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Pharm - Endocrine

Endocrine Pharmacology from First Aid 2013

QuestionAnswer
What are the treatment strategies for DM 1 and 2? Type I: insulin and low sugar diet Type II: dietary modification, exercise, weight loss, oral hypoglycemics; insulin after sulfonylureas cease to work
What is insulin's MOA? Toxicities? Binds insulin receptor (tyrosine kinase): Liver -> inc. glucose storage as glycogen Muscle -> inc. glycogen storage, protein uptake, K+ uptake Fat -> inc. TG storage Toxicities: hypoglycemia, rare H-S rxn
Which insulins are short-, intermediate-, and long-acting? Rapid: Lispro, Aspart, Glulisine, regular Inter: NPH Long: Glargine, Detemir
Metformin: Use, MOA, Tox MOA is unknown, decreases gluconeogenesis Use: 1st line oral Rx for Type II DM Tox: lactic acidosis
Sulfonylureas: 1st vs 2nd generation naming and toxicities 1st Gen: "-amide" Tolbutamide, Chlorpropamide 2nd Gen: "-ide" Glyburide, Glipizide 1st Gen has Disulfiram-like toxicity 2nd Gen only has hypoglycemia
Sulfonylureas: MOA and use MOA: closes beta cell K+channel (like ATP), depolarizing it to cause Ca2+ influx and insulin release. Use: Type II DM, useless in Type I (duh)
Glitazones / Thiazolidinediones: Use, MOA, Tox "-azones" bind PPAR-gamma nuclear transcription regulator -> inc. insulin sensitivity Use: Type II DM Tox: weight gain, edema, hepatotox, HF
a-glucosidase inhibitors: Use, MOA, Tox Acarbose, Miglitol: inhibit brush border glycosylase -> dec postprandial sugar Use: Type II DM Tox: GI upset
Amylin analogs (Pramlintide): Use, MOA, Tox Decreases glucagon Use: Type I and II DM Tox: hypoglycemia, nausea, diarrhea
GLP-1 Analogs: Use, MOA, Tox Exenatide, Liraglutide: inc insulin, dec glucagon Use: Type II DM Tox: N/V, pancreatitis
DPP-4 inhibitors: Use, MOA, Tox "-liptins" inc insulin, dec glucagon Use: Type II DM Tox: Mild urinary, respiratory infections
What does chromium (the mineral) do in the context of diabetes? It is a glucose tolerance factor (?)
Thiouracil: Use, MOA, Tox MOA: block peroxidase and 5'-deiodinase, inhibiting both iodide coupling and peripheral T4->T3 conversion Use: hyperthyroidism Tox: skin rash, hepatotox, aplastic anemia
Methimazole: Use, MOA, Tox MOA: blocks peroxidase -> no iodide coupling Use: Hyperthyroidism Tox: skin rash, aplastic anemia, teratogen
Levothyroxine, triiodothyronine (T3) Use, Tox Use: thyroxine replacement for hypothyroidism and/or myxedema Tox: heat intolerance, tremors, arrhythmias
What is Octreotide? When should you use it? Somatostatin analog! Use with: Acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices.
When should you use Oxytocin? To stimulate labor or to control uterine hemorrhage after birth.
When should you use desmopressin? To distinguish nephrogenic vs. central DI. Also raises VWF release from vessels in VWD.
Demeclocycline: Use, MOA, Tox MOA: ADH antagonist Use: SIADH Tox: Nephrogenic DI, photophobia, teeth stains (because related to Tetracycline)
Created by: wmwebb89