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30 Cards in this Set

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  • Back
treatment strategy for type I DM
low sugar diet, insulin replacement
treatment strategy for type II DM
dietary modification and exercise for weight loss; oral hypoglycemics
short acting insulin
lispro, insulin
intermediate acting insulin
NPH
long acting insulin
Lente, ultralente
how do oral insulins work
bind insulin receptor (tyrosine kinase activity)
sulfonylureas MOA
close K channel in B cell membrane so cell depolarizes- triggering insulin release via incr Ca influx
(stimulate endogenous release of insulin)
require beta cell function
Sulfonylureas tox
hypoglycemia
disulfiram like reactions
sulfonylureas
tolbutamide, chlorpropamide, glyburide, glimepiride, glipizide
metformin MOA
decrease GNG, increase glycolysis
metformin CI
renal disease, liver disease, CHF (monitor hepatic enzymes)
metformin SE
LACTIC ACIDOSIS, decr TG, LDL
no weight gain
glitazones MOA
improve target cell response to insulin by binding to PPAR
DOC!
directly targets MOA of DM
glitazones tox
weight gain, edema, hepatotox
do not use with CHF, liver dysfunction (but okay in renal disease)
alpha glucosidase inhibitors
acarbose, miglitol
delayed surgar hydrolysis and glucose absorption lead to decreased postpranial hyperglycemia
causes GI disturbances
orlistat
alters fat metaboism by inhibiting pancr lipases
long term obesity management
tox: steatorrhea, GI discomfort, reduced abspt of fat sol vitamins, HA
sibutramine
sympathomimetic serotonin and NE reuptake inhibitor
tox: hypertension and tachy
bisphosphonates
decrease OC activity
hyperCa
etidronate, pamidronate
osteoporosis
alendronate, risedronate
Pagets
risedronate, tiludronate
Propylthoiuracil, methimazole
inhibit organification and coupling of thyroid hormone synthesis (inhibit iodination of tyrosyl groups)
PTU: also decreases peripheral conversion T4-T3
tox: skin rash, agranulocytosis, aplastic anemia
GH use (somatotropin)
GH def, turner's
somatostatin use (octreotide)
acromegaly, carcinoid, gastrinoma, glucagonoma, PUD, eso varices, pancreatitis
oxytocin
stimulates labor, uterine contractions, milk let down, controls uterine hemorrhage
ADH (desmopressin)
pituitary (central) DI
levothyroxine, triiodothyronine
thyroid replacement
used for hypothyroid, myxedema
tox: tachy, heat intol, tremors
glucocorticoids
decrease production of LT and PG by inhibiting phospholipase A2 and expression of COX2
use of glucocorticoids
Addisons, inflammation, immune suppression, asthma
Tox of glucocorticoids
Iatrogenic Cushings- buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, easy bruisability, osteoporosis, adrenocortical atrophy, peptic ulcer, diabetes