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34 Cards in this Set

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What is the action of insulin on Liver, skeletal muscle, and Fat?
1) inc. Liver glycogen synthesis
2) inc. muscle glycogen and protein synthesis, and K+ uptake
3) aids TG storage
What are the short-acting insulins?
1) regular insulin
2) Lispro
What are the long-acting insulins?
1) Lente
2) Ultralente
What is an intermediate-acting insulin?
NPH
When would you give someone insulin?
- type 1 diabetes mellitus
- life threatening hyperkalemia
- stress induced hyperglycemia
How do the sulfonylureas cause insulin release from beta-cells?
Close K+ channel --> depolarization --> Ca++ influx --> insulin release
Sulfonylureas are only for which type of diabetic?
type 2 - need some pancreatic islet function to release insulin
What side effect do Tolbutamide & Chlorpropamide have that the 2nd generation sulfonylureas don't?
Disulfiram-like effects
What are Glyburide, Glimepiride, and Glipizide?
2nd generation sulfonylureas
What is Metformin?
Biguanide - oral hypoglycemic that dec. gluconeogenesis, inc. glycolysis, and dec. serum glucose levels
If a diabetic on medication gets lactic acidosis, what drug could he possibly be on?
Metformin! Lactic acidosis is most adverse side effect.
How do the Glitazones help in diabetes?
For type 2 diabetics - inc. target cell response to insulin
What are side effects of the Glitazones?
- wt. gain
- hepatotoxicity
Acarbose and Miglitol work by:
inhibit intestinal brush border a-glucosidases --> delay glucose absorption after meal
Orlistat =
inhibit pancreatic lipases, for long-term obesity management (think: Orlando Bloom is skinny because he's taking Orlistat)
Sibutramine =
serotonin & NE reuptake inhibitor, for short- and long-term obesity management (can cause HTN and tachcardia)
What do you give for HYPERthyroidism?
Propylthiouracil or methimazole - inhibit thyroid hormone synthesis
Toxicities of propylthiouracil or methimazole =
skin rash, agranulocytosis, aplastic anemia
To which patients would you give GH?
- GH deficiency (duh)
- Turner's syndrome (45,X0)
To which patients would you give octreotide (somatostatin)?
- acromegaly
- carcinoid tumor
- gastrinoma
- glucagonoma
What does oxytocin do?
- uterine contraction
- milk letdown
- controls uterine hemorrhage
When would you give a patient desmopressin (ADH)?
central/pituitary diabetes insipidus
What do you give for hypothyroidism?
Levothyroxine, triiodothyronine (thyroxine replacement)
What do glucocorticoids inhibit?
phospholipase A2 and expression of COX-2
Name some glucocorticoids:
hydrocortisone, beclamethasone, prednisone, dexamethasone, triamcinolone
What are glucocorticoids used for?
- inflammation reduction
- asthma
- immune suppression
- Addison's disease
Increased levels of sex hormone binding globulin -->
gynecomastia (less free testosterone)
Low levels of sex hormone binding globulin -->
hirsutism (too much free testosterone)
List the 5 functions of T3/T4:
1) bone growth
2) CNS maturation
3) beta adrenergic effects (inc. CO and contractility)
4) inc. BMR (inc. O2 consumption and body Temp)
5) inc. glycogenolysis, glucogenesis, lipolysis
How is thyroid hormone inhibited?
T3 feeds back to anterior pituitary to dec. sensitivity to TRH from the hypothalamus
In a person with liver failure, what happens to free T3/T4 levels?
increase, because decreased production of thyroxine binding globulin
What happens to T3/T4 during pregnancy?
decrease, because increased production of thyroxine binding globulin
To review, which organs need insulin for glucose uptake?
fat, skeletal muscle (GLUT-4)
Brain and RBCs have GLUT-___ receptors and do not need insulin for glucose uptake.
GLUT-1