First Aid - Endocrine - Pharmacology

Front 1

Insulin - ordered by t-half

Back 1

Lispro (rapid)
Aspart (rapid)
Regular (short)
NPH (intermediate)
Glargine (long)
Determi (long)

Front 2

Sulfonylureas

MOA?
clinical use?
toxicities?
names?

Back 2

close K+ channel in beta-cell membrane --> cell depolarizes --> insulin release via Ca++ influx

type II diabetes - stimulates insulin release
(not useful in type I b/c requires some islet cell fxn)

1st gen - disulfiram like effects
2nd gen - hypoglycemia

1st gen: Tolbutamide, Chlorpropamide
2nd gen: Glyburide, Glimepiride, Glipizide

Front 3

Biguanides

MOA?
clinical use?
toxicities?
names?

Back 3

exact MOA unknown
decrease gluconeogenesis,
increase glycolysis,
increase peripheral glucose uptake

oral. 1st line therapy in type 2 DM. can be used in pts w/o islet fxn (type 1)

most grave adverse effect - lactic acidosis
contraindicated in renal failure

Metformin

Front 4

what is first line therapy in type 2 DM?

Back 4

Metformin

Front 5

what is contraindication for metformin?

Back 5

renal failure

can cause grave lactic acidosis

Front 6

Thiazolidinediones

-names?
-MOA?
-clinical use?
-toxicities?

Back 6

Pioglitazone, Rosiglitazone

increase insulin sensitivity in peripheral tissue
binds to PPAR-gamma nuclear transcription regulator (adiponectin)

used as monotherapy in type 2 DM, or combined w/agents above

can cause weight gain, edema.
Hepatotoxicity, heart failure

Front 7

alpha-glucosidase inhibitors

-names?
-MOA
-clinical use?
-toxicities?

Back 7

acarbose, miglitol

inhibit intestinal brush border alpha-glucosidases
delayed sugar hydrolysis & glucose absorption, decreased postprandial hyperglycemia

monotherapy in type 2 DM, or in combination

can cause GI disturbances

Front 8

Pramlinide?

Back 8

mimetic;
decreases glucagon

used in type 2 DM

can cause hypoglycemia, nausea, diarrhea

Front 9

Exenatide?

Back 9

GLP-1 analog

increases insulin, decreases glucagon release

used in type 2 diabetes

can cause nausea, vomiting, pancreatitis

Front 10

potassium perchlorate?

Back 10

block iodine absorption by thyroid
(anion inhibitor)

Front 11

iodide salts?

Back 11

decrease synthesis & release of thyroid hormones
(anion inhibitor)

Front 12

Methimazole? (other similar agent?)

MOA?
clinical use?
toxicity?

Back 12

also, propylthiouracil

blocks peroxidase, inhibiting organification of iodide & coupling of thyroid hormone synthesis

propylthiouracil also blocks 5' deiodinase, decreasing peripheral conversion of T4 to T3

used for hyperthyroidism

can cause:
-skin rash, agranulocytosis (rare), aplastic anemia

propylthiouracil can cause hepatotoxicity
methimazole is a possible teratogen

Front 13

Levothyroxine, triiodothyrine

MOA?
clinical use?
toxicity?

Back 13

thyroxine replacement

used for hypothyroidism, myxedema

can cause tachycardia, heat intolerance, tremors, arrhythmia

Front 14

GH?

Back 14

used in GH deficiency and Turner syndrome

Front 15

Octreotide?

Back 15

somatostain

used to tx acromegaly, carcinoid, gastrinoma, glucagonoma

Front 16

Oxytocin?

Back 16

stimulates labor, uterine contractions, & milk-let down

controls uterine hemorrhage

Front 17

ADH (desmopressin)?

Back 17

used for central DI

also apparently can help in pts w/ von Willebrands / hemophilia too

Front 18

Democlocycline?

Back 18

ADH antagonist (member of tetracycline family - not used as antibiotic anymore)

used for siADH

can cause nephrogenic DI, photosensitivity, abnormaliteis of bone & teeth

Front 19

Beclomethasone, triamcinolone, dexamethasone, hydrocortisone, prednisone?

Back 19

Glucocorticoids

inhibits phospholipase A2 & expression of COX-2, decreasing produciton of leukotrienes & prostaglandins

used for addison's dz, inflammation, immune suppression, asthma

can cause iatrogenic cushing's syndrome, adrenocortical atrophy, peptic ulcers, diabetes, thin skin, easy brusing

adrenal insufficiency when drug stopped after chronic use