pharm chart Flashcards
1
Q
Sulfonylureas 2nd Generation
A
Glipizide [Glucotrol]
2
Q
Glipizide [Glucotrol] MOA
A
Stimulates
pancreatic β-cell
release of insulin
3
Q
Glipizide [Glucotrol] Indications
A
T2DM
4
Q
Meglitinides
Non-Sulfonylurea
Secretagogue
A
Repaglinide
[Prandin]
5
Q
MOA of Repaglinide
[Prandin]
A
binds to sulfonylurea receptor on β-cell to stimulate insulin release
6
Q
Indications of Repaglinide
[Prandin]
A
T2DM if sulfa allergy;
↓post-prandial glucose;
↓ A1c 0.6-1.9
↓ Gluc 65-75mg/Dl
7
Q
Amylin (β-cell)–> released in response to ↑ blood glucose
o Inhibits gastric emptying
o Inhibits glucagon release
A
Amylin analog
8
Q
Amylin analog
A
Pramlintide [Symlin]
9
Q
MOA of Pramlintide
[Symlin]
A
Amylin analogue
↓gastric emptying, ↓glucagon secretion, ↓appetite
10
Q
Indications of Pramlintide
[Symlin]
A
T1DM, T2DM ↓ postprandial glucose levels
↓ A1c 0.4-0.5
11
Q
Incretin mimetic: Glucagon-Like Peptide-1 Agonist (GLP-1)
Synthetic analogue
What are the two drugs?
A
Exenatide [Byetta]
Liraglutide [Victoza]
12
Q
MOA of Exenatide
[Byetta]
A
↑insulin release;
↓glucagon release;
↓gastric emptying;
↓appetite
13
Q
Indications of Exenatide
[Byetta]
A
T2DM w/ metformin,
+/- sulfonylurea to lower postprandial glucose levels
↓ A1c 0.5 - 1.0%
14
Q
MOA of Liraglutide
[Victoza]
A
↑insulin release; ↓glucagon release; ↓gastric emptying; ↓appetite ↑ β-cell growth/replication
15
Q
Indications of Liraglutide
[Victoza]
A
T2DM w/ metformin,
+/- sulfonylurea to
lower postprandial glucose levels
16
Q
Dipeptidyl peptidase-4 inhibitors
DPP-4 Inhibitors
A
Sitagliptin
[Januvia]
17
Q
MOA of Sitagliptin
[Januvia]
A
Inhibits DPP-4 to reduce degradation of GLP-1 –> incr levels of GLP-1; reduces postprandial glucose levels
18
Q
Indications of Sitagliptin
[Januvia]
A
T2DM
19
Q
Rapid Acting Insulin
A
Lispro
[Humalog]
20
Q
MOA of Lispro
[Humalog]
A
insulin replacement,
supplement
21
Q
Indications of Lispro
[Humalog]
A
T1DM
T2DM
22
Q
Short-Acting
Insulin
A
Regular
[Humulin-R]
23
Q
MOA of Regular
[Humulin-R]
A
insulin replacement,
supplement
24
Q
Indications of Regular
[Humulin-R]
A
T1DM
T2DM
25
Intermediate- Acting Insulin
Neutral
Protamine
[Humulin-N]
26
MOA of Neutral Protamine
| [Humulin-N]
insulin replacement,
| supplement
27
Indications of Neutral Protamine
| [Humulin-N]
T1DM,
| T2DM
28
Long-Acting Insulin
| 100u/mL
Insulin Glargine
| [Lantus]
29
MOA of Insulin Glargine
| [Lantus]
insulin replacement,
| supplement
30
Indications of Insulin Glargine
| [Lantus]
T1DM,
| T2DM
31
Long-Acting Insulin
| 300u/mL
Insulin Glargine
| [Toujeo Solostar]
32
MOA Insulin Glargine
| [Toujeo Solostar]
insulin replacement,
| supplement
33
Indications of Insulin Glargine
| [Toujeo Solostar]
T1DM,
| T2DM
34
Oral Inhalation, Rapid Acting Insulin
Human rDNA Insulin
| [Afrezza]
35
MOA of Human rDNA Insulin
| [Afrezza]
Inhaled insulin
36
Indications of Human rDNA Insulin
| [Afrezza]
T1DM,
T2DM
used w/longacting
insulin
37
Biguanides
Metformin
| [Glucophage]
38
MOA of Metformin
| [Glucophage]
```
unknown mechanism
to
decr hepatic glucose
production,
decr renal
gluconeogenesis,
slow intestinal
absorption glucose,
incr glucose
