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34 Cards in this Set
- Front
- Back
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What is the action of insulin on Liver, skeletal muscle, and Fat?
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1) inc. Liver glycogen synthesis
2) inc. muscle glycogen and protein synthesis, and K+ uptake 3) aids TG storage |
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What are the short-acting insulins?
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1) regular insulin
2) Lispro |
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What are the long-acting insulins?
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1) Lente
2) Ultralente |
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What is an intermediate-acting insulin?
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NPH
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When would you give someone insulin?
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- type 1 diabetes mellitus
- life threatening hyperkalemia - stress induced hyperglycemia |
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How do the sulfonylureas cause insulin release from beta-cells?
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Close K+ channel --> depolarization --> Ca++ influx --> insulin release
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Sulfonylureas are only for which type of diabetic?
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type 2 - need some pancreatic islet function to release insulin
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What side effect do Tolbutamide & Chlorpropamide have that the 2nd generation sulfonylureas don't?
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Disulfiram-like effects
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What are Glyburide, Glimepiride, and Glipizide?
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2nd generation sulfonylureas
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What is Metformin?
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Biguanide - oral hypoglycemic that dec. gluconeogenesis, inc. glycolysis, and dec. serum glucose levels
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If a diabetic on medication gets lactic acidosis, what drug could he possibly be on?
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Metformin! Lactic acidosis is most adverse side effect.
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How do the Glitazones help in diabetes?
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For type 2 diabetics - inc. target cell response to insulin
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What are side effects of the Glitazones?
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- wt. gain
- hepatotoxicity |
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Acarbose and Miglitol work by:
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inhibit intestinal brush border a-glucosidases --> delay glucose absorption after meal
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Orlistat =
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inhibit pancreatic lipases, for long-term obesity management (think: Orlando Bloom is skinny because he's taking Orlistat)
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Sibutramine =
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serotonin & NE reuptake inhibitor, for short- and long-term obesity management (can cause HTN and tachcardia)
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What do you give for HYPERthyroidism?
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Propylthiouracil or methimazole - inhibit thyroid hormone synthesis
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Toxicities of propylthiouracil or methimazole =
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skin rash, agranulocytosis, aplastic anemia
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To which patients would you give GH?
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- GH deficiency (duh)
- Turner's syndrome (45,X0) |
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To which patients would you give octreotide (somatostatin)?
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- acromegaly
- carcinoid tumor - gastrinoma - glucagonoma |
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What does oxytocin do?
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- uterine contraction
- milk letdown - controls uterine hemorrhage |
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When would you give a patient desmopressin (ADH)?
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central/pituitary diabetes insipidus
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What do you give for hypothyroidism?
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Levothyroxine, triiodothyronine (thyroxine replacement)
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What do glucocorticoids inhibit?
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phospholipase A2 and expression of COX-2
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Name some glucocorticoids:
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hydrocortisone, beclamethasone, prednisone, dexamethasone, triamcinolone
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What are glucocorticoids used for?
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- inflammation reduction
- asthma - immune suppression - Addison's disease |
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Increased levels of sex hormone binding globulin -->
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gynecomastia (less free testosterone)
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Low levels of sex hormone binding globulin -->
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hirsutism (too much free testosterone)
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List the 5 functions of T3/T4:
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1) bone growth
2) CNS maturation 3) beta adrenergic effects (inc. CO and contractility) 4) inc. BMR (inc. O2 consumption and body Temp) 5) inc. glycogenolysis, glucogenesis, lipolysis |
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How is thyroid hormone inhibited?
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T3 feeds back to anterior pituitary to dec. sensitivity to TRH from the hypothalamus
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In a person with liver failure, what happens to free T3/T4 levels?
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increase, because decreased production of thyroxine binding globulin
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What happens to T3/T4 during pregnancy?
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decrease, because increased production of thyroxine binding globulin
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To review, which organs need insulin for glucose uptake?
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fat, skeletal muscle (GLUT-4)
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Brain and RBCs have GLUT-___ receptors and do not need insulin for glucose uptake.
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GLUT-1
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