pharmacology Flashcards Preview

LS endocrine > pharmacology > Flashcards

Flashcards in pharmacology Deck (34):
1

when is insulin given?

to manage type 1 diabetes and can be used in type 2 diabetes when oral medication has not been tolerated/successful

IV in diabetes emergencies or pre-operative procedures

alongside glucose in treatment of hyperkalaemia - only temporary measure

2

MOA

stimulates glucose uptake by tissue and use of glucose
stimulates glycogen, protein, fat synthesis
in hyperkalaemia stimulates K to enter cells, but the K will leak out when insulin no longer given

inhibits gluconeogenesis and ketogenesis

3

SE

Hypoglycemia can lead to coma and death
when given subcutaneously can cause fat overgrowth -lipohypertrophy

4

warnings

renal impairment due to reduced clearance of insulin can cause hypoglycaemia

5

drug interactions

caution wen given with other hypoglycaemia agents
concurrent corticosteroid therapy can increase insulin requirement

6

what should they look out for?

signs of hypoglycaemia
dizziness
nausea
confusion
lethargy
sweating
agitation

7

what are the different classes

Rapid acting -rapid onset, short duration - IV given this way - novorapid
Short acting -early onset, short duration- actrapid
Intermediate acting - intermediate both- humalin
Long acting - flat profile, requires regular supply- levenir, lantus

some solutions are combined such as novomix which is rapid and intermediate

8

what is glidazide

it is a suphonyleas

9

what is it used to treat?

diabetes when metformin is not tolerated or not sufficient
reduces risk of diabetic complications
can be used in combo with metformin when blood glucose is not adequately controlled by a single agent

10

MOA/

increase insulin secretion by blocking ATP K channel of voltage gated ca2 on the beta cell this enables an increase in intracellular ca2 , needed for insulin secretion

however, in the long term it can worsen diabetes as it causes weight gain - anabolic process
relies on functioning pancreas

11

SE

gi upset-nausea, diarrhoea, constipation
hypersensitivity reaction
haemolytic abnormalities
cholestatic jaundice

12

contraindications

elderly
renal impairment
liver impairment
adrenal adenoma/insufficiency
malnutrition

13

drug interactions

other anti-diabetic drugs
drugs causing elevated blood sugars- thiazide, prednisolone, diuretics

14

what is metformin used for?

it is used to treat type 2 diabetes as a first line treatment
it can be given in combo with sulphonyleas if not sufficient alone

15

MOA

increases glucose sensitivity
does not stimulate increase insulin secretion from beta cells
it supress hepatic glucose production -glycogenolysis

increases uptake by muscle cells and intestinal absorption
does not cause hypoglycaemia and can induce weight loss therefore prevent worsening of resistance

16

SE

gi upset- nausea, diarrhoea,, vomiting, anorexia, change In taste
LACTIC ACIDOSIS

17

warning

renal impairment --> can cause tissue hypoxia
caution with heart failure

and AKI caused by sepss, dehydration shock for example
alcohol intoxication
hepatic impairment due to reduce clearance of lactate

18

DI

beware that prednisolone, diuretics, thiazides increase blood glucose so may reduce efficacy
use caution with other anti-diabetic therapies
to be within 48 hr before and after IV contrast media to prevent renal impairment , metaformin accumulation and lactic acidosis

19

what can be used to treat hyperthyroidism?

carbimazole

20

MOA?

when absorped converted into the active form metimazole where it prevents the enzyme thyroid perioxidase from coupling and iodinating the thyrosine residue on the thyroglobulin so reduces production of t3 and t4

21

ci

blood disorders
severe liver disease/impairment
pregnancy and breasfeeding

22

SE

rash and puritis can be given anti-histamines

bone marrow supression -neutropenia and granulocytosis with fever, ST, ulcer, easy bruising, nausea

23

DI

SWET
steroids-prednisolone
warfarin
erythromycin
theophylline

24

name an bisphosphonate and wen is it given?



alendronic acid
alendronate
it is an alendronic acid given for proplyaxis purpose in those at risk of osteoprotic fragility
it is also given for the treatment of pagets disease to reduce pain and bone turnover

25

MOA

inhibits osteoclast activity, which therefore reduces bone reabsorption
and bone mass

26

CI

renal impairment
osteonecrosis of the jaw - in smokers and those with dental disease
active upper GI disease
HYPOCALCEMIA

27

SE

Osphagitis
hypophostphatemia, osteonecrosis
atypical femoral fractures

28

DI

binds to calcium therefore reduced uptake
so do not give or in caution with antacids, iron salts, cal vitamin d supplements

29

bare in mind what with alendronates

dental visits before and during treatment

30

what is thyroxine given for

primary hypothyroidism
seocndayr hypothyroidism due to hypopituataryism

31

moa

it is a replacement hormone of t4- synthetic t4
can give synthetic t3triiodothyronine which has a shorter half life and quicker onset so better for acute situations

32

SE

D and V
tremors restlessness insomnia
weight loss
palpitations arrhythimas angina

33

DI

interact with antacids, iron salts -reduced uptake od thyroxine therefore administer 4 hr apart
increase effects of warfarin
increased dose when taken with phenytoin

34

CI

if given with hypopitutaryism give corticosteroid therapy first to prevent addinson crisis
increases heart rate therefore may trigger ischaemia in coronary artery disease therefore low dose and monitor pts