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Endocrine Modulating Drugs

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bhom14's version from 2017-12-04 04:23

Section 1

Question Answer
MetforminBiguanide
chlorpropamide1st generation sulfonylurea
tolbutamide1st generation sulfonylurea
glimepiride2nd generation sulfonylurea
glipizide2nd generation sulfonylurea
glyburide2nd generation sulfonylurea
1st generation sulfonylurea side effectdisulfiram-like effect
2nd generation sulfonylurea side effecthypoglycemia
Pioglitazonethiazolidinediones
Rosiglitazonethiazolidinediones
Mechanism of thiozolidinedionesbinds to PPAR-gamma transcription factor to decrease glucose production in liver, increase fat storage in adipose tissues, increase insulin sensitivity for glucose reuptake in skeletal muscles.
Mechanism of sulfonylureascloses ATP-sensitive K+ channels to depolarize cell and induce release of endogenous insulin from pancreatic beta cells
Side effects of thiozolidinediones increases LPL and HDL levels; weight gain; edema; increased fracture risk
what drug share similar mechanism to thiozolidinediones?Fibrates
When is Metformin contraindicated? Why?for patients with renal problems or heart failure due to risk of lactic acidosis
Nateglinide
Repaglinide
Mechanism of Meglitinidessimilar to sulfonylureas, but binds to another site on K+ channels of beta pancreatic cells; more rapid onset (good for post-prandial hyperglycemia; also good for those allergic to sulfa)
Mechanism of GLP-1 analogsbehaves like endogenous incretins, GLP-1 and GIP (which are released after meals and induce insulin release from pancreas); better than incretins bc not deactivated by enzyme DDP-4. Other functions effects include decrease in glucagon release, decrease gastric emptying, increase satiety
what enzyme breaks down GLP-1 and GIP?DDP-4
ExenatideGLP-1 analogs
LiraglutideGLP-1 analogs
LinagliptinDDP-4 inhibitors
saxagliptinDDP-4 inhibitors
sitagliptinDDP-4 inhibitors
PramlintideAmylin analog. Can be used for DM1 (lessen insulin dose requirement)
What does amylin hormone do?decrease gastric emptying and secretions; promotes satiety.
CanagliflozinSLGT2 inhibitors
Where are Sodium-glucose co-transporter 2 located?proximal tubules of the renal system
dapaglifozinSLGT2 inhibitors
empaglifozinSLGT2 inhibitors
Side effects of SLGT2 inhibitorshypotension, UTIs, yeast infection, glucosuria, dehydration, hyperkalemia, weight LOSS
acarbosealpha-glucosidase inhibitors
miglitolalpha-glucosidase inhibitors
where are alpha-glucosidase inhibitors located? what is their function?on brush border to break down foods into simple sugars
side effects to alpha-glucosidase inhibitorsGI upset (fart, diarrhea, AP, bloating)
GLP-analog side effectsnausea, vomiting, modest weight lost, pancreatitis
side effects to DDP-4 inhibitorsmild urinary or respiratory infections; no effect on weight
which DM drug does not affect weight? DDP-4 inhibitors
Rapid acting insulin"Girls And Lads" = glulisine, aspart, lispro; (peak at 1 hr, last 4 hrs; for post-prandial glucose control)
Short acting insuliRegular insulin (peak at 2 hrs, last 8hrs)
intermediate acting insulinNPH (peak at 6 hours, last 18 hours)
long acting insulin"Don't Glare/Go" = Determir, Glargine (for basal glucose control, can last up to 24 hours; glargine does not peak)
memorize

Section 2

Question Answer
Propylthiouracilthioamides to tx HYPERthryoidism; block thyroid peroxidase & blocks 5'-deiodinase (cannot convert periphery T4 to T3)
methimazolethioamide to tx HYPERthyroidism; block thyroid peroxidase
What does thyroid peroxidase do?oxidation of iodide; organification and coupling of iodine
which tioamides blocks peripheral conversion of T4 to T3?propylthiouracil ("TU blocks Peripheral conversion")
Which thiomides is a teratogen?methimazole; can cause aplasia cutis. "No Met for Moms"
Levothyroxinethyroid hormone replacement; tx HYPOthyroidism, myxedema
triiodothyroninethyroid hormone replacement; tx HYPOthyroidism, myxedema
what is myxedemapre-tibial derm changes due to hypothyroidism
side effects to thyroid hormone replacementtachycardia, heat intolerance, tremors, arrhythmias
memorize
bromocriptine: dopamine agonist, tx for prolactinoma
cabergoline: dopamine agonist, tx for prolactinoma
Octreotide: somatostatin analog
Pegvisomant: GH receptor antagonist; tx acromegaly
Desmopressin: ADH analog