USMLE Endocrine pharm

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Author:
andresjm
ID:
21065
Filename:
USMLE Endocrine pharm
Updated:
2010-05-28 16:06:46
Tags:
USMLE step endocrine pharmacology diabetes
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Description:
USMLE pharmacology for step 1 from FA 2010
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  1. Short acting insulins
    • Lispro
    • Aspart
    • Regular
  2. Intermediate acting insulins
    NPH
  3. Long-acting insulins
    • Glargine
    • Detemir
  4. Insulin: MOA
    • Tyrosine kinase activation
    • Increases liver glycogen
    • Increases muscle glycogen, protein synthesis, and K uptake
    • Aids TG storage in fat
  5. Sulfonylureas: names
    • Tolbutamide
    • Chlorpropamide
    • Glyburide
    • Glimepiride
    • Glipizide
  6. Sulfonylureas: MOA and use
    • Close K channel in beta cell membrane causing depolarization of cell
    • Ca influxes, insulin is release
    • For type 2 DM only (requires islet function)
  7. First generation sulfonylureas: names and toxicity
    • Tolbutamide
    • Chlorpropamide
    • Disulfiram-like
  8. Biguanides: name and MOA
    • Metformin; acts like an insulin sensitizer
    • Decreases gluconeogenesis
    • Increases glycolysis
    • Decreases serum glucose
  9. Glitazones/thiazolidinediones: names
    • Pioglitazone
    • Rosiglitazone
  10. Glitazones: MOA
    Increase insulin sensitivity in peripheral tissue
  11. Metoformin: toxicity
    Lactic acidosis (don't use in renal failure)
  12. Glitazones: toxicity
    • Weight gain, edema
    • Hepatotox
    • CV tox
  13. Alpha-glucosidase inhibitors: names
    • Acarbose
    • Miglitol
  14. Alpha-glucosidase inhibitors: MOA
    • Inhibit intestinal brush-border alpha-glucosidases
    • Decrease postprandial hyperglyceia due to delayed sugar hydrolysis
  15. Alpha-glucosidase inhibitors: toxicity
    GI
  16. Pramlintide: MOA
    Decreases glucagon for type 2 DM
  17. Exenatide: MOA
    • GLP-1 mimetic
    • Increases insulin
    • Decreases glucagon
  18. Orlistat: everything
    • Inhibits pancreatic lipases
    • Obesity management
    • Toxicities: obvious plus HA
  19. Sibutramine: MOA and use
    • Sympathomimetic serotonin and NE reuptake inhibitor
    • For obesity
  20. Sibutramine toxicity
    HTN and tachy
  21. Propylthiouracil and methimazole: MOA
    • Inhibit organification of iodide and coupling of thyroid hormone synthesis
    • PTU also decreases conversion of T4 to T3
  22. PTU and methimazole: toxcity
    • Skin rash
    • Agranulocytosis
    • Aplastic anemia
  23. GH: clinical use
    GH deficiency and Turner's syndrome
  24. Somatostatin/octreotide: clinical use
    • Acromegaly
    • carcinoid
    • gastrinoma
    • glucagonoma
  25. Oxytocin: clinical use
    • Stimulate labor
    • Milk let-down
    • Uterine hemorrhage
  26. Demeclocycline: MOA
    ADH antagonist (tetracycline family)
  27. Demeclocycline: tox
    • Nephrogenic DI
    • Photosensitivity
    • Abnormalities of bone and teeth
  28. Glucocorticoids: MOA
    Inhibit phospholipase A2 and COX-2 expression, which decreases leukotrienes and prostaglandins
  29. Glucocorticoids: uses
    • Addison's
    • Inflammation
    • Immune suppression
    • Asthma

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