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Flashcards in Extra Clinical in Endocrine Deck (29):
1

What is the action of sulfonylureas?

displacing the binding of ADP-Mg2+ from the SUR subunit (closing the KATP channel)

2

Give some examples of sulfonylureas.

Tolbutamide, glibenclamide, glipizide

3

Undesirable effects of sulfonylureas?

weight gain
may cause hypoglycaemia

4

How do glinides work?

bind to SUR at distinct site close to Katp channel

5

Which two hormones are released from the small intestine causing enhanced insulin resistance?

GLP-1 and GIP

6

Which cells are GIP1 and GIP released from?

L cells in ileum and colon
K cells in jejenum/duodenum

7

Mechanism of incretin analogues?

mimic action of GLP-1 but are longer lasting

8

Desirable effects in incretin analogues?

reduce hepatic fat accumulation
weight loss

9

How are incretin analogyes administered?

subcutaneously, twice a day

10

Adverse effects of incretin analogues?

hypoglycaemia
nausea
pancreatitis (rare)

11

What are gliptins?

Competitive DPP 4 inhibitors

12

Do gliptins/DPP4 inhibitors cause hypoglycaemia?

no

13

What is DPP-4?

an enzyme that terminated the actions of GLP-1 and GIP

14

What is acarbose?

alpha-glucosidase inhibitor

15

What is alpha-glucosidase?

an enzyme that breaks down starch and disaccharides into glucose

16

In who is acarbose used?

T2DM patients inadequately controlled by other drugs

17

Where do the adverse effects of acarbose occur?

GI tract

18

What is metformin?

biguanine

19

What is the mechanism of metformin?

reduced hepatic gluconeogenesis, increases glucose uptake by skeletal muscle, reduces carb absorption, increased fatty acid oxidation

20

What do glitazones do?

Enhance action of insulin at target tissues

21

What is dapagliflozin

Sodium-glucose cotransporter inhibitor

22

Who is tertiary hyperparathyroidism most commonly seen in?

patients with chronic renal failure

23

How do steroids cause osteoporosis?

by blocking production of interleukin

24

Name two antithyroid drugs.

carbimazole and PTU

25

Which antithyroid drug can be used in preg?

PTU

26

What is the most worrying adverse effect of carbimazole?

agranulocytosis

27

Name two macrovascular complications of diabetes.

Heart disease, stroke

28

Name three microvascular complications of diabetes.

retinopathy, nephropathy, neuropathy

29

Give some complications of Turner's.

CVS - coarctation of aorta, bicuspid aortic valve, hypoplastic left heart
GI Bleed due to vascular malformation, increased risk of IBD
Also lymphoedema, hypothyroid, ototis medial, scoliosis, renal problems