Week 12/13 - Endocrine

Question 1

hormones related to anterior lope of pituitary gland

Answer 1

• growth hormone (GH)
• luteinizing hormone (LH)
• follicle stimulating hormone (FSH)
• thyroid stimulating hormone (TSH)
• adrenocorticotropic hormone (ACTH)
• prolactin (Pr)

Question 2

hormones related to the posterior lobe of pituitary gland

Answer 2

oxytocin and antidiuretic hormone (ADH)

Question 3

growth hormone is also known as what?

Answer 3

somatropin

Question 4

GH MOA

Answer 4

synthetic hormone that impacts bone, skeleton muscle, organs, and fat

Question 5

GH AE

Answer 5

fluid retention/edema, muscle and joint pain

Question 6

vasopressin is also known as what?

Answer 6

antidiuretic hormone (ADH) or arginine vasopressin (AVP)

Question 7

what is the role of vasopressin?

Answer 7

decrease water excretion by causing increased urine concentration

Question 8

DDAVP MOA

Answer 8

DDAVP binds to V2 receptor in collecting duct which increased aquaporin 2 on cell to make cell more permeable to water

Question 9

what is the synthetic vasopressin?

Answer 9

desmopressin (DDAVP)

Question 10

what can DDAVP be used for in kids?

Answer 10

nocturia - bed wetting at night

Question 11

DDAVP AE

Answer 11

dry mouth, hyponatremia

Question 12

what are the symptoms of diabetes? (10)

Answer 12

• always tired
• always hungry
• always thirsty
• sudden weight loss
• sexual problems
• vaginal infections
• numb/tingling hands or feet
• frequent urination
• wounds that won’t heal
• blurry vision

Question 13

what is latent autoimmune diabetes (LADA) and how is it managed

Answer 13

slower beta-cell destruction and managed like T2DM

Question 14

what are symptoms of hypoclycemia?

Answer 14

think about how you feel when you are hangry

• shaky
• sweaty
• dizzy
• confusion and difficulty speaking
• hungry
• weak or tired
• headache
• nervous or upset

Question 15

what would you give a patient that is hypoglycemic?

Answer 15

sugary snack or drink like OJ

Question 16

MOA of metformin

Answer 16

not fully known but inhibits production of glucose, inhibits instestinal absorption of glucose, and increases insulin sensitivity in muscle and fat

Question 17

risk of hypoglycemia with metformin

Answer 17

low

Question 18

AE of metformin

Answer 18

GI - diarrhea, nausea, abdominal cramping/bloating

Question 19

what can develop over time with metformin?

Answer 19

vitamin B12 deficiency

Question 20

MOA of sulfonylureas

Answer 20

binds to sulfonylurea receptor in pancreas and depolarization causes insulin release

Question 21

sulfonylureas AE

Answer 21

hypoglycemia (especially in elderly and renal dysfunction) and weight gain

Question 22

GLipizide is in what drug class

Answer 22

sulfonylureas - remember GL for prefix

Question 23

when are sulfonylureas taken?

Answer 23

typically before breakfast; immediate release must be 30 minutes before meal otherwise you increase risk of hypoglycemia

Question 24

Thiazolidinedione (TZD) MOA

Answer 24

increase insulin sensitivity by agonizing PPARgamma which increases glucose metabolism; insulin sensitizer

Question 25

Thiazolidinedione (TZD) hypoglycemia risk

Answer 25

low

Question 26

Thiazolidinedione (TZD) AE

Answer 26

edema, long term increase risk of bone fracture (especially in females)

Question 27

What is boxed warning for Thiazolidinedione (TZD)?

Answer 27

can worsen heart failure after starting or increasing dose

Question 28

DDP4 inhibitors suffix

Answer 28

-gliptin

Question 29

DDP4 inhibitors MOA

Answer 29

inhibits DDP4 enzyme that breaks down incretin hormones; prolonged incretin hormone levels increases insulin synthesis and release and decreases glycogen secretion

Question 30

DDP4 inhibitors hypoglycemia risk

Answer 30

low

Question 31

DDP4 inhibitors AE

Answer 31

very well tolerated, new case reports show AE of arthralgia

Question 32

SGLT2 inhibitor suffix

Answer 32

-flozin

Question 33

SGLT2 inhibitor MOA

Answer 33

blocks glucose reabsorption in kidney at SGLT2 which increases urinary glucose excretion

Question 34

SGLT2 inhibitor AE

Answer 34

volume-depletion related AE - dizziness/light-headed, genitourinary infections, renal insufficiency - leads to increased ketones which increases body pH

Question 35

GLP1 receptor agonist MOA

Answer 35

- think GLP (gut, liver, pancreas) increases insulin secretion in presence of elevated glucose, decreases glucagon secretion which decreases blood glucose, slows gastric emptying

Question 36

GLP1 receptor agonist AE

Answer 36

GI - nausea, bloating, diarrhea

Question 37

Insulin MOA

Answer 37

binds tyrosine kinase receptors which promotes increased expression of GLUT4 receptor to increase glucose uptake; inhibits production of glucose

Question 38

Insulin AE

Answer 38

hypoglycemia and weight gain

Question 39

what is basal insulin

Answer 39

- think "base" bc it is always working in the background | - 24 hour insulins given once per day

Question 40

what is bolus insulin

Answer 40

- think "bowl" of food | - given before a meal; sliding-scale insulin

Question 41

what blood glucose level is too high for PT

Answer 41

> 300 mg/dL