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Intermediate acting insulins
NPH
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Insulin: MOA
- Tyrosine kinase activation
- Increases liver glycogen
- Increases muscle glycogen, protein synthesis, and K uptake
- Aids TG storage in fat
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Sulfonylureas: names
- Tolbutamide
- Chlorpropamide
- Glyburide
- Glimepiride
- Glipizide
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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)
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First generation sulfonylureas: names and toxicity
- Tolbutamide
- Chlorpropamide
- Disulfiram-like
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Biguanides: name and MOA
- Metformin; acts like an insulin sensitizer
- Decreases gluconeogenesis
- Increases glycolysis
- Decreases serum glucose
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Glitazones/thiazolidinediones: names
- Pioglitazone
- Rosiglitazone
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Glitazones: MOA
Increase insulin sensitivity in peripheral tissue
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Metoformin: toxicity
Lactic acidosis (don't use in renal failure)
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Glitazones: toxicity
- Weight gain, edema
- Hepatotox
- CV tox
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Alpha-glucosidase inhibitors: names
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Alpha-glucosidase inhibitors: MOA
- Inhibit intestinal brush-border alpha-glucosidases
- Decrease postprandial hyperglyceia due to delayed sugar hydrolysis
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Alpha-glucosidase inhibitors: toxicity
GI
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Pramlintide: MOA
Decreases glucagon for type 2 DM
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Exenatide: MOA
- GLP-1 mimetic
- Increases insulin
- Decreases glucagon
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Orlistat: everything
- Inhibits pancreatic lipases
- Obesity management
- Toxicities: obvious plus HA
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Sibutramine: MOA and use
- Sympathomimetic serotonin and NE reuptake inhibitor
- For obesity
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Sibutramine toxicity
HTN and tachy
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Propylthiouracil and methimazole: MOA
- Inhibit organification of iodide and coupling of thyroid hormone synthesis
- PTU also decreases conversion of T4 to T3
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PTU and methimazole: toxcity
- Skin rash
- Agranulocytosis
- Aplastic anemia
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GH: clinical use
GH deficiency and Turner's syndrome
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Somatostatin/octreotide: clinical use
- Acromegaly
- carcinoid
- gastrinoma
- glucagonoma
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Oxytocin: clinical use
- Stimulate labor
- Milk let-down
- Uterine hemorrhage
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Demeclocycline: MOA
ADH antagonist (tetracycline family)
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Demeclocycline: tox
- Nephrogenic DI
- Photosensitivity
- Abnormalities of bone and teeth
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Glucocorticoids: MOA
Inhibit phospholipase A2 and COX-2 expression, which decreases leukotrienes and prostaglandins
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Glucocorticoids: uses
- Addison's
- Inflammation
- Immune suppression
- Asthma
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