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USMLE Endocrine Pharmacology

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razuvopi's version from 2016-06-16 02:38

Diabetes Pharmacology by Class

DrugAnswerQuestion
LisproRapid acting insulinClass
AspartRapid acting insulinClass
GlulisineRapid acting insulinClass
SemilenteShort acting insulinClass
RegularShort acting insulinClass
LenteIntermediate acting insulinClass
Isophane (NPH)Intermediate acting insulinClass
GlargineLong acting insulinClass
DetemirLong acting insulinClass
Protamine ZincLong acting insulinClass
MetforminBiguanidesClass
Tolbutamide1st gen sulfonylureaClass
Chlorpropamide1st gen sulfonylureaClass
Glyburide2nd gen sulfonylureaClass
Glimepiride2nd gen sulfonylureaClass
Glipizide2nd gen sulfonylureaClass
PioglitazoneGlitazone/thiazolidinedionesClass
RosiglitazoneGlitazone/thiazolidinedionesClass
AcarboseAlpha glucosidase inhibitorClass
MiglitolAlpha glucosidase inhibitorClass
PramlintideAmylin analogClass
ExenatideGLP-1 analogClass
LiraglutideGLP-1 analogClass
LinagliptinDDP-4 inhibitorClass
SaxagliptinDDP-4 inhibitorClass
SitagliptinDDP-4 inhibitorClass
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Diabetes Pharmacology by Class

DrugAnswerQuestion
InsulinsDM1/2/gestational diabetes/life threatening hyperK/stress hyperglycemiaUse
BiguanidesFirst line oral in DM2/can be used w/o islet functionUse
SulfonylureaDM2 (useless in DM1/requires islet fxn)Use
Glitazone/thiazolidinedionesDM2 monotherapy (or w/others)Use
Alpha glucosidase inhibitorDM2 monotherapy (or w/others)Use
Amylin analogDM1/2Use
GLP-1 analogDM2Use
DDP-4 inhibitorDM2Use
InsulinsInsulin receptor/hepatic glycogenesis/muscle glycogenesis/protein anabolism/K+ uptake/adipose TG storageMechanism (6)
BiguanidesPeripheral insulin sensitization/hepatic decreased gluconeogenesis/increased glycolysisMechanism (3)
SulfonylureaBlock K+ channel in Beta cell like ATP from glucose/depolarization/Ca++ influx/insulin releaseMechanism (4)
Glitazone/thiazolidinedionesBinds PPAR-gamma/nuclear transcription regulator/increases insulin sensitivityMechanism (3)
Alpha glucosidase inhibitorDelayed sugar hydrolysis/glucose absorption/reduced postprandial hyperglycemiaMechanism (3)
Amylin analogDecreased glucagonMechanism
GLP-1 analogIncrease insulin/decrease glucagonMechanism (2)
DDP-4 inhibitorIncrease insulin/decrease glucagonMechanism (2)
InsulinsHypoglycemia/rare hypersensitivityToxicity (2)
BiguanidesGI upset/lactic acidosis (contraindicated in renal failure)Toxicity (2)
SulfonylureaDisulfiram likeToxicity
Glitazone/thiazolidinedionesWeight gain/edema/hepatotoxicity/heart failureToxicity (4)
Alpha glucosidase inhibitorGI disturbancesToxicity
Amylin analogHypoglycemia/nausea/diarrheaToxicity (3)
GLP-1 analogNausea/vomiting/pancreatitisToxicity (3)
DDP-4 inhibitorMild urinary/respiratory infectionsToxicity (2)
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Diabetes Pharmacology Individually

