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48 Cards in this Set
- Front
- Back
- 3rd side (hint)
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7 categories of diabetes drugs
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(1) insulin
(2) sulfonylureas (3) biguanides (4) glitazones/thiazolidinediones (5) a-glucosidase inhibitors (6) mimetics (7) GLP-1 mimetics |
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insulins
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- Lispro (short)
- Aspart (short) - Regular (short) - NPH (intermed) - Glargine (long) - Detemir (long) |
6 diff ones...but he said not to get too bogged down in knowing these
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1st gen sulfonylureas
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- tolbutamide
- chlorpropamide |
diabetes drugs
there are 2 |
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2nd gen sulfonylureas
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- glyburide
- glimepiride - glipizide |
diabetes drugs
there are 3 |
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biguanides
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metformin
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diabetes drug
only 1 |
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glitazones/thiazolidinediones
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- pioglitazone
- rosiglitazone |
diabetes drug
there are 2 |
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a-glycosidase inhibitors
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- acarbose
- miglitol |
diabetes drugs
there are 2 |
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mimetics
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pramlintide
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diabetes drugs
there is only 1! |
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GLP-1 mimetics
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exenatide
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diabetes drugs
there is only 1! |
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sulfonylureas MOA
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close K+ chans in β-cell memb, so cell depols → triggering of insulin release via ↑Ca2+ influx
(kick starts β-cells to pump out more insulin) |
(tolbutamide, chlorpropamide, glyburide, glimepiride, glipizide)
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first gen sulfonylurea toxicity
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disulfiram-like effects
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(tolbutamide, chlorpropamide)
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2nd gen sulfonylurea toxicity
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hypoglycemia
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(glyburide, glimepiride, glipizide)
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never give IV contrast dye to pts on:
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metformin
(biguanides) |
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MOA of sulfonylureas
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- close K+ chan in b-cell memb
- cell depols→ triggers insulin release (via ↑Ca2+ influx) ("kick starts" beta cells to pump out more insulin) |
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metformin adverse effects
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- lactic acidosis (rare)
- CONTRAIND in renal failure, liver dz, & CHF |
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metformin MOA
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unknown.
overall acts as insulin sensitizer |
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can metformin be used in pts w/o islet function?
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yes
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↑'s insulin sensitivity in peripheral tissue
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glitazones
(thiazolidinediones) |
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S/E's of glitazones
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- wt gain
- edema - hepatotox - CV tox - exacerb. HF |
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MOA of acarbose & miglitol
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- (-) intest brush-border a-glucosidases
- delayed sugar hydrolysis & glucose absorp l/t ↓ postprand hyperglycemia (a-glucosidase inhibitors) |
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S/E's of acarbose & miglitol
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GI disturbances
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MOA of mimetics (pramlintide)
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↓ glucagon
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MOA of GLP-1 mimetics (exenatide)
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↑ insulin, ↓ glucagon release
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insulin drugs useful in type 1 DM
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- insulin
- metformin (?) |
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orlistat MOA
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alters fat metab by (-) panc lipases
("orlistat gets rid of fat") |
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clinical use of orlistat
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long-term obesity management
(orlistat gets rid of fat) |
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orlistat toxicity
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- steatorrhea
- GI discomfort - ↓ absorp of fat-soluble vitamins - HA |
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sibutramine MOA
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(-) sympathomimetic 5HT & NE reuptake
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sibutramine clinical use
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short & long term obesity management
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sibutramine toxicity
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- HTN & tachycardia
- HA |
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sibutramine is contraindicated in:
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- CAD
- stroke - TIA - HF - arryth - avoid SSRI's & MAOI's (risk of serotonin synd) |
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PTU/methimazole MOA
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- (-) organification of iodide
- (-) coupling of thyroid synth - PTU also ↓ periph conversion of T4→T3 |
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PTU/methimazole clinical use
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hyperthyroidism
(you CAN use in pregnancy) |
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PTU/methimazole toxicity
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- skin rash
- agranulocytosis (rare) - aplastic anemia (rare) |
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thyroxine replacement
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- levothyroxine
- triiodothyronine (use in hypothyroidism) |
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clinical use of GH
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- GH deficiency
- Turner's syndrome |
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clinical use of somatostatin (octreotide)
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- acromegaly
- carcinoid - gastrinoma - glucagonoma - portal HTN (bleeding varices) - bleeding peptic ulcers - ACTH secr tumors - ZES - VIPoma - insulinoma |
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drug you can give to stim labor / uterine contractions
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oxytocin
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drug you can give for milk let-down
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oxytocin
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drug that controls uterine hemorrhage
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oxytocin
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drug for pituitary (central) diabetes insipidus
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ADH (desmopressin)
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ADH antagonist used in SIADH
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demeclocycline
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demeclocycline toxicity
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- nephrogenic DI
- photosensitivity - abnormalities of teeth (tetracycline family) |
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MOA of glucocorticoids
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↓ production of LT's & PGE's by (-) phospholipase A2 & expression of COX-2
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glucocorticoid clinical use
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- addison's
- inflammation - immune suppression - asthma - ↓ collagen synth (keloids) |
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glucocorticoid toxicity
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IATROGENIC CUSHING'S SYND
(tertiary adrenocortical atrophy) |
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somatostatin actions
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- ↓ endocrine/exocrine secr
- ↓ splanchnic BF - ↓ GI motility - ↓ GB cxn - (-) secr of most GI horms |
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where is somatostatin made
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- through-out GI (mostly in D cells of gut mucosa & islet cells)
- through-out nervous system |
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