Endocrine

Question 1

Metformin

Answer 1

• MOA: poorly understood, but generally sensitizes response to insulin
• SE: biggest adverse event related to lactic acidosis– higher risk in people with renal insufficiency because of decreased rate of lactate clearance

Question 2

Methimazole

Answer 2

• MOA: interferes with organification and coupling rxns

- tx: hyperthyroid

Question 3

Levothyroxine

Answer 3

-synthetic thyroxine used in tx of hypothyroid

Question 4

Amiloride

Answer 4

• tx for nephrogenic diabetes insipidus

- K sparing diuretic

Question 5

Phenoxybenzamine

Answer 5

• used prior to surgery in pheo
• irreversible alpha 1 antagonist
• relaxes SMC in vasculature preventing hypertensive crisis
• SE: miosis

Question 6

Chlorpropramide

Answer 6

• 1st generation sulfonylurea
• tx: diabetes
• MOA: close K+ channels in B-cells of pancreas, leading to insulin release
• SE: hypoglycemia and disulfram!

Question 7

disulfram like reaction with medications

Answer 7

-metronidazole, chlorpropramide, procarbazine, some cephalosporins

Question 8

Sulfonylureas (name 2)

Answer 8

• chlorpropramide, tolbutamide
• MOA: close K+ channels in B-cells of pancreas, leading to insulin release
• SE: hypoglycemia and disulfram!

Question 9

rosiglatazone

Answer 9

• oral hypoglycemic, increases sensitivity to insulin
• MOA: modulating effects of peroxisome proliferator-activated receptors (PPAR-gamma), increase adiponectin and GLUT4 on adipocytes

Question 10

propylthiouracil

Answer 10

• previous firstline tx for hyperthyroid, replaced by methimazole
• safer for use in pregnancy

Question 11

methimazole

Answer 11

-first line tx in hyperthyroid

Question 12

chlorpromazine

Answer 12

• MOA: D2 receptor antagonist
• mesolimbic: decrease positive symptoms of schizophrenia
• mesocortical: exacerbate negative symptoms of schizophrenia
• nigrostriatal: pathway implicated in parkinsons (decrease D2, increase parkinsonism)
• tuberoinfundibular: increase in prolactin (due to decreased inhibition by DA)

Question 13

octreotide

Answer 13

• synthetic somatostatin
• tx for acromegaly
• also will affect many other hormones, don’t forget GI tract, insulin, all the pancreatic enzymes, gastric acid etc.

Question 14

troglitazone

Answer 14

• tx: diabetes

- MOA: increase sensitivity to insulin, increase GLUT4 on adipocytes, increase adiponectin via increased PPAR-gamma

Question 15

tolbutamide

Answer 15

• 1st generation sulfonylurea
• tx: diabetes
• MOA: close K+ channels in B-cells of pancreas, leading to insulin release
• SE: hypoglycemia and disulfram!