DrugAnswerQuestion
InsulinsInsulin receptor/hepatic glycogenesis/muscle glycogenesis/protein anabolism/K+ uptake/adipose TG storageMechanism (6)
MetforminPeripheral insulin sensitization/hepatic decreased gluconeogenesis/increased glycolysisMechanism (3)
TolbutamideBlock K+ channel in Beta cell like ATP from glucose/depolarization/Ca++ influx/insulin releaseMechanism (4)
ChlorpropamideBlock K+ channel in Beta cell like ATP from glucose/depolarization/Ca++ influx/insulin releaseMechanism (4)
GlyburideBlock K+ channel in Beta cell like ATP from glucose/depolarization/Ca++ influx/insulin releaseMechanism (4)
GlimepirideBlock K+ channel in Beta cell like ATP from glucose/depolarization/Ca++ influx/insulin releaseMechanism (4)
GlipizideBlock K+ channel in Beta cell like ATP from glucose/depolarization/Ca++ influx/insulin releaseMechanism (4)
PioglitazoneBinds PPAR-gamma/nuclear transcription regulator/increases insulin sensitivityMechanism (3)
RosiglitazoneBinds PPAR-gamma/nuclear transcription regulator/increases insulin sensitivityMechanism (3)
AcarboseDelayed sugar hydrolysis/glucose absorption/reduced postprandial hyperglycemiaMechanism (3)
MiglitolDelayed sugar hydrolysis/glucose absorption/reduced postprandial hyperglycemiaMechanism (3)
PramlintideDecreased glucagonMechanism
ExenatideIncrease insulin/decrease glucagonMechanism (2)
LiraglutideIncrease insulin/decrease glucagonMechanism (2)
LinagliptinIncrease insulin/decrease glucagonMechanism (2)
SaxagliptinIncrease insulin/decrease glucagonMechanism (2)
SitagliptinIncrease insulin/decrease glucagonMechanism (2)
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Diabetes Pharmacology Individually

DrugAnswerQuestion
InsulinsHypoglycemia/rare hypersensitivityToxicity (2)
MetforminGI upset/lactic acidosis (contraindicated in renal failure)Toxicity (2)
TolbutamideDisulfiram likeToxicity
ChlorpropamideDisulfiram likeToxicity
GlyburideHypoglycemiaToxicity
GlimepirideHypoglycemiaToxicity
GlipizideHypoglycemiaToxicity
PioglitazoneWeight gain/edema/hepatotoxicity/heart failureToxicity (4)
RosiglitazoneWeight gain/edema/hepatotoxicity/heart failureToxicity (4)
AcarboseGI disturbancesToxicity
MiglitolGI disturbancesToxicity
PramlintideHypoglycemia/nausea/diarrheaToxicity (3)
ExenatideNausea/vomiting/pancreatitisToxicity (3)
LiraglutideNausea/vomiting/pancreatitisToxicity (3)
LinagliptinMild urinary/respiratory infectionsToxicity (2)
SaxagliptinMild urinary/respiratory infectionsToxicity (2)
SitagliptinMild urinary/respiratory infectionsToxicity (2)
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Insulin Times

Question Answer Column 3
Glargine4hOnset
Detemir4hOnset
Protamine Zinc4hOnset
Glargine36hDuration
Detemir36hDuration
Protamine Zinc36hDuration
GlarginePeaklessKey point
Glulisine15-20minOnset
Aspart15-20minOnset
Lispro15-20minOnset
Glulisine2-5hDuration
Aspart2-5hDuration
Lispro2-5hDuration
Regular15minOnset
Semilente15minOnset
Regular2-5hDuration
Semilente12hDuration
Lente2hOnset
Isophane (NPH)2hOnset
Lente24hDuration
Isophane (NPH)24hDuration
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Non Diabetic Pharmacology

