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Flashcards in FA Endo Pharm Deck (21):
1

Exact mechanism is unknown.
Dec gluconeogenesis, inc glycolysis, inc peripheral glucose uptake (insulin sensitivity); first line in type 2 DM.
SE: lactic acidosis (CI in RF, LF, CHF, check BUN/Cr before starting)

Metformin

2

Close K+ channel in beta cell membrane, so cell depolarizes --> insulin release via Ca2+ influx.

Sulfonylureas (2G: glyburide, glimepiride, glipizide)

3

Inc insulin sensitivity in peripheral tissue. Binds to PPAR-gamma nuclear transcription regulator --> increased insulin sensitivity and adiponectin.
SE: fluid retention, hepatox, hear failure

TZDs ( -glitazones)

4

Inhibit intestinal brush border alpha glucosidases.
SE: GI disturbances

Acarbose and miglitol

5

Decrease gastric emptying, decrease glucagon.
SE: hyoglycemia, nausea, diarrhea

Amylin analogs (Pramlintide)

6

Increase insulin, decrease glucagon release.

GLP-1 analogs (Exenatide, Liraglutide)
- SE: N/V, pancreatitis
DPP-4 inhibitors (-gliptans)
- SE mild UTI or URTI

7

Insulin - Lispro, Aspart, Glulisine

Rapid acting

8

Insulin - Regular

Short acting

9

Insulin - NPH

Intermediate acting

10

Insulin - Glargine, Detemir

Long acting

11

Ex: Glyburide, Glimepiride, Glipizide

Sulfonylureas

12

Ex: Pioglitazone, Rosiglitazone

TZDs

13

Ex: Acarbose, Miglitol

alpha-glucosidase inhibitors

14

Ex: Pramlintide

amylin analog

15

Ex: Exenatide, Liraglutide

GLP-1 analog

16

Ex: Linagliptin, Saxagliptin, Sitagliptin

DPP-4 inhibitors

17

Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine --> inhibition of thyroid hormone synthesis; ALSO blocks peripheral conversion of T4 to T3

PTU

18

Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine --> inhibition of thyroid hormone synthesis; does NOT block peripheral conversion of T4 to T3

Methimazole

19

Thyroxine replacement

Levothyroxine, triiodothyonine

20

ADH antagonist (member of the tetracycline family).
SE: nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Demeclocycline

21

Metabolic, catabolic, anti-inflammatory, and immunosuppressive effects mediated by interactions with glucocorticoid response elements and inhibition of transcription factors such as NF-kappaB.
SE: iatrogenic cushings - osteoporosis, diabetes, adrenal crisis if stopped

Glucocorticoids