Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/82

Click to flip

82 Cards in this Set

  • Front
  • Back
Insulin receptor
Tyrosine Kinase
Insulin preps are ______ in solution but need to be ____ to bind receptors.
Hexamer
Monomer
What property of ultra short acting makes them short acting?
Decreased hexamer stability --> falls apart easily
Lispro
Ultra short acting
Aspart
Ultra short acting
Glulisine
Ultra short acting
Why is there no antigenic response to ultra short acting insulin preps?
They are very similar to insulin --> decreased antigenicity
How do you administer ultra short acting insulin preps?
SubQ
Regular crystalline
Short acting
NPH
Intermediate
Protamine in phosphate buffer
Lente
Intermediate insulin prep
Insulin with zinc in acetate buffer
What's preferred, Lente or NPH? Why?
NPH preferred
LEnte + regular insulin converts all to intermediate insulin. We want 70% intermediate and 30% short acting.
Ultralente
Slow acting
Increased Zn in PO4- buffer
Unpredictable rate of absorption
Glargine
Slow acting
Stable hexamer, predictable from SubQ
Why do pts have to take insulin in the middle of the night?
Cortisol, epi, and GH increase glucose at night and can make you hyperglycemic when you wake up.
Watch out for this class if you're allergic to sulfa drugs
Sulfonylureas
Main SFx of sulfonylureas as a whole
Hypoglycemia
Chlorpropamide Side Effects
Alcohol induced flush
Hyponatremia(Inc. ADH in Kidney)
1st gen. sulfonylureas
Tolbutaminde
Chlorpropamide(antabuse rxn, hypoNa+)
Tolazamide
Acetohexamide
2nd gen. sulfonylureas
Glyburide
Glipizide
Gliclazide
Glimeripride
What's the difference between 1st and 2nd gen sulfonylureas?
2nd gen. are more potent than the 1st gen.
Shorter half life.
Repaglinide
Meglitinide
Nateglinide
Meglitinide
Meglinitide MOA
Simular to sulfonylureas in K+ ch. effect
No sulfur in structure*
No direct effect on insulin exocytosis
Metformin
NOT Hypoglycemic
Decrease liver glucose output
Decrease insulin resistance
Contraindics:
Renal impairment
Hepatic Dz
***Lactic acidosis*** in the past
Thiazolidinediones
Pioglitazone, Rosiglitazone, Troglitazone
Increase glucose transporters --> insulin action
Bind PPAR-y
Sfx:
Monitor liver function!(liver Cx risk)
Increase HDL, lower LDL
a-glucosidase inhibitors
Acarbose, Miglitol
Decrease carb absorption
SFx: Flatulence(d/t bacteria), diarrhea, abd pain
GLP-1 analogs
Exenatide
Increase glucose dependent insulin secr
Given by injection (Rest are orally active)
Ethanol: Hyper or hypoglycemic?
Hypo
Diuretics: Hyper or hypoglycemic?
Hyper
Salicylates: Hyper or hypoglycemic?
Hypo
Increase insulin release
beta-blockers: Hyper or hypoglycemic?
Hypo
Blocks epi effects. Epi counters insulin. So beta blockers have a pro-insulin effect
Ca channel blockers: Hyper or hypoglycemic?
Hyper
Asthmatic patient taking beta 2 agonist. Will he be hyper or hypoglycemic? Tx for that?
Hyperglycemic (Beta 2 agonist -> hyper)
Tx: Increase insulin dose
ADH receptor on vascular smooth muscle
V1
Acts via PLC->Ca2+ and PKC
ADH receptor on principal cells and collecting duct
V2
cAMP & PKA
Desmopressin
V2 selective agonist - no vascular effects
Centra DI
Chlorpropamide
Enhance ADH action
Augment V2 transduction
Centra DI and 1st gen Hypoglycemic
BUT - Antabuse rxn!
Carbamazepine/clofibrate
Central DI
Enhance ADH action on kidney
Pitocin
Peptide or GlycoProtein?
Uses?
Sustain or induce?
Oxytocin
Peptide
**Stim uterine contractions, milk ejection,
Ups PG production in uterus
Misoprostol
PGE1 analog
Induces abortion, stimulate sustained contractions(PGE stimulates contractions)
Ergonovine/methylergonovine
Tx: Post partum hemorrhage
Tocolytic agents do what?
Delay labor
B2 selective tocolytics
Terbutaline, ritodrine
Delay labor & relax uterus
**Increase renin - Na/H20 retention - HTN!
HYPERGLYCEMIA
hypokalemia
pulmonary edema
Nifedipine
Uses?
Ca2+ ch. blocker
Relax uterine smooth muscle
Vascular active
Prefer vascular active to cardiac active!!
Indomethacin
PG inhibitor
adverse: closure of ductus arteriosus --> i.e, treat persistent ductus(PG keeps ductus open)!
atosiban
Oxytocin receptor antagonist
Stop labor!
Prolactin uses?
No pharmacologic uses!!
GH analogs
Somatotropin - identital to humans
Somtrem - immunogenic response chance
LH analog
hCG from pregnant women!
acts at LH receptor
Menotropins
both FSH and LH
Urofollitropin
mainly FSH
follitropin
recombinant FSH
Thyrotropin
TSH agonist?
Cosyntropin
ACTH, diagnostic use,
Gonadorelin
short acting GnRH analog
pulsatile IV - stimulate LH/FSH release
GnRH analogs
long acting GnRH analogs - initial increase in LH/FSH but continuous admin suppresses release
Chemical Castration; tx for precocious puberty

