Pharmacology - Endocrine

Front 1

Treatment Strategies for:
-DM1
-DM2

Back 1

-Low sugar diet, insulin replacement
-dietary modification & exercise for wt loss; oral hypoglyemics

Front 2

Insulin types:
name them(5)
long/short/intermediate acting?

Back 2

1. Lispro (short-acting)
2. Insulin (short-acting)
3. NPH (intermediate)
4. Lente (long-acting)
5. Ultralente (long-acting)

Front 3

Insulin:
-mechanism
-effects on liver, mm, fat

Back 3

-Binds insulin receptor (tyrosine kinase activity)
-Liver: increase glucose sotred as glycogen
-Muscle: increase glycogen and protein synthesis, K+ uptake
-Fat: aids TG storage

Front 4

Insulin:
-clinical use

Back 4

-for Type 1 DM
-for life-threatening hyperkalemia
-for stress-induced hyperglycemia

Front 5

Insulin:
-toxicity

Back 5

-hypoglycemia
-hypersensitivity reaction (v. rare)

Front 6

Sulfonylureas: name them
-1st generation (2)
-2nd generation (3)

Back 6

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

Front 7

Sulfonylurea
-mechanism

Back 7

Close K+ channel in beta cell membrane -> depolarizes -> Ca2+ influx -> trigger insulin release

Front 8

Sulfonylurea
-clinical use

Back 8

-stim release of endogenous insulin in DM2
-require some islet function (useless in DM1!)

Front 9

Sulfonylurea
-toxicity

Back 9

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

Front 10

Disulfiram-like reaction:
sxs

what is disulfiram

Back 10

flushing, nausea, vomiting, thirst, palpitations, chest pain, vertigo, and hypotension

-disulfiram is an aldehyde dehydrogenase inhibitor

Front 11

Bigaunide - name it (1)

Back 11

Metformin

Front 12

Metformin
-mechanism

Back 12

-exact mech unknown
-possibly decreases gluconeogenesis, increases glycolysis, decreases serum glucose levels

Front 13

Metformin
-clinical use

Back 13

-oral hypoglycemic
-can be used in pts without islet function

Front 14

Metformin
-toxicity

Back 14

LACTIC ACIDOSIS (most grave effect)

Front 15

Glitazones: name them (2)

Back 15

-pioglitazone
-rosiglitazone

Front 16

Glitazone
-mechanism

Back 16

-increases target cell response to insulin

Front 17

Glitazone
-clinical use

Back 17

used as monotherapy in DM2 or combined with other agents

Front 18

Glitazone
-toxicity

which one is no longer use?

Back 18

-weight gain
-edema

*Troglitaozone - no longer used

Front 19

alpha-Glucosidase inhibitors:
name them (2)

Back 19

Acarbose
Miglitol

Front 20

Acarbose, miglitol:
-mechanism

Back 20

-inhibit intestinal brush border alpha-glucosidases
-delayed sugar hydrolysis and glucose absorption lead to decreased postprandial hyperglycemia

Front 21

Acarbose, miglitol:
-clinical use

Back 21

Used as monotherapy in DM2 or in combination with other agents

Front 22

Acarbose, miglitol:
-toxicity

Back 22

GI disturbance

Front 23

Orlistat
-mechanism (inhibits which enzymes?)

Back 23

Alters fat metabolism by inhibiting PANCREATIC LIPASES

Front 24

Orlistat
-clinical use

Back 24

Long-term obesity mgmt (in conjunction with modified diet)

Front 25

Orlistat
-toxicity

Back 25

-steatorrhea
-GI discomfort
-reduced fat-soluble vitamin absorption
-HA

Front 26

Sibutramine
-mechanism

Back 26

sympathomimetic serotonin and norepinephrine reuptake inhibitor (SNRI)

Front 27

Sibutramine
-clinical use

Back 27

Short term and long term obesity management

Front 28

Sibutramine
-Toxicity

Back 28

HTN
tachycardia

Front 29

Propylthiouracil, Methimazole
-Mechanism

-extra effect of PTU?

Back 29

inhibit organification and coupling of thyroid hormone synthesis

PTU also decreases peripheral conversion of T4 to T3

Front 30

GH
-clinical use

Back 30

-GH deficiency
-Turner's syndrome

Front 31

Somatostatin
-other name?

Back 31

Octreotide

Front 32

Somatostatin
-clinical uses

Back 32

-acromegaly
-carcinoid
-gastrinoma
-glucagonoma

Front 33

Oxytocin
-clinical uses

Back 33

-stimulates labor
-uterine contractions
-milk-letdown
-controls uterine hemorrhage

Front 34

ADH
-other name (exogenously given)

Back 34

Desmopressin

Front 35

Desmopression
-clinical use

Back 35

Pituitary diabetes insipidus (central, not nephrogenic)

Front 36

Levothyroxine, Triiodothyronine
-mechanism
-clinical use
-toxicity

Back 36

-thyroxine replacement
-for hypothyroidism
-for myxedema
-toxicity: tachycardia, heat intolerance, tremors

Front 37

Glucocorticoids
-name them (5)

Back 37

- hydrocortisone
- prednisone
- triamcinolone
- dexamethasone
- beclomethasone

Front 38

Glucocorticoid
-mechanism

Back 38

-decreases the production of LTs and PGs by inhibiting phospholipase A2 and expression of COX-2

Front 39

Glucocorticoid
-clinical use

Back 39

-Addison's disease
-inflammation
-immune suppresion
-asthma

Front 40

Glucocorticoid
-toxicity

Back 40

Iatrogenic Cushing's syndrome:
-buffalo hump
-moon facies
-truncal obesity
-mm wasting
-thin skin
-easy bruisability
-osteoperosis
-adrenocortical atrophy
-PUD
-Diabetes (if chronic)