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83 Cards in this Set
- Front
- Back
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Differentiate Cushing’s and Addison’s syndrome.
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Cushing’s - adrenal hormone excess; Addison’s - adrenal hormone deficiency
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Name the 3 adrenal cortex hormones.
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glucocorticoids, mineralocorticoids, androgens
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What is the main pharmacologic effect of glucocorticoids?
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supression of immune system and therefore inflammation
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Name 5 AE of glucocorticoids.
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adrenal insufficiency, osteoporosis, infection, fluid + electrolyte disturbanc, growth retardation
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When are glucocorticoids contraindicated (2)?
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do not give with systemic fungal infections or live vaccines
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When should glucocorticoids be administered?
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give before 9am
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What mineralocorticoid is produced endogenously?
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aldosterone
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What do mineralocorticoids treat?
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Addison’s syndrome
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What drug class is fludrocortisone (Florinef Acetate)?
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mineralocorticoid
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Where is fludrocortisone absorbed, metabolized, and excreted?
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GI tract, liver, kidneys
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What is the normal fasting plasma glusose level? Diabetic level?
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normal < 100 mg/dl; diabetic > 126 mg/dl
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What casual plasma glucose value indicates diabetes?
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anything > 200 mg/dl with s/s
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What is the normal oral glucose toleralance test glucose level? Diabetic level?
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normal < 140 mg/dl; diabetic > 200 mg/dl
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What are 3 treatments used to prevent type 1 diabetic-related complications?
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insulin, ACE inhibitors (or ARBs), statins
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What does HbA1c indicate?
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reflects the average glucose level over a 3 month period by binding to the hemoglobin in RBCs
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In diabetics, what is the HbA1c goal?
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< 7% (measured 2-4 times per year)
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Where is insulin synthesized?
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pancreatic beta cells (islets of Langerhans)
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How does pancreatic alpha cell activation relate to insulin?
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inhibits the release of insulin
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Name the 4 categories of insulin.
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rapid-acting/short duration, slower-acting/short duration, intermediate duration, long duration
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Name 3 examples of short duration/rapid acting insulins.
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lispro (Humalog), aspart (NovoLog), glulisine (Apidra)
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When should short duration/rapid acting insulins be administered?
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with meals
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Can rapid acting insulins be given IV?
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no
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Are prescriptions required for rapid acting insulins?
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yes
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What drug class is regular insulin?
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slower acting
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Can regular insulin be given IV?
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yes (it is the only insulin that can be administered IV)
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Does regular insulin require a prescription?
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no (except Exubera)
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NPH and detemir (Levemir) are in what drug class?
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intermediate duration insulins
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Which is the only insulin suspension that is cloudy?
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NPH
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Does NPH require a prescription?
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no
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Which is the only long acting insulin that can be mixed with short acting insulin?
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NPH
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When should NPH be administered?
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between meals and at bedtime
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How is detemir (Levemir) administered (frequency, route)?
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qd-bid, SQ, between meals
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Glargine (Lantus) is in what drug class?
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long duration insulin
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Can glargine (Lantus) be given IV?
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no; follow-up: which insulin can? (regular insulin)
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How long are insulin mixtures stable?
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out of fridge - 28 days, in fridge - 1 month
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How long is insulin stable?
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out of fridge - 1 month
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Which is the only insulin that can be given IV?
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regular insulin
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What other conditions might insulin treat?
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hyperkalemia or ketoacidosis
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What drug class in known to mask the s/s of hypoglycemia?
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beta blockers
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What blood glucose level indicates hypoglycemia?
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< 50 mg/dl
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What are 4 s/s of rapid onset hypoglycemia?
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tachycardia, palpitations, sweating, nervousness; related to activation of sympathetic nervous system
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What are 4 s/s of slow onset hypoglycemia?
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HA, confusion, drowsiness, fatigue
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What is the function of pancreatic alpha cells?
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produce glucagon (increases plasma glucose level)
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What is the MOA of sulfonylureas?
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stimulate pancreatic release of insulin relative to glucose level
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What is a common suffix of 1st generation sulfonylureas?
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“-amide”
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What is a common way to recognize 2nd generation sulfonylureas?
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“G…ide” (e.g. GlipizIDE)
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“-glinide” is a common suffix of what drug class?
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metglitinides
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What is the MOA of metglitinides?
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stimulates pancreatic insulin release relative to gluocose
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When should metglitinides be administered?
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no MORE than 30 min before a meal
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Are sulfonylureas used to treat type 1 diabetes?
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no
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Are metglitinides used to treat type 1 diabetes?
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no
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What drug class is metformin?
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biguanides
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What are biguanide’s MOA?
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enhances glucose uptake and utilization by muscle (does NOT promote insulin release)
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Can biguanides be used to treat type 1 diabetes?
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yes
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The suffix “-glitizones” is commonly used in what drug class?
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thiazolidineodiones
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What is the MOA of thiazolidineodiones?
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they increase skeletal muscle’s sensitivity to insulin
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Are thiazolidineodiones used to treat type 1 diabetes?
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no
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What drug class are acarbose and miglitol?
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alpha-glucosidase inhibitor
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What is the MOA of alpha-glucosidase inhibitor?
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decreases the rise in glucose after meals by decreasing absorption and breakdown of carbs
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What is the MOA of amylin mimetics?
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they delay gastic emptying and suppress glucagon secretion
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Which thyroid hormone is most potent?
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T3
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Which thyroid hormone is most prevelant?
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T4
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When are thyroid medications typically administered?
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the morning
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What does hyperthyroidism do to eyes?
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prominent
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What does hyperthyroidism do to the integumentary system?
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fine, thin hair; hot, moist skin
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What does hyperthyroidism do to body temp?
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heat intolerance
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What does hyperthyroidism do to weight and appetite?
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decreases weight, increases appetite
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What does hyperthyroidism do to emotions?
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nervousness, irritable, insomnia
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What does hyperthyroidism do to GI tract?
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diarrhea
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What does hypothyroidism do to eyes?
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ptosis, edema
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What does hypothyroidism do to the integumentary system?
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dry, brittle hair; cold, dry skin
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What does hypothyroidism do to body temp?
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cold intolerance
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What does hypothyroidism do to weight and appetite?
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increased weight, decreased appetite
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What does hypothyroidism do to emotions?
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lethargy, depression, increased sleep
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What does hypothyroidism do to GI tract?
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constipation
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What does a high TSH level indicate?
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hypothyroidism
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What do the names of medications that treat hypothyroidism have in common?
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they usually contain “thyro” somewhere within the generic or brand name
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What is myxedema?
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severe thyroid hormone deficiency
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What is Grave’s disease?
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an autoimmune disorder that results in hyperthyroidism
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What does methimazole treat?
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hyperthyroidism
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What does PTU treat?
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hyperthyroidism
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What is the preferred hyperthyroid treatment for pregnant women?
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PTU (less likely to cross placenta than methimazole)
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What is an important teaching element for PTU?
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if a dose is missed, take ASAP
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