conversion to lactate
by enterocytes,
stim tissue glycolysis,
incr glucose removal from blood (decr insulin resistance),
decr plasma glucagon levels
```
39
Indications of Metformin
| [Glucophage]
T2DM
| Initial DOC
40
Thiazolidinediones
| TZD’s
Pioglitizone
| [Actos]
41
MOA of Pioglitizone
| [Actos]
decr insulin resistance
by activation of nuclear PPAR-ϒ in myocytes, hepatocytes, adipocytes;
most potent insulin sensitizer;
pioglit also PPAR-α activity (incr trig metab)
42
Indications of Pioglitizone
| [Actos]
T2DM
43
α-glucosidase
| Inhibitors
Acarbose
| [Precose]
44
MOA of Acarbose
| [Precose]
reduces postprandial glucose levels by inhibition intestinal α-glucosidase conversion polysaccrides to monoscaccrides;
delays absorption & levels blood glucose
45
Indications of Acarbose
| [Precose]
T1DM,
| T2DM
46
SGLT2 Inhibitor Sodium-Glucose
| CoTransportor 2
Canaglifloxin
| [Invokana]
47
MOA of Canaglifloxin
| [Invokana]
inhibits glucose resorption in proximal renal tubule
48
Indications of Canaglifloxin
| [Invokana]
Adjunct therapy in T2DM
| Not T1DM
49
Bile Acid Sequestrant
Colesevelam
| [Welchol]
50
MOA of Colesevelam
| [Welchol]
unknown in DM
(decrease intestinal
glucose absorption?)
51
Indications Colesevelam
| [Welchol]
hypercholest erolemia;
adjunct to metformin,
sulfonylurea, insulin in T2DM
52
Vasopressin Receptor Agonists
Desmopressin
| [DDAVP]
53
MOA of Desmopressin
| [DDAVP]
incr permeability of renal tubular cells to water
resorption→ decr urine volume;
incr vonW factor, VIII, t-PA levels
54
Indication Desmopressin
| [DDAVP]
diabetes insipidus;
primary nocturnal enuresis;
(off label) to control uremic bleeding; bleeding in hemophilia
55
Adjunct Drugs:
ACEI / ARBs
HMGCoARI (‘statins’)
ASA
56
Estrogens
Conjugated
| estrogens
57
Selective Estrogen
Receptor
Modulators
(SERMs)
Raloxifine
| [Evista
58
MOA of Raloxifine
| [Evista
binds to selected estrogen
recepters and decr bone
resorption
59
Indications of Raloxifine
| [Evista
Px & Tx
| osteoporosis
60
Bisphosphenate:
| Oral
Alendronate
| [Fosamax]
61
MOA of Alendronate
| [Fosamax]
decreases rate bone
| resorption
62
indication Alendronate
| [Fosamax]
Px & Tx of osteoporosis
in women; Tx in men;
Paget’s Disease
63
Bisphosphenate:
| IV
Zoledronic Acid
| [Reclast]
64
MOA of Zoledronic Acid
| [Reclast]
Inhibits osteoclast activity
and skeletal calcium
release
65
Indications of Zoledronic Acid
| [Reclast]
```
Px & Tx Osteoporosis;
Tx multiple myeloma,
metastatic bone lesions;
hypercalcemia of malignancy,
Paget’s Disease
```
66
RANK Ligand Inhibitor
Denosumab
| [Prolia]
67
MOA of Denosumab
| [Prolia]
Human monoclonal antibody which attaches to RANKL blocking
ability to bind to RANK receptor on surface of osteoclast thereby
inhibiting osteoclastogenesis &
increasing osteoclast apoptosis
68
Indications of Denosumab
| [Prolia]
Males and postmenopausal females at high fracture risk d/t osteoporosis; men on androgen deprivation rx and women
receiving aromatase inhibitor rx
69
Calcitonin Hormone
Calcitonin Salmon
| [Miacalcin]
70
MOa of Calcitonin
Salmon
[Miacalcin]
```
protein sequence similar
to human calcitonin;
antagoizes impact of
