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26 Cards in this Set
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- Back
- 3rd side (hint)
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Insulin (Lispro, Aspart, Glulisine) |
Binds insulin receptor (tk activity) RAPIDLY: DM 1, DM 2, GDM liver- increase glycogen, muscle- increase glycogen, protein synthesis, K+ uptake, fat- increase TG storage |
S/E: Hypoglycemia, lipodystrophy |
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Insulin |
Binds insulin receptor (tk activity) REGULAR: DM 1, DM 2, GDM, DKA(IV), hyperkalemia(+glucose), stress hyperglycemia liver- increase glycogen, muscle- increase glycogen, protein synthesis, K+ uptake, fat- increase TG storage |
S/E: Hypoglycemia, lipodystrophy |
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Insulin (NPH) |
Binds insulin receptor (tk activity) INTERMEDIATE: DM 1, DM 2, GDMliver- increase glycogen, muscle- increase glycogen, protein synthesis, K+ uptake, fat- increase TG storage |
S/E: Hypoglycemia, lipodystrophy |
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Insulin (Detemir, Glargine) |
Binds insulin receptor (tk activity) LONG ACTING: DM 1, DM 2, GDM (basal)liver- increase glycogen, muscle- increase glycogen, protein synthesis, K+ uptake, fat- increase TG storage |
S/E: Hypoglycemia, lipodystrophy |
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Metformin |
BIGUANIDES: first line for DM2, weight loss, use in pts w.o islets Decrease gluconeogenesis, increase glycolysis, increase INSULIN SENSITIVITY(peripheral glucose uptake) |
S/E: GI upset, LACTIC ACIDOSIS (in Renal insufficiency) |
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Chlorpropamide, Tolbutamide |
SULFONYLUREAS 1st GEN: Closes K+ channel in beta-cell membrane > cell depolarizes > insulin release via increase Ca2+ influx Stimulates release of endogenous insulin in DM2 |
S/E: Hypoglycemia in RF patients, weight gain, Disulfiram-like effects |
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Glimepiride, Glipizide, Glyburide |
SULFONYLUREAS 2nd GEN: Closes K+ channel in beta-cell membrane > cell depolarizes > insulin release via increase Ca2+ influxStimulates release of endogenous insulin in DM2 |
S/E: Hypoglycemia in RF patients, weight gain, Hypoglycemia and increase hepatic enzymes |
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Pioglitazone, Rosiglitazone |
THIAZOLIDINEDIONES: monotherapy in DM2 or with others (safe in Renal) Increase insulin sensitivity in peripheral tissue, Binds PPAR-gamma nuclear transcription regulator (regulate fatty acid storage and glucose metabolism, increase levels of adiponectin) |
S/E: Weight gain, edema, hepatotoxicity, HF, increase risk of fractures |
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Nateglinide, Repaglinide |
MEGLITINIDES: monotherapy in DM2 or w. Metformin Stimulate postprandial insulin release by binding to K+ channels on beta cell membranes (different site from sulfonylureas) |
S/E: hypoglycemia (increase risk with RF), weight gain |
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Exenatide, Liraglutide (sc injection) |
GLP-1 ANALOGS: DM2 Increase glucose dependant insulin release, decrease glucagon release, decrease gastric emptying, increase satiety |
S/E: Nausea, vomiting, pancreatitis, modest weight loss |
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Linagliptin, Saxagliptin, Sitagliptin |
DPP-4 INHIBITORS: DM2 Inhibits DPP-4 enzyme that deactivates GLP-1, thereby increasing glucose dependant insulin release, decrease glucagon release, decrease gastric emptying, increase satiety |
S/E: Mild urinary or respiratory infections, weight neutral |
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Pramlintide (sc injection) |
AMYLIN ANALOGS: DM1, DM2 Decrease gastric emptying, decrease glucagon |
S/E: Hypoglycemia (mistimed prandial insulin), nausea |
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Canagliflozin, dapagliflozin, empagliflozin |
SODIUM-GLUCOSE-COTRANSPORTER 2 (SGLT-2) INHIBITORS: DM2 Block reabsorption of glucose in PCT |
S/E: Glucosuria, UTIs, vaginal yeast infections, hyperkalemia, dehydration (orthostatic hypotension) |
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Acarbose, miglitol |
ALPHA-GLUCOSIDASE INHIBITORS at intestinal brush-border: DM2 Delayed carbohydrate hydrolysis and glucose absorption leads to decrease postprandial hyperglycemia |
S/E: GI disturbances |
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Methimazole |
THIONAMIDES: Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine > inhibition of thyroid hormone synthesis HYPERTHYROIDISM |
S/E: Skin rash , AGRANULOCYTOSIS, APLASTIC ANEMIA, hepatotoxicity, TERATOGEN (causes aplasia cutis) |
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Propylthiouracil (PTU) |
THIONAMIDES: Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine > inhibition of thyroid hormone synthesis; PTU blocks 5'-deiodinase > decrease peripheral conversion of T4 --> T3HYPERTHYROIDISM, block peripheral conversion of T4 to T3, PREGNANCY |
S/E: Skin rash , AGRANULOCYTOSIS, APLASTIC ANEMIA, hepatotoxicity |
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Levothyroxine (T4), Triiodothyronine (T3) |
Thyroid replacement therapy HYPOTHYROIDISM, MYXEDEMA, off the label weight loss supplements |
S/E: Tachycardia, heat intolerance, tremors, arrhythmias |
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Conivaptan, Tolvaptan |
ADH ANTAGONISTS: Block ADH at V2-receptor SIADH |
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Desmopressin acetate |
CENTRAL DI |
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GH |
GH deficiency, Turner syndrome |
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Oxytocin |
Stimulates labor, uterine contractions, milk let-down; controls uterine hemorrhage |
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Octreotide |
SOMATOSTATIN: Acromegaly Carcinoid Syndrome Gastrinoma Glucagonoma Esophageal Varices |
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Demeclocycline |
ADH ANTAGONIST: Member of tetracycline family SIADH |
S/E: Nephrogenic DI, photosensitivity, abnormalities of bone and teeth |
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Beclomethasone, Dexamethasone, Hydrocortisone, Methylprednisolone, Prednisone, Triamcinolone |
GLUCOCORTICOIDS: metabolic, catabolic, anti-inflam, and immunosuppressive effects (inhibition of Phospholipase A2, inhibition of transcription factors such as NF-kB Adrenal Insufficiency, Inflammation, Immunosuppression, Asthma |
S/E: Iatrogenic Cushing syndrome (hypertension, weight gain, moon facies, truncal obesity, buffalo hump, thinning skin, striae, acne, osteoporosis, hyperglycemia, amenorrhea, immunosuppression) , adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis, cataracts. Adrenal Insufficiency when drug is stopped abruptly after long term use |
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Fludrocortisone |
SYNTHETIC ANALOG OF ALDOSTERONE w little glucocorticoid effects Primary Adrenal Insufficiency |
S/E: similar to glucocorticoids; Edema, exacerbated HF, Hyperpigmentation |
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Cinacalcet |
Sensitizes Ca2+-sensing receptor (CaSR) in parathyroid gland to circulating Ca2+ --> decrease PTH Primary and Secondary hyperparathyroidism |
S/E: hypocalcemia |
