pharm chart Flashcards

1
Q

Sulfonylureas 2nd Generation

A

Glipizide [Glucotrol]

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2
Q

Glipizide [Glucotrol] MOA

A

Stimulates
pancreatic β-cell
release of insulin

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3
Q

Glipizide [Glucotrol] Indications

A

T2DM

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4
Q

Meglitinides
Non-Sulfonylurea
Secretagogue

A

Repaglinide

[Prandin]

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5
Q

MOA of Repaglinide

[Prandin]

A
binds to
sulfonylurea
receptor on β-cell
to stimulate insulin
release
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6
Q

Indications of Repaglinide

[Prandin]

A

T2DM if sulfa allergy;
↓post-prandial glucose;
↓ A1c 0.6-1.9
↓ Gluc 65-75mg/Dl

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7
Q

Amylin (β-cell)–> released in response to ↑ blood glucose
o Inhibits gastric emptying
o Inhibits glucagon release

A

Amylin analog

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8
Q

Amylin analog

A

Pramlintide [Symlin]

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9
Q

MOA of Pramlintide

[Symlin]

A

Amylin analogue

↓gastric emptying, ↓glucagon secretion, ↓appetite

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10
Q

Indications of Pramlintide

[Symlin]

A

T1DM, T2DM ↓ postprandial glucose levels

↓ A1c 0.4-0.5

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11
Q

Incretin mimetic: Glucagon-Like Peptide-1 Agonist (GLP-1)
Synthetic analogue

What are the two drugs?

A

Exenatide [Byetta]

Liraglutide [Victoza]

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12
Q

MOA of Exenatide

[Byetta]

A

↑insulin release;
↓glucagon release;
↓gastric emptying;
↓appetite

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13
Q

Indications of Exenatide

[Byetta]

A

T2DM w/ metformin,
+/- sulfonylurea to lower postprandial glucose levels
↓ A1c 0.5 - 1.0%

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14
Q

MOA of Liraglutide

[Victoza]

A
↑insulin release;
↓glucagon release;
↓gastric emptying;
↓appetite
↑ β-cell growth/replication
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15
Q

Indications of Liraglutide

[Victoza]

A

T2DM w/ metformin,
+/- sulfonylurea to
lower postprandial glucose levels

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16
Q

Dipeptidyl peptidase-4 inhibitors

DPP-4 Inhibitors

A

Sitagliptin

[Januvia]

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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

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18
Q

Indications of Sitagliptin

[Januvia]

A

T2DM

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19
Q

Rapid Acting Insulin

A

Lispro

[Humalog]

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20
Q

MOA of Lispro

[Humalog]

A

insulin replacement,

supplement

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21
Q

Indications of Lispro

[Humalog]

A

T1DM

T2DM

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22
Q

Short-Acting

Insulin

A

Regular

[Humulin-R]

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23
Q

MOA of Regular

[Humulin-R]

A

insulin replacement,

supplement

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24
Q

Indications of Regular

[Humulin-R]

A

T1DM

T2DM

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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