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20 Cards in this Set
- Front
- Back
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Treatment strategy for type 1 DM
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low sugar diet, insulin replacement
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Treatment strategy for type 2 DM
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dietary modification and exercise for weight loss; oral hypoglycemics and insulin replacement
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Insulin:
lispro (short acting) aspart (short acting) regular (short acting) NPH (intermediate) glargine (long acting) detemir (long acting) |
Binds insulin receptor; increased tyrosine kinase activity.
liver: increased glucose stored as glycogen muscle: increased glycogen and protein synthesis, K uptake (taken up with glucose) Fat: aids TG storage use: Type I and II DM, life threating hyperkalemia and stress induced hyperglycemia toxicity: hypoglycemia, hypersensitivity reaction |
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Sulfonylureas:
1st gen: Tolbutamide Chlorpropamide |
close K channel on B cell membrane to depolarize cell --> triggers insulin release via increased Ca influx
use: type II DM toxicity: disulfiram like reaction |
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Sulfonylureas:
2nd gen: Glyburide Glimepiride Glipizide |
close K channel on B cell membrane to depolarize cell --> triggers insulin release via increased Ca influx
use: type II DM toxicity: hypoglycemia |
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Biguanides:
Metformin |
unknown mechanism: possibly decreased gluconeogenesis, increased glycolysis, decreased serum glucose levels. Overall insulin sensitizer.
use: oral hypoglycemic. can be used in patients wo islet function. toxicity: lactic acidosis, contraindicated in renal failure. |
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Glitazones/thiazolidinediones:
pioglitazone rosiglitazone |
increased insulin sensitivity in peripheral tissue.
use: monotherapy in type II or combined with other agents. toxicity: weight gain, edema, hepatotoxicity, CV toxicity |
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a-glucosidase inhibitors:
acarbose miglitol |
inhibit intestinal brush border a-glucosides. delayed sugar hydrolysis and glucose absorption lead to decreased postprandial hyperglycemia.
use: monotherapy in type II or combined with other agents. toxicity: FART (gi disturbance) |
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Mimetics:
Pramlintide |
decrease glucagon
use: Type II toxicity: hypoglycemia, nausea, diarrhea |
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GLP-1 (glucagon like peptide) mimetics:
Exenatide |
increase insulin, decrease glucagon release
use: type II toxicity: n/v, pancreatitis |
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orlistat
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alters fat metabolism by inhibiting pancreatic lipases.
use: long term obesity management with modified diet. toxicity: steatorrhea, GI discomfort, reduced vit. KADE absorption, HA orliSTAT gets rid of FAT |
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sibutramine
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indirect sympathomimetic serotonin and norepinephrine reuptake inhibitor
use: short and long term obesity management by reducing appetite toxicity: hypertension and tachycardia |
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propylthiouracil, methimazole
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inhibit organification and coupling of iodide for thyroid hormone synthesis. propylthiouracil also decreases peripheral conversion of T4 to T3.
use: hyperthyroidism toxicity: skin rash, agranulocytosis (rare), aplastic anemia. |
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levothyroxine, triiodothyronine
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thyroxine replacement
use: hypothyroidism, myxedema toxicity: tachycardia, heat intolerance, tremors, arrhythmias (general symptoms seen in hyperthyroidism) |
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hypothalamic/pituitary drugs
GH |
GH deficiency, Turner's syndrome
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hypothalamic/pituitary drugs
Somatostatin (octreotide) |
Acromegaly, carcinoid, gastrinoma, glucagonoma
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hypothalamic/pituitary drugs
oxytocin |
stimulate labor, uterine contraction, milk let-down; controls uterine hemorrhage
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hypothalamic/pituitary drugs
ADH (desmopressin) |
central diabetes insipidus
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demeclocycline
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ADH antagonist (its a tetracycline)
use: SIADH toxicity: nephrogenic DI, photosensitivity, abnormalities of bone and teeth |
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Glucocorticoids:
hydrocortisone, prednisone, triamcinolone, dexmethasone, beclomethasone |
decreases the production of LT and PG by inhibition of PLA2; also inhibit COX-2 expression.
use: addison's disease, inflammation, immune suppression, asthma toxicity: iatrogenic cushing's syndrome (MCC) - buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, easy bruisability, osteoporosis, adrenocortical atrophy, peptic ulcers, diabetes (if chronic) |
