Insulin
hypoglycemia:(tremors, palpitations, sweating, excessive hunger, HA, mood changes, irritability, uncousness, sz)secretion of glucagon and epinephrine are blunted, weight gain, lipohypertrophy, hypokalemia, allergic reaction at injection site, insulin antibodies
Pramlintide(symlin)
hypoglycemia(black box warning)*** nausea.
SulfonylureasRepaglinide
hypoglycemia,weight gain, muscular weakness, dizziness, confusion, skin rash, photosensitivity, blood dyscrasias, cholestatic jaundice
Repaglinide
hypoglycemia, weight gain
Metformin
diarrhea, abd bloating, nausea, ***lactic acidosiswith greater potential with **renal failure pts
Rosiglitazone(Avandia) and pioglitazone(actos)
fluid retention and peripheral edema, weight gain, **new onset heart failure. ***Black box warning regarding CHF and MI
Acarbose(precise) and miglitol (glyset)
NOT well tolerated, loose stools, flatulence, abd cramping
Sitagliptin(Januvia) and Saxagliptin (onglyza)
well tolerated
Colesevelam (WelChol)
constipation/nausea, indigestion, increase TG
Exenatide (Byetta)
N/V/D, modest weight loss, hypoglycemia, anti-exenatide antibodies
Levothyroxine(synthroid, levothroid, levoxyl, unithroid)
arrhythmias, tachycardia, angina pain, cramps, HA, restlessness, sweating, weight loss, osteoporosis
Propylthiouracil(PTU) and Methimazole(Tapazole)(MMI)
cause hypothyroidism, arganulocytosis, hypatotoxicity, vasculitis, rash, arthralgia, myalgia, cholestatic jaundice, lymphadenopathy, drug fever, psychosis, alopecia
KI
hypersensitivity rxn, HA, lacrimation, conjunctivitis, laryngitis, thyrotoxicosis, drug fever, acneform rash, metallic taste in mouth
Metyrapone(metopirone)
N/V, HTN, alopecia, hirsutism
Aminoglutethimide(cytadren)
N/V, sedation, hypothyroidism
Ketoconazole(Nizoral)
hepatotoxicity, gynecomastia, nausea
Mitotane(lysodren)
N/V, lethargy, somnolence, hypercholesterolemia
Spironolactone
hyperkalemia, gynecomastia
Octreotide
N, D, hyperglycemia, arrhythmias, hypothyroidism, cholelithiasis
Bromocriptine and Ergot alkaloid
N/V, HA, dizziness, hypotension
Pegvisomant
N,D, AST & ALT elevations
Genotropin
slipped capital femoral epiphysis, idiopathic intracranial hypertension
Mescasermin
***Hypoglycemia, dizziness, arthralgias
Bromocriptine
N/V, HA, dizziness, hypotension
Cabergoline
N/V, HA, dizziness, hypotension, reports of valvular heart disease when high dose used
Glucocorticoids
Withdrawal of therapy= flare up of underlying disease, acute adrenal insufficiencyGeneral: wt gain, increase appetiteCNS: mood changes- euphoria leads to depression, psychosisOpthamology: cataracts later in life, **Glaucoma due to increased intraocular pressureCV: HTN, dyslipidemiaHeme: immunosuppression, infection, impaired wound healingGI: Peptic ulcer disease, suppression of response to H. pyloriBone: osteoporosis (prevent w/ bisphos + calcium and Vit D), Aseptic necrosis of hip, growth suppression, myopathyEndocrine: cushing’s syndrome, adrenal suppression, glucose intolerance/ DMmineral corticoid ADRSkin: Acne, easy bruising, thin skin, striae