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65 Cards in this Set
- Front
- Back
alpha-glucosidase inhibitors (AGIs) are
including... 1. 2. |
1. Precose (acarbose)
2. Glyset (migitol) |
|
what class of Biguanide is?
Ex: Metformin (glucophage) |
what class of Biguanide is?
Ex: Metformin (glucophage) |
|
What are the possibile side effects from
metformin? |
1. GI upset
2. Megalblastic anemia 3. Lactic acidosis |
|
What is MOA of actos?
|
Actos is TZD (Thiazoladinediones;
glitazones/TZD); 1. increase skeletal muscle, adipose tissue, and insulin sensitivity; 2. Decreased hepatic glucose production |
|
What are the common AE of TZD drugs, ex:
Actos, avandia? |
1. Edema
2. Anemia 3. wt gain 4. excerabation of CHF |
|
What is the MOA of Prandin?
|
MOA of Prandin (Repaglinide): To stimulate
pancreatic beta-cells to secrete insulin |
|
What are the examples of sulfonylurea diabetes
drugs? 1) 1st generation? 2) 2nd generation? |
1) 1st Generation:
- Dymelor (acetohexamide) - Diabinese (chlorpropamide) - Tolinase (Tolazamide) - Orinase (Tolbutamide) 2) 2ns generation - Amaryl (glimeperide) - Glucotrol (Glipizide) - Diabeta, Micronase (Glyburide) Glynase (Glyburide micronized) |
|
What are the 2 classes of antidiabetes agents that
can cause 1) weight gain and 2) hypoglycemia |
1) Sulfonylureas
2) Meglitinides |
|
What classes of antidiabetic agent do not cause
hypoglycemia? |
1. alpha-glucosidase inhibitors (acarbose and
miglitol) 2. Insulin sensitizers (biguanide and TZD) |
|
Meformin should be withheld 48 hours after pts
undergoing radiological study. True or False? |
True
|
|
List the 6 drugs containing Metformin.
|
1. Glucophage
2. Glucophage XR 3. Riomet 4. Glucovance 5. Avandamet 6. Metaglip |
|
What are CIs in metformin?
|
For female, Cr >1.4
For male, Cr > 1.5 Predisposed to potentially fatal lactic acidosis |
|
TZD (actose, avandia)+ oral contraceptive pills -->
? |
Need to increase estrogen dose
|
|
What are Contraindications in TZD (actose,
avandia) |
1. ALT >2.5 normal
2. CHF 3. Hepatic patients |
|
What are the monitoring parameters taking
metformin? |
1. Renal
2. Liver, 3. serum B12 4. folic acid 5. Hgb 6. Hct 7. CBC |
|
Chlorpropamide + prednisone
--> ??? (DDI) |
hyperglycemia
|
|
Phenytoin + tolazamide --> ??
|
Increased BG levels
|
|
Glimepiride + itraconazole
--> ??? (DDI) |
Decreased BG level
|
|
Which insulin can be adminstered IV?
|
Regular (clear); glargine is clear but it's low
pH=4.0 (no IV) |
|
What is myxedema?
What are the S/Sx? |
Myxedema is an end stage of hypothyroidism.
S/Sx: weakness, confusion, hypothermia, hypoventilation, hypoglycemia, hyponatremia, coma and shock |
|
" High TSH
Low T4"; what is the Dx? |
Hypothyroidism
|
|
What is MOA of Levothyroxine?
|
To increase oxygen consumption by most of
tissues and increase metabolic rate of CHO, lipids and protein |
|
Take Levothyroxine with or without food?
|
Without food, take 30 mins before breakfast
|
|
what is thyroid storm?
|
thyroid stormis life-threatening, fever, tachycardia,
delirium, and coma |
|
what is MOA of Propylthiouracil (PTU)?
|
1. The peripheral conversion of T4 to T3
2. Inhibits the synthesis of thyroid hormone by preventing the incorporation of iodine into iodothrosine 3. ..by inhibiting the coupling of monoiodotyrosine nd diiodtyrosine to form T4 abd T3 |
|
What is the MOA of methimazole?
|
1. Inhibits the synthesis of thyroid hormone by
preventing the incorporation of iodine into iodothrosine 2. ..by inhibiting the coupling of monoiodotyrosine nd diiodtyrosine to form T4 abd T3 |
|
Lithium + Lugol's solution
--> ??? (DDI) |
Increased Lugol's solution effects
|
|
what is Grave's disease?
|
Hyperthyrodism
|
|
What is Cushing's syndrome?
|
1. Increased ACTH by pituitary gland adenomas
(Increased CRH-corticotropin-rleasing hormone --> Increased ACTH --> Increased adrenal cortex to produce cortisol 2. Chronic use of glucocortiocoid excess |
|
What is the MOA of aminoglutethimide?
|
Inhibits conversion of cholesterol to pregnenolone
|
|
What is the MOA of metyrapone?
