question

Lispro, Aspart, Glulisine

answer

Rapid acting Insulin

question

Risks of all insulin:

answer

Hypoglycemia, lipodystrophy, rare hypersensitivity reaction

question

This is the only short acting insulin:

answer

Regular

question

This is the only intermediate acting insulin:

answer

NPH

question

Detemir, glargine:

answer

long acting insulins

question

Diet for Type 1 DM:

answer

Low carb, insulin replacement

question

Treatment plan for Type II DM:

answer

Dietary modification, exercise for weight loss; oral agents, non-insulin injectables, insulin replacement

question

Treatment plan for GDM:

answer

dietary modifications, exercise, insulin replacement if lifestyle modification fails

question

This drug decreases gluconeogenesis, increases glycolysis, increases peripheral glucose reuptake and insulin sensitivity, is the first line therapy in type 2 DM, causing modest weight loss, doesn't need functioning islets

answer

Metformin (Biguanide)

question

Lactic acidosis is the most serious adverse effect of this oral hypoglycemic drug, also seen GI upset and is contraindicated in renal insufficiency

answer

Metformin (Biguanide)

question

Chlorpropamide, tolbutamide are:

answer

First generation sulfonyureas

question

Chlorpropamide and tolbutamide are associated with what unique SE:

answer

Disulfram like effects (also increase risk of hypoglycemia in renal failure and weight gain)

question

Glimepiride, glipizide, glyburide are:

answer

Second generation sulfonylureas

question

These hypoglycemic drugs close K channels in B-cell membrane leading to cell depolarization, insulin release via elevated Ca influx, thus stimulating release of endogenous insulin in type 2 DM, need some islet function in type 1 DM

answer

Sulfonyureas

question

These can be used as mono therapy in 2DM, safe in renal impairment, cause increase in insulin sensitivity in peripheral tissue by binding PPAR-gamma nuclear transcription regulator:

answer

Glitazones/thiazolidinediones (piglitazone, rosiglitazone)

question

The SE of these oral hypoglycemic drugs included weight gain, edema, hepatotoxicity, HF, and increase risk of fracture:

answer

Glitazones/thiazolidinediones

question

This class of oral hypoglycemic drugs can be used as a mono therapy in type 2 or combined with metformin, they stimulate postprandial insulin release by binding to K channels on Beta cell membranes (different site than sulfonylureas)

answer

Meglitinides (nateglinide, repaglinide)

question

Risks of this class of hypoglycemic drug are hypoglycemia increased in renal failure and weight gain

answer

Meglitinides

question

These hypoglycemic drugs are used in type 2 DM and cause increase in glucose-dependent insulin release, decrease in glucagon release, decrease in gastric emptying and elevated satiety:

answer

GLP-1 analogs (Exenatide, liraglutide sc injection)

question

SE of these oral hypoglycemics are nausea, vomiting, pancreatitis and modest weight loss:

answer

GLP-1 analogs (Exenatide, liraglutide)

question

These type 2 DM hypoglycemic drugs inhibit DPP-4 enzyme that deactivates GLP-1 thereby increasing glucose-dependent insulin release, lowering glucagon release, and delaying gastric emptying increasing satiety:

answer

Linagliptin, saxagliptin, sitagliptin (DPP-4 inhibitors)

question

These drugs delay gastric emptying and suppress glucagon, can be used in 1 or 2 DM

answer

Amylin analogs (pramlintide: sc injection)

question

SE of these hypoglycemic drugs include mild urinary or respiratory infections, modest weight change:

answer

DPP-4 inhibitors (-gliptins)

question

SE of these hypoglycemic drugs include hypoglycemia in setting of mistimed prandial insulin, nausea:

answer

Amylin analogs

question

These type 2 DM hypoglycemic drugs block reabsorption of glucose in PCT

answer

SGLT-2 inhibitors (Canagliflozin, dapagliflozin, empagliflozin)

question

SE of these hypoglycemic drugs include Glucosuria, UTI, vaginal yeast infections, hyperkalemia, dehydration, orthostatic hypotension)

answer

SGLT-2 inhibitors (-gliflozin)

question

These type 2 DM hypoglycemic drugs inhibit intestinal brush-border alpha-glucosidases causing delayed hydrolysis and glucose absorption leading to decrease postprandial hyperglycemia

answer

alpha-glucosidase inhibitors (acarbose, miglitol)

question

SE of these hypoglycemic drugs include GI disturbances solely:

answer

Alpha-glucosidase inhibitors (acabose, miglitol)

question

These drugs block thyroid peroxidase, inhibiting the oxidation of iodide and the organification of iodine thereby inhibiting thyroid hormone synthesis

answer

Thionamides (PTU, methimazole)

question

This thionamide also functions in the periphery blocking 5'-deiodinase:

answer

PTU

question

This thionamide cay be used in hyperthyroidism in pregnancy:

answer

PTU

question

Adverse effects of these drugs include: skin rash, rare agranulocytosis, aplastic anemia, hepatotoxicity

answer

Thionamide (PTU, methimazole)

question

This thionamide is a possible teratogen that can cause aplasia cutis:

answer

Methimazole

question

This is a T4 hormone replacement used in hypothyroidism, myxedema, off label weight loss, can cause tachycardia, heat intolerance, tremors, arrhythmias:

answer

Levothyroxine

question

This is a T3 hormone replacement used in hypothyroidism, myxedema, off label weight loss, can cause tachycardia, heat intolerance, tremors, arrhythmias:

answer

Triiodothyronine (T3)

question

These drugs can treat SIADH by blocking action of ADH at V2 receptor:

answer

Convaptan, tolvaptan (ADH antagonists)

question

This is the DOC for central DI (not nephrogenic)

answer

Desmopressin acetate

question

This treats GH deficiency or Turner Syndrome

answer

GH

question

This stimulates labor, uterine contractions, milk let-down: and can control uterine hemorrhage

answer

Oxytocin

question

This can be used for Acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varicies:

answer

Somatostatin (Octreotide)

question

This is an ADH antagonist used in SIADH with adverse effects of Nephrogenic DI, photosensitivity, bone and teeth abnormalities:

answer

Demeclocycline

question

These inhibit phospholipase A2, TF-kappa beta, and mediate metabolic, catabolic, antiinflammatory and immunosuppressive effects used in adrenal insufficiency, inflammation, immunosuppression, asthma:

answer

glucocorticoids

question

What happens when you stop long term use glucocorticoids abruptly:

answer

Adrneal insufficiency

question

This is a synthetic analog of aldosterone with little glucocorticoid effect used as a mineralocorticoid replacement in primary adrenal insufficiency:

answer

Fludrocortisone (SE similar to glucocorticoids, also edema, hyper pigmentation and can exacerbate HF)

question

This sensitizes Ca sensing receptor (CaSR) in parathyroid gland to circulating Ca leading to lowered PTH treating primary or secondary hyperparathyroidism:

answer

cinacalcet (SE of hypocalcemia)

USMLE First Aid 2016 Pharm: Endocrine – Flashcards

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