First Aid- Endocrine Drugs Flashcards Preview

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Flashcards in First Aid- Endocrine Drugs Deck (36):
1

-Blocks thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine -->Ž inhibition of thyroid hormone synthesis. -PTU also blocks 5′-deiodinase Ž --> decreased peripheral conversion of T4 to T3.

Propylthiouracil, methimazole

2

Used in hyperthyroidism

Propylthiouracil, methimazole Note: PTU blocks Peripheral conversion, used in Pregnancy

3

Toxicity includes: Skin rash, agranulocytosis (rare), aplastic anemia -which drug is associated with hepatotoxicity? -which drug is a possible teratogen (can cause aplasia cutis).

Propylthiouracil, methimazole -PTU --> hepatotoxicity -methimazole --> teratogen

4

-thyroid hormone replacement -used for hypothyroidism, myxedema and off label for wt loss

Levothyroxine (T4), triiodothyronine (T3)

5

Toxicity: Tachycardia, heat intolerance, tremors, arrhythmias.

Levothyroxine (T4), triiodothyronine (T3)

6

Used in SIADH, blocks action of ADH at V2-receptor.

ADH antagonists --> conivaptan, tolvaptan -note: these are hypothalamic/pituitary drugs

7

hypothalamic/pituitary drug used in CENTRAL DI

Desmopressin acetate

8

Used in GH deficiency and Turner syndrome

GH

9

-Stimulates labor, uterine contractions, milk let down -also controls uterine hemorrhage

oxytocin

10

used to tx acromegaly, carcinoid syndrome, gastinoma, glucagonoma, esophageal varices

somatostatin (Octreotide)

11

-ADH antagonist (member of tetracycline family) used to tx SIADH -toxicity: Nephrogenic DI, photosensitivity, abnormalities of bone and teeth.

Demeclocycline

12

Beclomethasone, dexamethasone, fludrocortisone (mineralocorticoid and glucocorticoid activity), hydrocortisone, methylprednisolone, prednisone, triamcinolone.

Glucocorticoids

13

MOA: Metabolic, catabolic, anti-inflammatory, and immunosuppressive effects mediated by interactions with glucocorticoid response elements, inhibition of phospholipase A2, and inhibition of transcription factors such as NF-κB.

Glucocorticoids --> Beclomethasone, dexamethasone, fludrocortisone (mineralocorticoid and glucocorticoid activity), hydrocortisone, methylprednisolone, prednisone, triamcinolone.

14

Used to tx addison disease, inflammation, immunosuppression, asthma

Glucocorticoids --> Beclomethasone, dexamethasone, fludrocortisone (mineralocorticoid and glucocorticoid activity), hydrocortisone, methylprednisolone, prednisone, triamcinolone.

15

Toxicity: Iatrogenic Cushing syndrome, adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis.

Glucocorticoids --> Beclomethasone, dexamethasone, fludrocortisone (mineralocorticoid and glucocorticoid activity), hydrocortisone, methylprednisolone, prednisone, triamcinolone.

16

Toxicity can lead to adrenal insufficiency when stopped abruptly after chronic use

Glucocorticoids --> Beclomethasone, dexamethasone, fludrocortisone (mineralocorticoid and glucocorticoid activity), hydrocortisone, methylprednisolone, prednisone, triamcinolone.

17

Sensitizes Ca2+-sensing receptor (CaSR) in parathyroid gland to circulating Ca2+ Ž --> decreases PTH.

Cinacalcet

18

-Used for Hypercalcemia due to 1° or 2° hyperparathyroidism. -toxicity: hypocalcemia

cinacalcet

19

decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake and increases insulin sensitivity

Biguanides - metformin

20

1st line therapy in type 2 DM; causes modest wt loss and can be used in pts without islet function

Biguanides - Metformin

21

GI upset and lactic acidosis --> CI in renal insufficiency

biguanides - metformin

22

-close K channels in beta cell membrane --> cell depolarizes --> insulin release via increased ca2+ influx -stimulate release of endogenous insulin in type 2 DM -require some islet function

sulfonylureas -First generation: Chlorpropamide, Tolbutamide -Second generation: Glimepiride, Glipizide, Glyburide

23

-risk of hypoglycemia is increased in renal failure

sulfonylureas -2nd gen: Glimepiride, Glipizide, Glyburide --> assoc with hypoglycemia

24

which group of diabetes drugs is associated with disulfiram like effects

first generation sulfonylureas: Chlorpropamide, Tolbutamide

25

-increases insulin sensitivity in peripheral tissue. Binds to PPAR-γ nuclear transcription regulator. -used as mono therapy in type 2 DM or combined with biguanides or sulfonylureas

Glitazones/ thiazolidinediones --> Pioglitazone, Rosiglitazone -note: Genes activated by PPAR-γ regulate fatty acid storage and glucose metabolism. Activation of PPAR-㠏 increases insulin sensitivity and levels of adiponectin

26

associated with wt gain, edema, hepatotoxicity, HF and increased risk of fractures

Glitazones/ thiazolidinediones --> Pioglitazone, Rosiglitazone

27

drugs that are rapid acting insulin

aspart, Glulisine, Lispro

28

short acting insulin

regular

29

insulin preparation used in type 1 and 2 DM, gestational DM, DKA (IV), hyperkalemia (+ glucose) and stress hyperglycemia

short acting insulin --> Regular

30

intermediate acting insulin

NPH -used in type 1 and 2 DM and gestational DM

31

long acting insulin used in type 1 and 2 DM, gestational DM and for basal glucose control

Detemir, Glargine

32

oral hypoglycemic drug that increases insulin and decreases glucagon release used in type 2 DM associated with n+v and pancreatitis

GLP-1 analogs --> exenatide, liraglutide

33

oral hypoglycemic drug that increases insulin and decreases glucagon release used in type 2 DM associated with mild urinary or respiratory infections

DPP-4 inhibitors --> Linagliptin, Saxagliptin, Sitagliptin 

34

-oral hypoglycemic drug that decreases gastric emptying and glucagon used in type 1 and 2 DM.

-toxicity includes: hypoglycemia, nausea, diarrhea

amylin analogs --> Pramlintide

35

-oral hypoglycemic drug that blocks reabsorption of glucose in the proximal convoluted tubule used in type 2 DM

-associated with flucosuria, UTIs, vaginal yeast infections

-SGLT-2 inhibitors --> Canagliflozin 

36

-oral hypoglycemic agent that inhibits intestinal brush-border α-glucosidases.

-associated with delayed carbohydrate hydrolysis and glucose absorption --> decreased postprandial hyperglycemia 

-used as monotherapy in type 2 DM or in combination with other drugs

-associated with GI disturbances

α-glucosidase inhibitors --> Acarbose, Miglitol