DrugAnswerQuestion
GlucocorticoidsHydrocortisone/predisone/triamcinolone/dexamethasone/beclomethasoneID (5)
PropylthiouracilBlocks peroxidase (organification of iodide/coupling thyroid hormones)/blocks 5' deiodinase (decreases peripheral T4 to T3 conversion)Mechanism
MethimazoleBlocks peroxidase (organification of iodide/coupling thyroid hormones)Mechanism
LevothyroxineThyroxine replacementMechanism
TriiodothyronineThyroxine replacementMechanism
DemeclocyclineADH antagonist (tetracycline family)Mechanism
GlucocorticoidsInhibits phospholipase A2/COX2 expression/reduces LKT/PGMechanism
TeriparatideRecombinant PTH/pulsatile administration increases bone densityMechanism
FludrocortisoneAldosterone replacement/mineralocorticoidMechanism
CabergolineDopamine agonismMechanism
BromocriptineDopamine agonismMechanism
PergolideDopamine agonismMechanism
HaloperidolProlactin increase via dopamine level decreaseMechanism
Diazepam (Valium)Prolactin increase via dopamine level decreaseMechanism
ImipramineProlactin increase via dopamine level decreaseMechanism
PhenoxybenzamineIrreversible alpha blockerMechanism
MetotaneAntineoplastic/selectively inhibits adrenal cortexMechanism
KetoconazoleAntifungal/inhibits steroid synthesis/P450Mechanism
OrlistatReversible inhibitor of gastric/pancreatic lipasesMechanism
LeuprolideGnRH analog (pulsatile agonist/high levels chemical castration)Mechanism
PegvisomantGH receptor antagonist/blocks IGF-1 productionMechanism
ThiocyanateInhibit NaI transporterMechanism
PerchlorateInhibit NaI transporterMechanism
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Non Diabetic Pharmacology

DrugAnswerQuestion
PropylthiouracilHyperthyroidismUse
MethimazoleHyperthyroidismUse
LevothyroxineHypothyroidism/myxedemaUse
TriiodothyronineHypothyroidism/myxedemaUse
GHGH deficiency/Turner syndromeUse
Somatostatin/octreotideAcromegaly/carcinoid/gastrinoma (VIPoma diarrhea)/glucagonoma/esophageal variciesUse (5)
Oxytocin (pitocin)Stimulates labor/uterine contractions (ino/chronotropic)/milk let down/controls uterine hemorrhageUse (4)
ADHPituitary/central (not nephrogenic) DIUse
DemeclocyclineSIADHUse
GlucocorticoidsAddison's disease/inflammation/immunosuppression/asthmaUse (4)
LeuprolideInfertility (pulsatile)/chemical castration for hormone sensitive malignancies (high doses)Use (2)
CabergolineProlactinomasUse
BromocriptineProlactinomasUse
PergolideProlactinomasUse
PhenoxybenzaminePheochromocytomaUse
MetotaneCushing's syndromeUse
KetoconazoleCushing's syndromeUse
HaloperidolAntipsychoticUse
Diazepam (Valium)AnxiolyticUse
ImipramineTCAUse
PegvisomantAcromegaly/gigantismUse
ThiocyanateHyperthyroidismUse
PerchlorateHyperthyroidismUse
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Non Diabetic Pharmacology

DrugAnswerQuestion
PropylthiouracilSkin rash/agranulocytosis/aplastic anemia/hepatotoxicityToxicity (4)
MethimazoleSkin rash/agranulocytosis/aplastic anemia/teratogenToxicity (4)
LevothyroxineTachycardia/heat intolerance/tremors/arrhythmiasToxicity (4)
TriiodothyronineTachycardia/heat intolerance/tremors/arrhythmiasToxicity (4)
DemeclocyclineNephrogenic DI/photosensitivity/abnormalities of bones/teethToxicity (4)
GlucocorticoidsIatrogenic Cushing's (buffalo hump/moon facies/truncal obesity/muscle wasting/thin skin/easy bruisability/osteoprosis/adrenocortical atrophy/peptic ulcers/diabetes if chronic/Adrenal insufficiency with abrupt stoppage)Toxicity (11)
Oxytocin (pitocin)Hyponatremia/seizures (due to ADH-like effect)/subarachnoid hemorrhage/uterine rupture in pregnancyToxicity (4)
HaloperidolGalactorrhea (PRL disinhibition)Toxicity
Diazepam (Valium)Galactorrhea (PRL disinhibition)Toxicity
ImipramineGalactorrhea (PRL disinhibition)Toxicity
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