how do you treat T2DM neuropathy? names?

antidepressants topical anesthetic anticonvulsants foot care antidepress = duloxetine, amitriptyline anticonvulsant = pregabalin

Exam 1 Flashcards by Lindsay Young

Biguanides MOA

Treats what? Names?

incr AMPK -> incr skeletal m uptake and decr gluconeogenesis (liver)

T2DM, Metformin

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Biguanides ADR and CI

Treats what? Names?

ADR: gut stuff/B12 def, CI: renal and liver dysfuction/EtOH/acidosis

T2DM, Metformin

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Thiazolidinediones MOA

Treats what? Names?

Direct: incr PPAR -> decr FFA -> incr peripheral insulin sens
Indirect: incr skeletal m uptake, decr gluconeogenesis (liver)

T2DM, Pio- or rosi- glitazone

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Thiazolidnediones ADR and CI

Treats what? Names

ADR: LE edema, CHF, weight gain, decr bone density
CI: CHF, incr bladder cancer, severe liver dysfunciton

T2DM, pio- or rosi- glitazone

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Secretagogues MOA

Treats what? Names?

bind SUR1 and close K channel -> incr Ca -> insulin secretion

T2DM, sulfonylurea, meglitinides

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Sulfonylurea ADR

what kind of T2DM treatment is this? what are names?

hypoglycemia, weight gain

secretagogues, gli- or gly- + -ide

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meglitinides ADR

what kind of T2DM treatment is this? what are names

hypoglycemia and weight gain to lesser extent as compared to sulfonylurea

secretagogues, some other letter + -ide

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Incretins MOA (2 kinds)

Treats? Names?

DPP4 antagonists: DPP4 normally degrades GLP-1 and GIP
GLP-1 agonists

T2DM, DPP4 antag = -gliptin, GLP-1 ag = -tide

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DPP4 antagonist ADR and CI

what type of T2DM treatment is it?

ADR: nausea, HA
CI: CKD

incretins

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GLP-1 agonists ADR and CI

what type of T2DM treatment is it?

ADR: nausea, diarrhea, constipation
CI: Hx medullary thyorid cancer, GFR <30

incretins

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alpha glucosidase inhibitor MOA

Treats? Names?

inhibit last step of carb digestion at brush border

T2DM, acarbose, miglitol

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alpha glucosidase inhibitor ADR and CI

Treats? Names?

ADR: diarrhea, farty, bloat, abd pain
CI: liver and renal disease, IBD

T2DM, acarbose, miglitiol

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SGLT2 inhibitor MOA

Treats? Names

inhibits in PCT, incr glucose loss through urine

T2DM, -flozin

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SGLT2 inhibitor ADR and CI

Treats? Names?

ADR: polyuria, UTI, vaginal candidiasis, dehydration
CI: CKD

T2DM, - flozin

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Amylinomimetics MOA and ADR

Treats? Names?

MOA: incr satiety and suppress glucagon
ADR: nausea

T2DM, pramlintide

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Bile acid sequestrants ADR

Treats? Names?

T2DM, colesevetam

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D2R agonists MOA

Treats? Names?

incr insulin sens

T2DM, bromocriptine

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D2R agonists ADR and CI

Treats? Names?

ADR: nausea, HA
CI: nursing, pregnant

T2DM, bromocriptine

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Basal Insulin Names and Type

glargine, detemir
long-acting

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what does basal insulin control

long-acting, fasting glycemic control

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neutral protamine hagedorn type

intermediate-acting insulin

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bolus (prandial) insulin names and type

lispro, aspart, glulisine
rapid-acting (every meal)

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what does bolus/prandial insulin control?

post-prandial glycemic control

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regular insulin type and uses

short acting
grazing, feeding tubes, peritoneal dialysis

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combo pre-mixed insulin ## Footnote actually GIVEN at same time, not same as giving multiple Rx to a T1DM for different kinds of control

NPH + regular or rapid-acting insulin

How do you treat T2DM retinopathy? | break down by each symptom ## Footnote names?

macular edema: VEGF inhibitors prolif blood vessels: panretinal anticoag ## Footnote VEGF: bevacizumab, ranibizumab, aflibercept

how do you treat T2DM neuropathy? ## Footnote names?

antidepressants topical anesthetic anticonvulsants foot care ## Footnote antidepress = duloxetine, amitriptyline anticonvulsant = pregabalin

Treat craniopharyngioma?

surgery or radiation

Treat pituitary adenomas in hypo-pit?

relieve mass effect (surg/radiation) and replace deficient hormones

what is exception to treating pit adenomas in hyper-pit

trans-sphenoidal surgery in all but PRLoma

How do you treat PRLoma?

DA agonists cabergoline, bromocriptine

How do you treat DKA?

