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46 Cards in this Set
- Front
- Back
6 types of insulin
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short-acting
--lispro --aspart --regular intermediate --NPH long-acting --glargine --detemir |
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sulfonylureas
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1st gen
--tolbutaminde --chlorpropamide 2nd gen --glyburide --glimepiride --glipizide |
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metformin is a _
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biguanide
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glitazones/thiazolidinediones
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pioglitazone
rosiglitazone |
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alpha-glucossidase inhibitors
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acarbose
miglitol |
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"mimetics" among diabetes drugs
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pramlintide
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glp-1 analogs
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exenatide
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diabetes drugs 7 groups
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insulin
sulfonylureas biguanides glitazones/thiazolidinediones alpha-glucosidase inhibitors mimetics GLP-1 analogs |
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insulin action
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liver:
^ glucose stored as glycogen muscle: glycogen, protein synthesis K+ uptake fat: aids TG storage |
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insulin rx
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--type 1 and type 2 DM
--gestational diabetes --life-threatening hyperkalemia --stress-induced hyperglycemia |
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insulin s/e
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hypersensitivity (very rare)
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sulfonylureas moa
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close K+ channel in beta-cell membrane
--> depolarization --> Ca++ influx --> triggers insulin release |
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sulfonylureas rx
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--> release of endogenous insulin in type 2 DM
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sulfonylureas s/e
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1st generation:
--disulfiram-like effects 2nd generation: --hypoglycemia |
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metformin moa
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v gluconeogenesis
^ glycolysis ^ peripheral glucose uptake |
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metformin rx
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oral
can be used in pts without islet function |
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metformin s/e
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most grave s/e is lactic acidosis (contraindicated in renal failure)
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pioglitazone
rosiglitazone moa |
^ insulin sensitivity in peripheral tissue
binds to PPAR-gamma nuclear transcription regulator |
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pioglitazone
rosiglitazone rx |
monotherapy in type 2 DM
or combined with above agents (insulin, sulfonylureas, metformin) |
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pioglitazone
rosiglitazone s/e |
CV toxicity
hepatotoxicity edema weight gain Conceptual way to organize the s/e's: CV toxicity is like heart failure which inevitably causes liver problems & edema. edema is a form of "weight gain" |
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acarbose
miglitol s/e |
GI disturbances
(duh, they inhibit intestinal brush border alpha glucosidases...) |
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acarbose
miglitol moa |
inhibit intestinal brush-border alpha glucosidases
|
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acarbose
miglitol rx |
monotherapy in type II DM
"or in combo with above agents" |
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pramlintide moa
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v glucagon
|
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exenatide
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^ insulin
v glucagon release |
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pramlintide rx
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type II DM
|
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exenatide
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type II DM
|
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pramlintide s/e
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HaND (think of a white, pramlintide brand glove)
hypoglycemia nausea diarrhea |
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exenatide s/e
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nausea
vomiting pancreatitis |
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propylthiouracil
methimazole mechanism |
inhibit
--organification of iodide --coupling of thyroid hormone synthesis PTU also v peripheral T4 --> T3 conversion |
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drugs for hyperthyroidism
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propylthiouracil
methimazole |
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propylthiouracil
methimazole s/e |
the SAp will SAg
skin rash agranulocytosis (rare) aplastic anemia methimazole: possible teratogen |
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levothyroxine
triiodothyronine rx |
hypothyroidism
myxedema |
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levothyroxine
triiodothyronine s/e |
tachycardia
heat intolerance arrhythmias tremors |
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treat myxedema with...
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thyroid hormone
|
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GH
Rx |
GH deficiency
Turner syndrome |
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somatostatin (octreotide) rx
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acromegaly
carcinoid gastrinoma glucagonoma |
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oxytocin rx
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labor
uterine contractions milk-let down controls uterine hemorrhage |
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ADH aka _ rx
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desmopressin
pituitary DI |
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demeclocycline moa
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ADH antagonist
|
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demeclocycline rx
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SIADH
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demeclocycline s/e
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nephrogenic DI
photosensitivity abnormalities of bone & teeth |
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5 glucocorticoids
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hydrocortisone
prednisone triamcinolone dexamethasone beclomethasone |
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glucocorticoids moa
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inhibits phospholipase A2
expression of COX2 v leukotrienes & prostaglandins |
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glucocorticoids rx
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addison's
inflammation immune suppression asthma |
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glucocorticoids s/e
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iatrogenic cushing's syndrome:
3 rock 3 paper 3 scissors buffalo hump moon facies truncal obesity muscle wasting thin skin easy bruisability osteoporosis adrenocortical atrophy peptic ulcers diabetes (if chronic use) adrenal insufficiency when stopped after chronic use |