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Résidence - Pharmacology > Endocrino (DB) > Flashcards

Endocrino (DB) Flashcards

(43 cards)

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1
Q

Name categories of tx (6)

A
  • Insulin
  • Metformin
  • SLT2 inhibitor
  • Sulphonylurea
  • GLP-1 Agonist
  • DPP4 inhibitor
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2
Q

Name class members : SGLT2 inhibitor (3)

A
  • GLIFLOZIN
  • Dapaglifozin
  • Empagliflozin
  • Canagliflozin
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3
Q

Name class members : Sulfonylurée (4)

A

GLI -
* Glipizide
* Glyburide
* Gliclazide

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4
Q

Name class members : GLP-1 agonist (4)

A
  • GLUTIDE
  • Liraglutide
  • Semaglutide
  • Dulaglutide
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5
Q

Name class members : DPP4 inhibitor (5)

A
  • GLIPTIN
  • Linagliptin
  • Sitagliptin
  • Saxagliptin
  • Alogliptin
  • Vildagliptin
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6
Q

Name indication : Insulin (2)

A
  • DB1m DB2
  • Diabetic ketoacidosis
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7
Q

Name adverse effects : Insulin (6)

A
  • Peripheral edema
  • Injection site reaction
  • Hypoglycemia
  • Weight gain
  • HypoK
  • Lipodystrophy

Remember : patients shoudl rotate sites regularly to prevent this side efect

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8
Q

Describe mechanism : Insulin

A

Effect on liver :
* Stimulatie glycogen synthesis
* Promote fatty acids synthesis

Effect on muscle and adipose tissue :
* Promote glucose transport across the cell mebrane
* Increase proteins synthesis
* Promote glycogen synthesis

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9
Q

Name classfication of insulin (5)

A
  • Rapid
  • Short
  • Intermediate
  • Long
  • Ultra long
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10
Q

Name examples of rapid insulin (3)

A
  • Lispro (Humalog)
  • Aspart (Novolog)
  • Glulisine (Aspidra)
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11
Q

Describe rapid insuline (5)

A
  • Onset : 15-30 mins
  • Peak : 1-3 h
  • Duration : 4-6 h
  • Use just before meal
  • Highest risk of hypoglycemia
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12
Q

Name short acting insulins (2)

A
  • Humulin Regular
  • Novalin Regular
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13
Q

Name short acting insulins : Humulin R, Novalin R (2)

A
  • Onset : 30 - 60 mins
  • Peak : 2-4 h
  • Durtion : 5-8h
  • Take 30-60 mins before meal
  • Useful for managing diabetic ketoacidosis
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14
Q

Name intermediate insulin (2)

A

NPH (Humulin N)
NPH (Novalin N)

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15
Q

Describe intermediate insulin : Humulin N, Novalin N (5)

A
  • Onset : 2-4h
  • Peak 8-12h
  • Duration 10-18 h
  • Act as basal insulin
  • Cover insulin need around 0.5 day
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16
Q

Name long acting insulin (2)

A
  • Glargin (lantus)
  • Detenir (Levemir)
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17
Q

Describe long acting insulin : Glargine, Detenir (5)

A
  • Onset 1-2 hours
  • No peak
  • Duration 24h+
  • Act as basal insulin
  • Cover insulin need around 1 day
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18
Q

Name ultra long acting insulin (1)

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A

**Degludec (Tresiba) **

19
Q

Name ultra long acting insulin : Degludec (Tresiba) (1)

Study These Flashcards
A
  • Onset 1h
  • No peak
  • Dureation 42h+
  • Useful for extra long glucose control
20
Q

Describe indication : Metformin (4)

Study These Flashcards
A
  • 1st line tx DB2
  • GDM
  • Polycystic ovary syndrome
  • Antipsychotic-induced weight gain
21
Q

Name adverse effects : Metformine (3)

Study These Flashcards
A
  • Weight loss
  • Lactis acidosis (myalgia, respiratory distress, somnolence, abdominal pain)
  • Vit B12 deficiency (long-term uses)
22
Q

Describe mechanism : Metformine (3)

Study These Flashcards
A
  • Decrese hepatic glucose production
  • Decrease intestinal absorption of glucose
  • Improve insulin sensitivity
23
Q

Name C-I : Metformine (1)

Study These Flashcards
A

Severe renal impairment eGFR < 30ml/min/1.73 m2

24
Q

Describe metformine with iodinated contrast (3)

Study These Flashcards
A
  • Discontinue metformine 48h before injecting contrast
  • Evaluate eGFR 48h after imaging
  • Restart metformin if eGFR stable
25
Name class members : SGLT2 inhibitor (3)
- GLIFLOZIN * Dapa**glifozin** * Empa**gliflozin** * Cana**gliflozin **
26
When is SGLT2 inhibitor prefered ?
May be preferred in patients with multiple risk factors of **CARDIAC** disease, such as atherosclerotic cardiovascular disease or heart failure
27
Name adverse effects : SGLT2 inhibitor (5)
* **Urinary tract infection** * **Acute kidney injury** * Increase risk of bone fx * Hypotension, caused by volume depletion * Ketoacidosis (rare)
28
Describe mechanism : SGLT2 inhibitor (4)
* Inhibit sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubules * Reduse reabsorption of filtered glucose from the tubular lumen * Increasing excretion of gluclose * End result : Reduse body's glucose
29
SGLT2 inhibitor is not recommended in who?
In patients with severe renal failure (eGFR < 30) BECAUSE mechanism of action relies on renal gluclose extreaction. So if renal failure, won'T work properly
30
Name class members : DPP4 inhibitor (5)
- GLIPTIN * Linagliptin * Sitagliptin * Saxagliptin * Alogliptin * Vildagliptin
31
Name indications : DPP4 inhibitor (3)
* DB2 * Cannot tolerate metformin * Patients with stage 4 or 5 CKD
32
Name adverse effects : DPP4 inhibitor (5)
* **Risk hypoglycemia** * **Increase risk of heart failure** * Bullous pemphigoid * Acute pancreatitis * Muscle pain
33
Describe DPP4 inhibitor and renal impairment
Dosing adjustment is required in renal failiure (except Linagliptin)
34
DPP4 inhibitors need to be careful with what other rx?
With CYP3A4 inhibitors (ex. Clarithromycin)
35
Name class members : GLP-1 agonist (4)
- GLUTIDE * Liraglutide * Semaglutide * Dulaglutide
36
Name indications : GLP-1 agonist (3)
* DB2 * For patients with CARDIORENAL comorbidities that cannot tolerate metformine * Chronic weight management
37
Name adverse effect : GLP-1 agonist (3)
* GI upset * AKI * Gallbladder disease * Acute pancreatitis
38
Name C-I : GLP-1 agonist (1)
Family history Medullary thyroid carinoma
39
Name class members : Sulfonylurée (4)
GLI - * Glipizide * Glyburide * Gliclazide
40
Name indicatiosn : Sulfonylurée (2)
* DB2 * Adjunctive agent, or monotherapy for patients unable to tolerate metformin
41
Name adverse effects : Sulfonylurée (4)
* **Risk of hypoglycemia** * Weight gain * GI upset * Rash
42
Describe renal and Sulfonylurée (1)
In patients with CKD, prefer shorter-acting sulfonylurée such as glipzide and glimepiride
43
Name agents at risk of hypoglycemia (3)
* Insulin * Sulfonylurée * DPP4 inhibitor

Résidence - Pharmacology (4 decks)

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