- replace fluids and electrolytes, correct hyperglycemia/metabolic acidosis - treat precipitating cause (give insulin) - prevent recurrence

What is DKA lab triad?

ketonemia hyperglycemia AG metabolic acidosis

Type 1 APS symptoms | need 2/3 symptoms to Dx ## Footnote what is another name for it? what is it assoc with?

- hypoparathyroidism - chronic mucocutaneous candidiasis - adrenal insufficiency ## Footnote whitaker, T1DM

Type 2 APS symp | need 2/3 to dc ## Footnote what is another name for it? what is it assoc w?

- adrenal insufficiency - autoimmune thyroid disease - T1DM ## Footnote schmidt, T1DM

what does GH do

maintains BG in fasting state

what does insulin do

maintains blood glucose in fed state

how can you treat short stature

recomb IGF-1 (mecasermin, dep height velocity) or HGH (dep IGF-1 response)

ocreotide MOA ## Footnote treats?

somatostatin analog ## Footnote acromegaly

pegvisomant MOA ## Footnote treats

mutated GH-r peptide (inhibits GH-r) ## Footnote acromegaly

cabergoline MOA ## Footnote treats?

DA agonist ## Footnote acromegaly (also PRLoma)

leptin

adipokine, fat storage molecule

laeral hypothalamus

hunger center

ventromedial hypothalamus

fat center (lose = gain weight)

phentermine MOA

Na dep NE transporter, decrease NE uptake, inhibit 5HT and DA reuptake

phentermine ADR and CI

ADR: symp shit (dry mouth, palpitations) CI: CVD, HTN, arrhythmias, hyperthyroid, glaucoma

Phentermine/topiramate MOA

NE release in hypo decrease hunger

phentermine/topiramate ADR and CI

ADR: symp stuff + brain stuff CI: +kidney stones, MAOI

Naltrexone/bupropion MOA

inhibit DA and NE reuptake (incre POMC)

Naltrexone/bupropion ADR and CI

ADR: SI, nausea, HA, insomnia CI: seizures, HTN, bulimia, chronic opiod use

Liraglutide MOA ## Footnote Use?

GLP-1 agonist ## Footnote DM and prediabetes

liraglutide ADR and CI

ADR: nausea, HA, angioedema CI: MTC, MEN2, Hx pancreatitis

Semaglutide MOA ## Footnote Use

GLP-1 agonist ## Footnote chronic weight management

Semaglutide ADR and CI

ADR: nausea, HA, angioedema CI: MTC, MEN2

Gelesis MOA ## Footnote Use

non-absorbent hydrogel ## Footnote BMI 25-40 with lifestyle changes

Gelesis ADR and CI

ADR: GI CI: pregnant, allergies

Setmelanotide MOA ## Footnote uses

MC4 R agonist ## Footnote obesity due to POMC, PCSK1, or LEPR def

Pheochromocytoma triad

- sustained/paroxysmal HTN - HA - generalized sweating

treat pheochromocytoma

alpha then beta blockade, surgery

MIBG test

utilizes Type 1 reuptake like NE, shows what cells are active in pheochromocytoma

basal secretory rate of cortisol

9-12 mg/day

treat adrenal insufficiency

GC: hydrocortisone MC: fludrocortisone androgen: DHEA

ACTH-dep cushing syndrome specific symp

hyperpigmented skin, achne, hirsutism

what can you use to treat chronic inflamm?

prednisone, methylprednisone

treat hypoaldo

fludrocortisone

meds to treat hyperaldo

1st line is mc inhibitors (spironolactone, epleronon) then K sparing diuretics (amiloride, triamterene)

where does sup thyroid a br from

external carotid

where does inf thyroid a br from

thyrocervical trunk

thyroid ima a br from

brachiocephalic a

bisphosphonates moa ## Footnote treat

antiresorptive ## Footnote hypercalcemia

cinacalcet moa ## Footnote treat

calcimimetic ## Footnote hypercalcemia

treat acute/severe hypercalcemia

vol expand (lose Ca in urine) give calcitonin/bisphosphonates denosumab (RANKL inhibitor)

treat hypocalcemia

iv ca or oral calcitriol maintenance with oral ca and cholecalciferol

DiGeorge symp

cardiac, abnormal facies, thymic aplasia, cleft palate, hypocalcemia

treat hypothyroidism

levothyroxine ## Footnote incr dose in pregnancy

treat hyperthyroid with nuclear med

131-I, low dose graves (8-20), high dose toxic adenoma or Plummer (20-25)

treat hyperthyroid ## Footnote names

thionamides: inhibit iodine oxidation ## Footnote methimazole, propylthiouracil

MEN1

hyperparathyroid, ant pit tumor, pancreatic islet tumor

MEN2A

MTC, hyperparathyroid, pheochromocytoma

MEN2B

MTC, Hyperparathyroid, pheochromocytoma, mucosal neuromas, ganglioneuromas, marfanoid habitus

Exam 1 Flashcards

(80 cards)