Flashcards in Exam 2: Endocrine Pharmacology pt. 2 Deck (31):
What is the most popular oral drug for type 2 diabetes
- class of Biguanides
Benefits of Metformin
1. More effective than other agents
2. Reduces all-cause and cardiovascular mortality
3. Reduces rates of cancer in pts with Type 2 Diabetes.
-*there are more but these are bolded
Risks of Metformin
1. Lactic acidosis if renal impairment
- avoid alcohol
2. Gastrointestinal side effects
Mechanism of action for Alpha-glucosidase Inhibitors
Inhibits the enzyme (alpha-glucosidase) responsible for degrading complex carbohydrates in gut
- thus no monosaccharides are made available for absorption after a meal.
When taking Alpha-Glucosidase inhibitors, what occurs after a meal?
There is a delay in blood glucose concentrations after a meal when taking these drugs
Mechanism of Action for Thiazolidinediones
Lower blood glucose by improving target cell response to insulin without increasing pancreatic insulin secretion
- reset insulin receptors = reduces insulin resistance
Activity of Thiazolidinediones depends on what?
Depends on the presence of insulin for activity
Name the Thiazolidinedione drugs
Which Thiazolidinedione has been associated with liver failure
- associated with > 30 deaths due to liver failure
- also increased risk for heart failure
Name the Incretins
GLP-1 receptor agonists (glucagon like peptide)
Action of GLP-1 receptor agonists
Boost insulin production by pancreas
Slow absorption of food
Action of DPP-4 Inhibitors
Blocks the enzyme dipeptidyl peptidase-4 that breaks down GLP-1 peptide in gut
What are the concerns with Incretin drugs
New concerns that these drugs cause inflammation and possible pre-cancerous changes of pancreas
What is the primary intervention to lower glucose in diabetics?
What is Estradiol
a steroid, natural estrogen
- Produced and secreted by the ovary
Name the Estrogen Replacement Drugs
-Conjugated equine estrogens (Premarin)
-Esterified estrogens (Estratab, Menest)
-Estradiol preps (many names...)
Conjugated equine estrogens are effective in what treatment?
In treatment of vasomotor symptoms of menopause
- May also be beneficial to prevent bone loss with osteoporosis (only while on drug)
Describe the serious side effect with Premarin and in women with an intact uterus:
- Increased risk for endometrial cancer
- May also increase risk for breast cancer if taken after menopause
What is the drug name of Estrogen with Progesterone?
(also Premarin + Provera)
Benefits of Prempro?
Adding progesterone to the estrogen preparation reduces risk for endometrial cancer
Prempro usage may increase risk for what things?
1. Heart disease
3. Pulmonary embolism
4. Invasive breast cancer
** May outweigh long term use to prevent osteoporosis
What are the guidelines for HRT use today:
Short term use only
- less than 5 years
Used to treat symptoms of menopause
Natural progesterone is produced and secreted by what body part?
Physiological action of natural progesterone
induces a secretory endometrium
- Affects uterine mobility and cervical mucous
Progesterone replacement drugs are generally used for what?
1. Treatment of menstrual disorders
2. Prevention of habitual abortion
3. Treatment of endometriosis
What does it mean that testosterone is used as a male climacteric?
When testosterone slowly decreases as well as sexual function during fourth or fifth decades, men may exhibit "menopausal" symptoms and can be treated with testosterone.
What is Hypogonadism
Clinical syndrome which comprises both symptoms and biochemical evidence of T deficiency
Evidence suggests that testosterone levels are associated with what things
1. linked to general health of male population
2. Biomarker for presence of occult diseases (cancer, early death, atherosclerosis)
Is testosterone therapy beneficial for women?
Only if women are postmenopausal with hypoactive sexual desire disorder.
T or F, There are NO FDA approved testosterone products for women