Endocrine Drugs

ekadar's version from 2016-03-13 07:43

Types of Insulin

Question Answer
Rapid actingaspart, glulisine, lispro
How should regular insulin be givenIV! only one that should be administered IV. Give to patients in DKA
Intermediate actingNPH
Long acting insulingdetemir and glargine

Oral hypoglycemic agents

Question Answer
Mechanism of action metforminunknown but decreases gluconeogenesis and increased glycolysis and increased peripheral glucose uptake and insulin sensitivity
Most serious side effect of metforminlactic acidosis
What are the sulfonyureasglimepiride, glipizide, glyburide
MOA of sulfonyureasclose K+ channel in B cell membrane causes cell to depolarize. Insulin release via increased calcium influx.
Clinical use of sulfonyureasrequire some islet function so useless in type 1 DM.
A/E of sulfonyureashypoglycemia
TZDSpioglitazone and rosiglitazone
MOA of TZDSincrease insulin sensitivity in peripheal tissue. Binds to PPAR gamma nuclear transcritpion regulator. increase GLUT 4 expression on adiopyocyte membranes
How long does it take to see the effects of TZDSdays to weeks.
what cytokine do TZDS regulateadiponectin
Who should not take TZDSCHF and severe liver disease
A/E of TZDSfluid retention with weight gain and edema
What are the GLP-1 analogsexenatide and liraglutide
What is the MOA of GLP-1 analogsincreases insulin, decreases glucagon release. Suppresses appetitie.
Incretin effect of GLP-1 analogsmimics actions of incretins by decreasing glucagon secretion increasing insulin secretion and delaying gastric emptying
Toxicity of GLP-1 agonistspossible increased risk of acute pancreatitis
What are the DPP-4 inhibitorslinagliptin, saxagliptin, sitagliptin
MOA of DPP-4 inhibitorsincreases insulin, decreases glucagon release. No weightloss, but oral unlike GLP-1 analogs
DPP-4 effect on incretinprolongs incretin action, which decreases glucagon secretion, increases glucose-dependent insulin secretion and delays gastric emptying
amylin analogpramlintide
MOA of pramlintidedecreases gastric empty; decreases glucagon
What are the SGLT-2 inhibitorscanagliflozin
MOA of canagliflozinblocks reabsorption of glucose in PCT. Requires kidney to work
Toxicity of canagliflozinglucosuria increased creatinine.
alpha glucoside inhibitorsacarbose, miglitol
MOA of alpha glucosidase inhibitorsinhibits intestinal brush-border alpha glucosidases. Delayed carbohydrate hydrolysis and glucose absorption. Decreases postprandial hyperglycemia.
Toxicity of alpha glucosidase inhibitorosmotic diarrhea
Patient with diabetes should take [ ] to slow or prevent nephropathyACEI or ARBS

Quick associations oral hypoglycemic agents

Question Answer
lactic acidosismetformin
most common side effect is hypoglycemiasulfonyureas
Not safe in patients with CHFTZDS
Should not be used in patients with abnormal kidney functionmetformin, SGLT-2 inhibits, sulfonyureas
Possible non-insulin treatment for patients with organ failureDPP-4 inhibitors

Thyroid Drugs

Question Answer
MOA of PTUblocks thyroid peroxidase, inhibiting the oxidation of iodide and the organification of iodine leading to inhibition of hormone synthesis. Blocks 5'-deiodinase- decreasing peripheral conversion of T4 to T3.
MOA of methimazoleblocks thyroid peroxidase, inhibiting the oxidation of iodide and the organification of iodine leading to inhibition of hormone synthesis.
Toxicity of both PTU and methimazoleagranulocytosis
MOA of demeclocyclineADH antagonist (member of tetracycline family)
Clinical use of demeclocyclineSIADH
Toxicity of demecyclinenephrogenic DI, photosensitivity, abnormalitites of bone and feet
MOA of cinacalcetsensitizes Ca sensing receptor in parathyroid gland to circulation Ca and decreases PTH
Clinical use of cinacalcethypercalcemia due to primary or secondary hyperparathyroidism
Toxicity of cinacalcethypocalcemia
Clincal use of somatostatin (octreotide)acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices
ADH antagonists othersconivaptan, tolvaptan
What drugs are used to control severe graves' ophthalmopathyhigh dose glucocorticoids