parathyroid hormone &
inhibits osteoclast activity
```
71
Indications of Calcitonin
Salmon
[Miacalcin]
osteoporosis,
Paget’s
disease,
hypercalcemia
72
Recombinant Human Parathyroid
Hormone
Fragment Hormone
Teriparatide
| [Forteo]
73
MOA of Teriparatide
| [Forteo]
recombinant form PTH (1-34);
| stim new bone formation
74
Indications of Teriparatide
| [Forteo]
Tx severe,
treatment resistant osteoporosis
(max 2 years use)
75
Thyroid Agents
synthetic T4 replacement
Levothyroxine (T4)
| [Levothroid, Levoxyl, Synthroid]
76
MOA of Levothyroxine (T4)
| [Levothroid, Levoxyl, Synthroid]
replacement T4
converted to T3 in peripheral tissues--> nuclear receptors-->
protein synthesis, metabolic rate,
promotes gluconeogeesis
77
Indications of Levothyroxine (T4)
| [Levothroid, Levoxyl, Synthroid]
Hypothyroidism
| Thyroid CA
78
Thyroid Agents
synthetic T3 replacement
Liothyronine (T3)
| [Cytomel]
79
MOA of Liothyronine (T3)
| [Cytomel]
```
T3 in peripheral
tissues --> nuclear
receptors --> protein
synthesis, metabolic
rate, promotes
gluconeogenesis
```
80
Indications of Liothyronine (T3)
| [Cytomel]
```
hypothyroidism
not responsive
to T4 Tx
Tx of myxedema
coma
```
81
Thyroid
| Ablation
Radioactive
| iodine (131 I) RAI
82
MOA of Radioactive
| iodine (131 I) RAI
```
radioactive iodine is
concentrated in
thyroid gland w/
death of gland cells
over 6-8wks
```
83
Indications of Radioactive
| iodine (131 I) RAI
thyroid ablation
| w/o surgery
84
Antithyroid Agents
Methimazole
| [Tapazole]
85
MOA of Methimazole
| [Tapazole]
```
Blocks oxidation of
iodine in thyroid
gland preventing
iodine combining w/
tyrosine to form T4,
T3
doesn't inactivate
circulating T4, T3
```
86
Indications of Methimazole
| [Tapazole]
hyperthyroidism
87
Antithyroid Agents
| Thiamine
Propylthiouracil
| [PTU}
88
MOA of Propylthiouracil
| [PTU}
```
interfere w/ thyroid
hormone synthesis;
inhibits conversion
T4 to T3;
has
immunosuppressive
effects (bone
marrow)
```
89
Indications of Propylthiouracil
| [PTU}
```
Graves disease,
pre-thyroid
surgery or
RAI131 therapy;
thyrotoxic crisis
```
90
Glucocorticoid
Intermediate acting
(T1/2= 12-36H)
2 drugs
1. Prednisone
| 2. Prednisolone [Omnipred]
91
MOA of Glucocorticoid
| Intermediate acting
```
suppresses adrenal
function at high dose;
decreased leukocyte
migration;
enters cell nucleus to
alters synthesis of
proteins
```
92
Indications of Glucocorticoid
| Intermediate acting
multiple
immunosuppress
ive fxns
93
what is important to remember about Prednisolone [Omnipred]
Same as Prednisone
| Active form of prednisone
94
Glucocorticoid Long acting
| T1/2 >48H
Dexamethasone
| [Maxidex]
95
what to know about Dexamethasone
| [Maxidex]
Same as Prednisone
Much more potent than predniseon (~7-10x)
Equiv dosing ---> prednisone 5mg = dexamethasone 0.75mg
96
Mineralcorticoid
Fludrocortisone
| [Florinef]
97
MOA of Fludrocortisone
| [Florinef]
promotes increase distal
renal tubule absorp
of Na+ & loss of K+
98
Indications of Fludrocortisone
| [Florinef]
```
Addisons ds (adrenocotical insufficiency)
resistant orothostatic hypotension
```
99
Adjunct Drugs:
| Beta Blockers
Propanolol
| Metoprolol