|
To decrease cortisol synthesis by inhibition of
11-hydroxylate activity |
|
What are adverse effects of Cytadren?
|
rash, blood dyscrasias and hypothyrodism; may
also decrease effects of warfarin |
|
What is Addison's disease?
|
Primary adrenocortical deficiency; in result of
glucococorticoid and mineralocorticoid deficiency |
|
what are therapeutic uses of desmopressin?
|
Nocturnal enuresis, diabetes insipidus, hemophilia
A, von Willebrand's disease; Also increase clotting factor VII levels |
|
Androgens and anabolic steroids are NOT
scheduled drugs. True or False? |
False; they are scheduled III
|
|
During postmenopausal,
1)Estrogen decreased or increased? 2)Progesterone decreased or increased? 3)FSH decreased or increased? 4)LH decreased or increased? |
1)Estrogen decreased
2)Progesterone decreased 3)FSH increased 4)LH increased |
|
To treat a women with an intact uterus for
postmenopausal hormone replacement therapy, which hormone is must included? |
Progestin to reduce the risk of endometrial
cancer/hyperplasia |
|
Climara, once a week or twice weekly?
|
Once a week
|
|
FemPatch once or twice a week?
|
Once
|
|
"Alora, Esclim, Estraderm, Menostar, Vivelle,
Vivelle Dot" once a week or twice a week? |
Twice a week
|
|
What is Vagifem dosing?
|
25 mcg/tab QHS for 2 weeks, and then twice a
week for 2 weeks (18 tabs for a month supply) |
|
What's the frequency of Estring?
|
90 days ( evry 3 months)
|
|
What are the common adverse effects of ERT
(Estrogen replacement therapy)? |
1. Breast tenderness
2. Heavy bleeding 3. Headache 4. Nausea |
|
What are the common adverse effects of progestin
therapy? |
1. Depression
2. Irritability 3. Headache |
|
s Estrogen a CYP450 2D6, 1A2, 2C9 or 3A4
inhibitors? |
3A4 inhibitors
|
|
Synthroid + Warfarin --> ??? (DDI)
|
Increased metabolism of Vit-K--> decreased
warfarin effects --> may neeed to increased warfarin dose |
|
Estrogen + thyroid hormone
--> ??? (DDI) |
Decreased thyroid hormone effects
|
|
When are "mini-pills" indicated?
|
1. breastfeeding women
2. Free CVD risks associated with estrogen-containing products |
|
What is estrogen's MOA in birth control pills?
|
1. To prevent development of a dominant follicile
by supression of FSH; 2. Do not block ovulation |
|
What is progestin's MOA in birth control pills?
|
Block ovulation by increasing the thickness and
atrophy of the endometrium |
|
List 3 Oral contraceptive pills are progestin only
pills. |
1. Camila
2. Ortho Micronor 3. Errin 4. Nor-QD 5. Nora-BE 6. Ovrette |
|
What much estrogen content in high-dose estrogen
OC? |
50 mcg; ex: Neocon 1/50, Ovcon50, Zovia 1/50
|
|
What much estrogen content in low-dose estrogen
OC? |
from 10 - 35 mcg
|
|
List 3 drugs/classes can increase oral
contraceptives level. |
List 3 drugs/classes can increase oral
contraceptives level. |
|
Oral contraceptives + pioglitazone (Actos) --> ???
(DDI) |
Decreased OC effects
|
|
Oral contraceptives + hypoglycemics
(tolbutamide, Diabinese, Orinase, Tolinase) |
Decreased effects hypoglycemics agents
|
|
Oral contraceptives + cortisone --> ??? (DDI)
|
Increased toxicity of cortisone
|
|
what types of hormone imbalance from the finding
"Spotting" and "Early, or mid-cycle? breakthrough bleeding" How do we adjust that? |
Estrogen deficiency; increased estrogen levels
|
|
what types of hormone imbalance from the finding
"fatigue" "weight gain" "acne or oily scalp" " depressoin" " increased appetite"? How do we adjust that? |
Progestin excess;
decreased progestin levels |
|
what are the daily Calcium and Vit-D
recommended? |
Calcium 1000-1500 mg
Vitamin D 400-800 IU/day |
|
What is the MOA of actonel, fosamax?
|
Bisphosphonates; Binds to bone (hydroxyapatite)
and incorporates into boneto increase and stablize bone mass |
|
Fosamax 10 mg/day + ASA
--> ??? (DDI) |
Increased risk of upper GI bleeding
|
|
What is the MOA of SERM (selective estrogen
receptor modulator, ex: Evista)? |
Raloxifene (Evista; act as estrogen receptor
agonist at the skeleton, decrease bone resorption and overall bone turnover |
|
Evista + warfarin --> ??? (DDI
|
Decreased Warfarin effects
|
|
What is the MOA of Miacalcin?
|
Inhibit bone resorption by binding to osteoclast
receptors |