Endocrine Pharm EC

Question 1

Lispro, Aspart, Glulisine (MOA, Use, Tox)

Answer 1

Rapid-acting insulin (Increase K uptake, increase glycogen and TG, increase protein synthesis)

Type 1 and 2 DM, Gestational diabetes, Life-threatening hyperkalemia

Hypoglycemia, hypersensitivity (very rare)

Question 2

Regular (MOA, Use, Tox)

Answer 2

Short-acting insulin (Increase K uptake, increase glycogen and TG, increase protein synthesis)

Type 1 and 2 DM, Gestational diabetes, Life-threatening hyperkalemia

Hypoglycemia, hypersensitivity (very rare)

Question 3

NPH (MOA, Use, Tox)

Answer 3

Intermediate-acting insulin (Increase K uptake, increase glycogen and TG, increase protein synthesis)

Type 1 and 2 DM, Gestational diabetes, Life-threatening hyperkalemia

Hypoglycemia, hypersensitivity (very rare)

Question 4

Glargine, Detemir (MOA, Use, Tox)

Answer 4

Long-acting insulin (Increase K uptake, increase glycogen and TG, increase protein synthesis)

Type 1 and 2 DM, Gestational diabetes, Life-threatening hyperkalemia

Hypoglycemia, hypersensitivity (very rare)

Question 5

Metformin (MOA, Use, Tox)

Answer 5

Biguanide (acts on liver)
Decrease gluconeogenesis
Increase glycolysis and peripheral glucose uptake

First line for T2 DM

GI upset
LACTIC ACIDOSIS (contraindicated in renal failure)

Question 6

Glyburide, Glimepiride, Glipizide (MOA, Use, Tox)

Answer 6

Second generation sulfonylureas
Close K channel in beta-cell, depolarization, Ca influx, endogenous insulin release

T2 DM (requires some islet function, useless in T1)

Hypoglycemia

Question 7

Tolbutamide, Chlorpropamide (MOA, Use, Tox)

Answer 7

First generation sulfonylureas
Close K channel in beta-cell, depolarization, Ca influx, endogenous insulin release

T2 DM (requires some islet function, useless in T1)

Disulfiram-like reaction

Question 8

Pioglitazone, Rosiglitazone (MOA, Use, Tox)

Answer 8

Increase insulin sensitivity in peripheral tissue
Bind PPAR-gamma nuclear transcription regulator

T2 DM (often in combo)

Weight gain, edema, hepatotoxicity, heart failure

Question 9

Acarbose, Miglitol (MOA, Use, Tox)

Answer 9

Inhibit brush border alpha-glucosidases
Delay sugar hydrolysis and glucose absorption which DECREASES POST-PRANDIAL HYPERGLYCEMIA

T2 DM (often in combo)

GI disturbance

Question 10

Exenatide, Liraglutide (MOA, Use, Tox)

Answer 10

GLP-1 analogs
Increase insulin, decrease glucagon resistance

T2 DM

N/V, Pancreatitis

Question 11

Pramlintide (MOA, Use, Tox)

Answer 11

Amylin analog - Decrease glucagon

T1&2 DM

Hypoglycemia, Nausea, Diarrhea

Question 12

Linagliptin, Saxagliptin, Sitagliptin (MOA, Use, Tox)

Answer 12

DPP-4 inhibitors
Increase insulin, decrease glucagon release

T2 DM

UTIs and URIs

Question 13

Propylthiouracil, Methimazole (MOA, Use, Tox)

Answer 13

Block peroxidase, inhibiting organification of iodide and coupling of thyroid hormone synthesis
PTU also blocks 5’-deiodinase (decrease peripheral activation to T3)

Hyperthyroidism

Skin rash, Agranulocytosis (rare), Aplastic anemia, Hepatotoxicity (PTU), Teratogen (Methimazole)

Question 14

Levothyroxine, Triiodothyronine (MOA, Use, Tox)

Answer 14

Thyroxine replacement

Hypothyroidism, myxedema

Tachycardia, heat intolerance, tremors, arrhythmias

Question 15

Growth hormone (clinical use)

Answer 15

GH deficiency

Turner syndrome

Question 16

Octreotide (clinical use)

Answer 16

Somatostatin

Acromegaly
Carcinoid
Gastrinoma
Glucagonoma
Esophageal varices

Question 17

Oxytocin (clinical use)

Answer 17

Simulates labor/uterine contractions
Stimulates milk letdown
Controls uterine hemorrhage

Question 18

Desmopressin [ADH] (clinical use)

Answer 18

Pituitary (central) DI

Question 19

Demeclocycline (MOA, Use, Tox)

Answer 19

ADH antagonist (tetracycline family)

SIADH

Nephrogenic DI, Photosensitivity, Bone/Teeth abnormalities

Question 20

Hydrocortisone, Prednisone, Triamcinolone, Dexamethasone, Beclomethasone (MOA, Use, Tox)

Answer 20

Glucocorticoids
Decrease production of leukotrienes and prostaglandins by INHIBITING PHOSPHOLIPASE A2 and EXPRESSION OF COX2

Addison’s, inflammation, immunosuppression, asthma

Iatrogenic Cushing’s, adrenal insufficiency when drop stopped abruptly after chronic use