Endocrine drugs

  1. Name an anti-thyroid drug used to treat hyperthyrodism?

    Thionamides act by inhibiting peroxidase-catalysed reactions necessary for iodine organification. 

    • Warnings: Agranulocytosis 
    •                  Not given in pregnancy - low thyroid levels can cause Cretinism
    • Propylthiouracil safe to give to pregnant women, can cause hepatic failure and agranulocytosis.
    • TSH should be <2.5 before trying to get pregnant.
  2. What do iodides treat?
    Preparation for thyroidectomy -It shrinks the size and vascularity of the gland.

    Thyroid storm - It reduces thyrotoxic fairly quickly (2-7 days).

    Not useful long-term as its anti-thyroid action diminishes over time.
  3. How is hypothyroidism treated?
    Levothyroxine (L-thyroxine) which is synthetic T4.

    Treatment is assesed by monitoring plasma TSH levels, which fall when the optimun dose is achieved. 

    Hypothyroid coma: Liothyronine (T3) & hydrocortisone given IV.
  4. What is metformin?
    • Biguanides.
    • 1st line drug for T2D which aren't underweight.
    • Oral drug.
    • Reduces hepatic glucose production.
    • Acts peripherally to increase glucose uptake.

    Adverse effects: nausea, vomiting, diarrhoea, lactic acidosis.
  5. How do sulphonylureas and repaglinide work?
    They close KATP channels causing depolarisation of the beta cells resulting in increased insulin release.

    • For patients who are near their ideal weight and diet is not a factor in their hyperglycaemia.  They must have partially functioning beta cells.
    • Glipizide
    • Glicazide

    • Adverse effects: GIT disturbances, rashes.
    • Contraindicated in severe hyperglycaemia, surgery and major illness (as insulin should be given instead).
  6. How do Glitazones works?
    Increase sensitivity to insulin.

    They bind to PPAR-γ which increases transcription of insulin-sensitive genes.


  7. Describe incretin analogues?
    • Incretins stimulate the release of insulin.
    • There are 2 types: GLP-1 and GIP.

    GLP-1 agonists: Exenatide and Liraglutide.

    • They're given subcutaneously with metformin and/or sulphonylureas.
    • Can cause nausea and vomiting.
Card Set
Endocrine drugs
Drugs for 3.2md