***Leuprolide(Prostate cancer!!!)
Histrelin
Deslorelin (Very potent)
Nafarelin (Nasal spray)
Buserelin(Nasal spray)
Goserelin - 28 day continuous release
Triptorelin - depot IM
Leuprolide
GnRH long acting analog
continuous - suppress FSH/LH secretion
Tx for: Prostate cancer
GnRH anatgonists
Ganirelix
Cetrorelix
Abarelix
Bromocriptine
D2 agonist - inhibit PRL release, *paradoxical decrease in GH release
Also: Cabergoline, Pergolide, Quinagolide
Octreotide
SST Analog
More resistant to degradation
LONGER HALF LIFE
Pegvisomant
GH Receptor antagonist
Acromegaly and gigantism
Levothyroxine
T4
Liothyronine
T3
Liotrix
T4+T3
Effect of high dosese of thyroid hormones?
Cardiac arrhythmias - can look like hyperthyroid pt.
Increase or decrease synthroid dose in pregnant woman?
Increase...
Estrogen in pregnance increases TBG -> free T4 drops transiently
Glucocorticoid effect on Thyroid hormones?
Decreases binding of T4 to TBG
But Decreases T4->T3 by Type I 5' DI
What other drugs inhibit type I 5' DI?
B blockers(propanaolol in high doses)
Amiodarone
PTU
Short half life - more dosing!
Inhibit Type I 5' DI - less T4->T3 conversion
Block T4 and T3 synthesis
Methimazole
toxicity possible to fetus
Decrease T4->T3
Anti thyroid drugs - name em!
Side effects of anti-thyroid drugs?
Agranulocytosis!! (WBC drops)
Most common side effect: rash
Perchlorate - BIG side effect
Fatal aplastic anemia
Ionic inhibits - anti thyroid
Thiocyanate, perchlorate, fluoroborate
NIS competition -> block I2 uptake
Explain wolf-chaikoff effects in Anti-thyroid tx.
Give iodide --> Decreases # NIS receptors
Pre-op tx for throidectomy & for thrytoxic crisis
RAPID EFFECTS THEN ESCAPE!
Desmopressin
V2 agonist - kidney effects only, no vasculature effects(which are via V1)
Tx: CENTRAL DI
Chlorpropamide
POTENTIATE ADH
Augment V2 rec. transduction
Disulfiram like rxn and HTN/Hypokalemia
Tx for lithium induced DI
Amiloride
Blocks Li uptake into cells
Nephrogenic DI tx
Hydration, Thiazide diuretics, Indomethacin( --> block PG's --> pro ADH)
Demeclocycline
Tetracycline antibiotic
Interferes with V2-R transduction
Loop diuretics in SIADH - why?
Lose interstitial gradient so less H20 absorbed
Lithium in SIADH
V2-R transduction
psyhic side effects