Step 1: Endocrine Iv Drugs

Front 1

Mechanism of Insulin? Effect on:
- liver
- muscle
- fat

Clincal uses?

Back 1

- stimulate glycogen synth
- ^^GLUT4 --> ^^glycogen suth and protein synt; also ^^K+ uptake
- Aids TG storage

Almost all Type 1's. Type 2's that get bad enough.
Life threatening hyperKalemia and stress-induced hyperglycemia

Front 2

1st line antiDM drug in those with mild-to-moderate renal failure?
- should be avoided in whom?

Back 2

Sulfonylureas
- those with sulfa-like allergies

Front 3

Tolbutamide?
- good for which type of DM?
- SE?

Back 3

first gen--sulfonylurea
- close K+ channel on B-cell membrane --> depolariezes --> triggers Ca influx --> insulin release.
- Type II. Obviously useless in type I.
- 1st gen like this one have disulfiram like effects. Contraindicated in hepatic failure.

Front 4

Chlorpropamide?
- good for which type of DM?
- SE?

Back 4

first gen--sulfonylurea
- close K+ channel on B-cell membrane --> depolariezes --> triggers Ca influx --> insulin release.
- Type II. Obviously useless in type I.
- 1st gen like this one have disulfiram like effects.

Front 5

Glipizide (and other things starting with Gly/Gli's)
- good for which type of DM?
- SE?

Back 5

second gen--sulfonylurea
- close K+ channel on B-cell membrane --> depolariezes --> triggers Ca influx --> insulin release.
- Type II. Obviously useless in type I.
- 2nd gen can cause hypoglycemia. Contraindicated in hepatic failure.

Front 6

Metformin... class?
- mech?
- does it require islet function?
- most grave adverse affect?
- DON'T give to pt's which what type of organ issues?

Back 6

Biguanide
- overall acts as an insulin synthesizer.... actual mech unknown.
- no.
- lactic acidosis.
- renal failure.

Front 7

Pioglitazone, Rosiglitazone... class?
- main toxicity?
- uses?

Back 7

glitazones/thiazolidinediones
- ^^ insulin sensitivity in peripheral tissue
- Cardiac toxicity = contraindicated in pts with heart failure
- monotx in TII, or combined with others.

Front 8

Acarbose.... class?
- mech?
- tox?
- uses?

Back 8

- inhibit intestinal brush border alpha-glucosidases. Delayed sugar hydrolysis and glucose absorption lead to drop in postprandial hyperglycemia.
- GI tox
- monotx, or combined tx for type II. Txing postprandial hyperG.

Front 9

Miglitol.... class?
- mech?
- tox?
- uses?

Back 9

- inhibit intestinal brush border alpha-glucosidases. Delayed sugar hydrolysis and glucose absorption lead to drop in postprandial hyperglycemia.
- GI tox
- monotx, or combined tx for type II. Txing postprandial hyperG.

Front 10

Pramlintide...class?
- mech?
- tox?
- uses?

Back 10

mimetics
- decreases glucagon release
- hypoglycemia, nausea, diarrhea
- type 2 DM

Front 11

Exenatide.... class?
- mech?
- tox?
- uses?

Back 11

GLP-1 mimetic
- increases insulin, decreases glucagon release.
- Type 2 DM
- PANCREATITIS, vomiting, nausea.

Front 12

Orlistat...
- mech?
- clinical use?
- toxicity?

Back 12

inhibits pancreatic lipase --> alters fat metabolism

Long-term obesity management i/conjunction w/ modified diet.

Steatorrhea, GI discomfort, reduced fat-sol vit's, HA

Front 13

Sibutramine
- mech?
- clinical use?
- toxicity?

Back 13

sympathomimetic 5HT and NE reuptake inhibitor
- short and long-term obesity management
- Hypertension and Tachycardia

Front 14

Propylthiouracil
- mech?
- clinical use?
- toxicity?

Back 14

inhibits organification of iodine and coupling of thyroid hormone synthesis. Also \\peripheral conversion of T4 to T3.

Hyperthyroidism

Agranulocytosis, skin rash, aplastic anemia

Front 15

methimazole
- mech?
- clinical use?
- toxicity?

Back 15

inhibits organification of iodine and coupling of thyroid hormone synthesis.

Hyperthyroidism

Agranulocytosis, skin rash, aplastic anemia

Front 16

Levothyroxine
- mech?
- clinical use?
- toxicity?

Back 16

throxine replacement

hypothyroid, myxedema

Tachycardia, heat intolerance, tremors, arrhythmias

Front 17

triiodothyronine
- mech?
- clinical use?
- toxicity?

Back 17

throxine replacement

hypothyroid, myxedema

Tachycardia, heat intolerance, tremors, arrhythmias

Front 18

What drug is used for G deficiency and Turner's syndrome?

Back 18

GH

Front 19

What is octreotide?
- uses? (4)

Back 19

analog of somatostatin
- acromegaly, carcinoid, gastrinoma, glucagonoma

Front 20

What drug can stimulate labor, uterine contractions, milk let-down; also controls uterine hemorrhage?

Back 20

oxytocin

Front 21

Demeclocycline
- mech
- uses
- toxicities

Back 21

ADH antagonist (member of tetracycline family)
- SIADH
- nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Front 22

Hydrocortisone, prednisome, triamcinolone, dexamethasone, beclomethasone
- class?
- mechanism?
- toxicities?

Back 22

glucocorticoids
- \\leukotriene production and prostraglandins by inhibiting phospholipase A2 and expression of COX-2
- inducing Cushing's: buffalo hump, moon facies, trnucal obesity, muscle wasting, thin skin, easy bruisability, osteoporosis, adrenocortical atroph, peptic ulcers, diabetes if chronic.

Front 23

Tx for Addison's dz, inflammation , inducing immune suppression, and asthma?

Back 23

Glucocorticoids