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17 Cards in this Set

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Treatment Strategy for Type I DM and Type II DM
Type I - low sugar diet, insulin replacement

Type II- diet modification, exercise, weight loss, and oral hypoglycemics as needed
Insulin
1)Short acting
2)Intermediate
3)Long acting
1) Lispro, Insulin
2) NPH
3) Lente, Ultralente
Insulin
1) MOA in liver, muscle, fat
2) Use
3) Toxicity
1) Binds Insulin Receptor and induced Tyrosine Kinase Activity
Liver- stores glucose as glycogen
Muscle- Glycogen synthesis and K+ uptake
Fat- TAG storage

2) Type I DM (IDDM) and in life threatening hyperkalemia

3) Hypoglycermia
Sulfonylureas

First Gen and Toxicity
Sec Gen and Toxicity
1) Tolbutamide and Chlorpropamide - disulfiram effects (EtOH sickness)

2) Glyburide, Glimepiride, Glipizide - Hypoglycemia
Sulfonylureas
1) MOA
2) Use
1) Acts like Glucose Binding GLUT2 because it blocks the K+ pump--> depolarizes the cell--> insulin is released

2)Type II DM because they need residual Insulin function
Metformin (Biguanide)
1)MOA
2)Use
3)Toxicity
1) decreases gluconeogenesis, increase glycolysis, lowers serum glucose

2) Oral Hypoglycemic that can be used in both Type I and Type II DM

3) Lactic Acidosis
Glitazones- Pioglitazone and Rosiglitizone

1)MOA
2)Use
3)Toxicity
1) increase target insulin sensitivity

2) Used in combo with other agents for Type II

3) Weight Gain, Hepatotoxic
alpha-glucosidase inhibitors
Acarbose
Miglitol

1)MOA
2)Use
3)Toxicity
1) Inhibits brush border carb digestion to delay sugar absorption in the gut

2)Monotherapy or combo therapy in Type II DM

3) GI upset, diarrhea
Orlistat
1)MOA
2)Use
3)Toxicity
1) Inhibits Pancreatic Lipases
2) longer term trt of obesity
3)Steatorrhea, GI discomfort, headache, Loss of Vit D,E,A,K
Sibutramine
1)MOA
2)Clincal Use
3)Toxicity
1) Blocks reuptake of 5-HT and NE

2) Short term and long term obesity

3) HTN and Tachy
Propothiouracil, Methimazole
1)MOA
2)Use
3)Toxicity
1) Inhibits organification and coupling to Iodine in T3/T4 synthesis (PTU also inhibits peripheral deiodinases)

2) Hyperthyroidism

3)Skin Rash, agranulocytosis, aplastic anemia
Growth Hormone (somatotropin)
1)use
GH deficiency, Turner's syndrome
Octreotide (Somatostatin)
1)MOA
2)Use
1) Feeds back to inhibit release of Hormones and VIP,5-HT

2) Acromegaly, Carcinoid Tumors (5-HT), Gastrinoma (VIP), and Glucagonoma
Oxytocin
Stimulates labor, uterine contractions, milk let down
ADH (desmopressin)
Only for central Diabetes Insipidus
Levothyroxine, Triiodothyronine

1)MOA
2)Use
3)Toxicity
1) Replaces T4
2) Hypothyroidism, myxedema
3) Tachycardia, Heat, Tremors
Glucocorticoids- Hydrocortisone, Prednisone, Triamcinolone, Dexamethasone

1)MOA
2)Use
3)Toxicity
1) Blocks production of Leukotrienes, Prostaglandins, weak collagen, Bone turnover, acts like Glucagon

2) Addison's, Sheehan's Syndrome, Inflammation, Immune Suppression, Asthma

3) Iatrogenic Cushing's