Endocrine Pharmacology For Step 1

Front 1

insulin analogs:
lispro (short acting)
aspart (short)
regular (short)
NPH (immediate)
glargine (long)
detemir (long)

Back 1

- bind insulin receptor
-allows liver to store ↑ glucose as glycogen
- ↑ glycogen & protein synthesis in muscle
- K uptake, aids TG storage
- used for Type 1 & 2 DM, can also be used for hyperkalemia and hyperglycemia

Front 2

sulfonylureas
first generation: tolbutamide, chlorpropamide
2nd generation: glyburide, glimepiride, glipizide

Back 2

- close K channel in beta cell membrane so cell depolarizes which leads to triggering of insulin release via Ca influx
-used to stimulate release of endogenous insulin in Type 2 DM. useless in type 1
- hypoglycemia, DISULFRAM like rxn so take w/ alcohol

Front 3

biguanides: metformin

Back 3

- overall acts as an insulin sensitizer, possibly ↓ gluconeogenesis, increase glycolysis, ↓ serum glucose
-used as an oral hypoglycemic. can be used in patients w/o islet function so good for type 1
- tox: LACTIC ACIDOSIS, avoid in pts with CHF

Front 4

glitazones
pioglitazone
rosiglitazone

Back 4

- increase target cell response to insulin. increase target cell response by regualting the release of adipokines (resistin & adiponectin) Adiponectin secretion is stimulated and it sensitizes tissues to insulin. resistin secretion is inhibited thereby reducing insulin resistance
- used as montherapy in type 2 DM
tox: weight gain, edema, hepatotoxicity, CV tox

Front 5

alpha glucosidase inhibitors
acarbose
miglitol

note: alpha glucosidase catalzes a step in glycogen breakdown

Back 5

- inhibit intestinal brush border alpha glucosidases. delayed sugar hydrolysis and glucose absorption leads to ↓ postprandial hyperglycemia
- used for type 2 DM
tox: Gi disturbances

Front 6

mimetics
pramlintide

Back 6

- ↓ glucagon
type 2 DM
tox: hypoglycemia, nausea, diarrhea

Front 7

GLP-1 mimetics
exenatide

Back 7

- increase insulin, ↓ glucagon release
- type 2 DM
- nausea, vomiting, pancreatitis

Front 8

orlistat

Back 8

"orlistat gets rid of fat"
- alters fat metabolism by inhibiting pancreatic lipases
- used for long term obesity management
-tox: steatorrhea, Gi discomfort, reduced absorption of fat soluble vitamins, headache

Front 9

sibutramine

Back 9

- sympathomimetic serotonin and NE reuptake inhibitor
- used for short term & long term obesity management
tox: HTN, tachycardia

Front 10

propylthiuracil, methimazole

Back 10

- inhibit organification and coupling of thyroid hormone sythesis. PTU also ↓ conversion of T4 to T3, also inhibit thyroid peroxidase
- used for hyperthyroidism
- tox; skin rash, agranulocytosis, aplastic anema

Front 11

GH

Back 11

- used for GH deficiency, Turner's syndrome

Front 12

somatostatin (octreotide)

Back 12

- somatostatin analogue (↓ gastric acid/ pepsin secretion, ↓ pancreatic secretion, ↓ SI fluid secretion, ↓ gall bladder contraction), ↓ insulin & glucagon release. INHIBITS GH
- used for acromegaly, CARCINOID, gastrinoma, glucagonoma

Front 13

oxytocin

Back 13

used for stimulating labor, uterine contractions, milk let down, controls uterine hemorrhage

Front 14

ADH

Back 14

used for central diabetes insipidus

Front 15

levothyroxine, triiodothyronine

Back 15

- thyroxine replacement
- used for hypothyroidism, myxedema
- tox: tachycardia, heat intolerance, tremors, arrythmias

Front 16

glucocorticoids
hydrocortisone, prednisone, triamcinolone, dexamethasone, beclomethasone

Back 16

- decrease the production of leukotrienes, and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
- used for addison's disease, inflammation, immune supppression, asthma
tox: cushings syndrome

Front 17

demeclocycline

Back 17

- tetracycline antibiotic that also works as an ADH antagonist
- SIADH
tox: photosensitivity, abnormalities of bone & teeth