Endocrinology Flashcards Preview

Drug Profiles > Endocrinology > Flashcards

Flashcards in Endocrinology Deck (48):
1

Drug Class: insulin

peptide hormone

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Insulin - how does it work?

stimulates glucose uptake, metabolism, absorption by skeletal muscle. Drives K into cells

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Indications: insulin

type 1 diabetes, type II diabetes, hyperkalaemia, diabetic ketoacidosis

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Contra-indications: insulin

renal impairment, hypoglycaemia

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Side effects: insulin

hypoglycaemia, fat overgrowth, weight gain, hypersensitivity

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Interactions: insulin

corticosteroids, B-blockers (mask warning signs of hypoglycaemia)

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Drug class: gliclazide

Sulphonylureas

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Gliclazide - how does it work?

stimulates pancreatic insulin secretion, block K channels, increases Ca in pancreatic B cells

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Indications: gliclazide

type II diabetes, reduce metformin complications

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Contra-indications: gliclazide

hepatic/renal/adrenal/pituitary insufficiency, malnutrition, elderly

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Side effects: gliclazide

hypoglycaemia, fat overgrowth

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Interactions: gliclazide

thiazide diuretics, metformin, insulin, prednisolone

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Drug class: metformin

Biguanide

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How does it work - metformin

increases insulin sensitivity, suppresses glucose production, reduces weight gain

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Indications: metformin

type II diabetes

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Contra-indications: metformin

renal/hepatic impairment, AKI, severe tissue hypoxia

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Side effects: metformin

GI issues, lactic acidosis, hypoglcaemia

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Interactions: metformin

alcohol, prednisolone

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Example - thyroid hormones

thyroxine, liothyronine

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How does it work? - thyroxine

mimics T4 to stimulate metabolism/growth

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Indications: thyroxine

hypothyroidism

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Contra-indications: thyroxine

coronary artery disease

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Side effects: thyroxine

GI upset, palpitations, arrhythmia, angina, tremor, restlessness

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Interactions: thyroxine

antacids, cytochrome p450 inducers, insulin, alcohol

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Example - anti-thyroid drugs

carbimazole

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How does it work - carbimazole

converted to methimazole. Inhibits tyrosine. Reduced T3/T4 production

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Indications: carbimazole

hyperthyroidism

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Contra-indications: carbimazole

pregnancy

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Side effects: carbimazole

GI problems, headache, rash, hypothyroidism

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interactions: carbimazole

calcium salts, NSAIDs

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Drug Class: colecalciferol

calcium salts

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how does it work? - colecalciferol

parathyroid hormones and vitamin D. Maintain calcium levels and bone mineralisation. Calcium binds phosphate to gut. Non-renal activated vitamin D source. Raises myocardial threshold potential, reduced excitability

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Indications: colecalciferol

osteoperosis, hyperparathyroidism, rickets, hyperkalaemia, hypocalcaemia, osteomalacia

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Contra-indications: colecalciferol

hypercalcaemia, metastatic calcification

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Side effects: colecalciferol

dyspepsia, constipation, cardiovascular damage, tissue damage

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Interactions: colecalciferol

bisphosphonates, tetracyclines, levothyroxine, calcium IV precipitation with sodium bicarbonate

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Example: bisphosphonates

aledronic acid

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How does it work? - aledronic acid

bone resorption, reduce bone marrow turnover, inhibit osteoclasts, less bone loss, more bone mass

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Indications: aledronic acid

osteoporotic fractures, malignant hypercalcaemia, Pagets disease, bone metastasis

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Contra-indications: aledronic acid

renal impairment, hypcalcaemia, upper GI issues, smokers

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Side effects: aledronic acid

oesophagitis, hypophosphataemia, jaw osteonecrosis

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Interactions: aledronic acid

calcium salts, antacids, iron salts

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Example - mineralcorticoids

fludrocortisone

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How does it work? - fludrocortisone

replaces aldosterone. Causes an increase in ion and water transport. increased extracellular fluid volume and blood pressure and decreased K level

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Indications - fludrocortisone

postural hypotension, adrenal insufficiency, Addison's disease

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Contra-indications: fludrocortisone

TB, fungal infections, hypothyroidism, diabetes

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Side effects: fludrocortisone

hypertension, swelling, heart failure, hypokalaemia

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Interactions: fludrocortisone

diuretics, NSAIDs