger

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16
Q

what is the indication for GLP-1 agonists?

17
Q

list some side effects of GLP-1 agonists:

A

Hypoglycaemia
Nausea
Vomiting
Diarrhoea

18
Q

What is important clinically regarding pharmacokinetics/dynamics for exanatide and liraglutide?

A

It can lower glucose alone, but when given in combination with metformin, sulfonylureas, and/or insulin it can improve glucose control
Renally excreted so dose adjustment needed in renal failure

19
Q

What info should be given to patient before starting a GLP-1 agonist?

A

Only given as injections

Twice a day

20
Q

what is the synthetic thyroid hormone drug called?

A

levothyroxine

21
Q

what is the MoA for levothyroxine?

A

Thyroxine increases the metabolic rate of all tissues in the body
Synthetically prepared levo-isomer of thyroxine
Acts like T4 and gets converted to T3 in the liver and kidney
Maintain brain function, food metabolism, and body temperature, among other effects

22
Q

what are the indications for synthetic thyroid hormone?

A

Hypothyroidism

Chronic lymphocytic thyroiditis

23
Q

list some side effects of levothyroxine

A
Chest pain
Coma
Diarrhoea
Tachycardia
Itching
Muscle cramps
(shouldn't happen if dose is correct)
24
Q

What is important clinically regarding pharmacokinetics/dynamics for levothyroxine?

A

Primarily eliminated by the kidneys
Intravenous formulations are available
The half-life is long (6 to 7 days) so thyroid function should be rechecked 6 weeks after a dose adjustment

25
what info should be given to patient before starting levothyroxine?
Take 30-60 minutes before breakfast.
26
what are 2 examples of anti-thyroid drugs - thionamides?
Carbimazole | Propylthiouracil
27
what is the MoA of thionamides?
Reduces activity of peroxidase enzyme (required for the production of thyroid hormones) May also reduce peripheral conversion of T4 to T3 Carbimazole is a pro-drug
28
what are the indications for carbimazole and propylthiouracil?
Hyperthyroidism Thyrotoxicosis Preparing patients for thyroid surgery
29
list some side effects of thionamides:
rash agranulocytosis sore throat
30
What is important clinically regarding pharmacokinetics/dynamics for thionamides?
Carbimazole is rapidly metabolised to thiamazole. The mean peak plasma concentration occurs one hour It crosses the placenta and can be found in breast milk The effect of anti-thyroid drugs can take several weeks to occur so are usually prescribed alongside a beta-blocker to reduce symptoms of hyperthyroidism
31
what info should be given to patient before starting a thionamide?
Compliance is important | Regular blood checks will be needed to monitor treatment response and renal, hepatic function and full blood counts.