Endocrine - Pharmacology Flashcards Preview

USMLE > Endocrine - Pharmacology > Flashcards

Flashcards in Endocrine - Pharmacology Deck (62)
Loading flashcards...
1

Pharmacologic drug: Lispro

Rapid-acting insulin

2

Is regular insulin short or long acting?

Short acting

3

Pharmacologic drug: NPH

Intermediate acting insulin

4

Pharmacologic drug: Glargine

Long acting insulin

5

Insulin: Mechanism of Action

Binds insulin receptor (RTK activity) Increases liver glucose storage as glycogen, muscle glycogen synthesis and protein snthesis; K+ uptake Increase TG storage

6

Insulin: Clinical Use

Type 1 and 2 DM Gestational diabetes Life-threatening hyperkalemia Stress-induced hyperglycemia

7

Insulin: Toxicity

Hypoglycemia, very rarely hypersensitivity reaction

8

Metformin: Mechanism of Action

Biguanide Decrease gluconeogenesis, increase glycolysis, increase peripheral glucose uptake (insulin sensitivity)

9

Metformin: Clinical Use

First-line therapy in Type 2 DM (oral) Can be used in patients without islet function

10

Metformin: Toxicities

GI upset Lactic acidosis (contraindicated in renal failure)

11

Pharmacologic drug: Tolbutamide

1st generation sulfonylurea

12

Pharmacologic drug: Glyburide

Second generation sulfonylurea

13

Sulfonylureas: Mechanism of Action

Close K+ channel in beta-cell membrane -> increase Ca2+ influx

14

Sulfonylureas: Clinical Use

Stimulate release of endogenous insulin in type 2 DM Requires some islet functions (not for DMI)

15

Sulfonylureas: Toxicities

First generation: disulfiram-like Second generation: hypoglycemia

16

Pharmacologic drug: Pioglitazone

Thiazolidinedione

17

Thiazolidinediones: Mechanism of Action

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

18

Thiazolidinediones: Clinical Use

Monotherapy in type 2 DM or combined

19

Thiazolidinediones: Toxicities

Weight gain, edema Hepatotoxicity Heart failure

20

Pharmacologic drug: Acarbose

Alpha-glucosidase inhibitor

21

Alpha-glucosidase inhibitors: Mechanism of action

Inhibit intestinal brush-border alpha-glucosidases Delayed sugar hydrolysis and glucose absorption -> decrease postprandial hyperglycemia

22

Alpha-glucosidase inhibitors: Clinical Use

Monotherapy in type 2 DM or in combination

23

Alpha-glucosidase inhibitors: Toxicities

GI disturbances

24

What is the amylin analog?

Pramlintide

25

Amylin analog (Pramlintide): Mechanism of action

Decreases glucagon

26

Amylin analog (Pramlintide): Clinical use

Type 1 and 2 DM

27

Amylin analog (Pramlintide): Toxicities

Hypoglycemia, nausea, diarrhea

28

Pharmacologic drug: Exenatide

GLP-1 analog

29

GLP-1 analogs: Mechanism of action

increase insulin, decrease glucagon release

30

GLP-1 analogs: Clinical use

Type 2 DM