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32 Cards in this Set
- Front
- Back
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What is the general treatment strategy for Type 1 DM?
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Low-sugar diet, insulin replacement
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What is the general treatment strategy for Type 2 DM?
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Dietary modification and exercise for weight loss, oral hypoglycemics
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What are the short acting insulins?
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Lispro and Aspart
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What are the intermediate insulins?
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NPH
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What are the long acting insulins?
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Lente and Ultralente
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What are the first generation sulfonyureas and what are the possible toxicities?
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Tolbutamide and chlorpropamide; disulfiram-like effects
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What are the second generation sulfonylureas and what are the possible toxicities?
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Glyburide, Glimepiride, Glipizide; hypoglycemia
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What is the mechanism of sulfonylureas?
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Close K+ channel in the beta cell --> cell depolarization --> increase Ca2+ influx --> insulin release
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What is metformin and what is the most grave adverse effect?
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Biguanides; lactic acidosis
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How does islet cell function affect metformin use? Sulfonylurea use?
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Metformin does not require islet cell functionl; Sulfonylureas do
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What are pioglitazone and rosiglitazone? What is the mechanism of action?
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Glitazones; Increase target cell response to insulin
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What are the toxicities of glitazones?
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Weight gain, edema, hepatotoxicity, cardiovascular toxicity
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What are acarbose and miglitol? What is the mechanism of action?
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alpha-glucosidase inhibitors; inhibit intestinal brush-border alpha-glucosidases
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What is the clinical use of orlistat?
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Long-term obesity management (in conjunction with modified diet)
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What is the mechanism of orlistat?
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Alters fat metabolism by inhibiting pancreatic lipases
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What is the toxicity of orlistat?
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Steatorrhea, GI discomfort, decreased absorption of fat soluable vitamin, headache
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What is the clinical use of sibutramine?
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Short-term and long-term obesity management
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What is the mechanism of sibutramine?
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Sympathomimetic serotonin and norepinephrine reuptake inhibitor
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What is the toxicity of sibutramine?
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Hypertension and tachycardia
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What is the clinical use of propylthiouracil and methimazole?
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Hyperthyroidism
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What is the mechanism of propylthiouracil and methimazole?
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Inhibits organification and coupling of thyroid hormone synthesis; Propylthiouracil also decreases peripheral conversion of T4 to T3
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What is the toxicity of propylthiouracil and methimazole?
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Skin rash, agrunlocytosis (rare), aplastic anemia
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What is the clinical use of GH?
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GH deficiency, Turner's syndrome
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What is the clinical use of somatostatin (octreotide)?
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Acromegaly, carcinoid syndrome, gastrinoma, glucagonoma
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What is the clinical use of oxytocin?
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Stimulation of labor, uterine contraction, milk let-down, control of uterine hemorrhage
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What is the clinical use of ADH (desmopressin)?
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Pituitary (central) diabetes insipidus
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What is the clinical use of levothyroxine and triiodothyronine?
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Hypothyroidism, myxedema
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What is the toxicity of levothyroxine and triiodothyronine?
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Tachycardia, heat intolerance, tremors, arrhythmias
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What are hydrocortisone, prednisone, triamcinolone, dexamethasone, beclomethasone?
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Glucocorticoids
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What is the clinical use of glucocorticoids?
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Addison's disease, inflammation, immun suppression, asthma
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What is the mechanism of glucocorticoids?
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Decreased production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
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What is the toxicity of glucocorticoids?
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Iatrogenic Cushing's syndrome - buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, easy bruisability, osteoporosis, adrenocortical atrophy, peptic ulcers, diabetes (if chronic use)
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