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8. Endocrinology & Reproductive
Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)
- Mechanisms
- Alpha Glucosidase Inhibitors
- Delays Absorption of Carbohydrates
- Indications
- Type 2 Diabetes
- Side Effects
- Flatulence
- Diarrhea
- Anemia
- Cramps
- Considerations
- Monitor LFTs
- Oral Glucose for Hypoglycemia
2 mins
Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)
- Mechanisms
- 1st Generation Sulfonylureas
- Stimulate Release of Insulin
- Indications
- Type 2 Diabetes
- Side Effects
- Hypoglycemia
- Possible Cardiovascular Toxicity
- Weight Gain
- Considerations
- Exacerbated Hypoglycemia with Beta-blockers
- Avoid During Pregnancy and Breast Feeding
- Avoid Alcohol
2 mins
Euthyroid Sick Syndrome (ESS)
- epi: hospitalized patients
- pathophys: dec T4 → T3 conversion
- workup: *dec total & free T3*
- inc rT3
- mgmt: supportive
Exenatide (Byetta)
- Mechanism
- Incretin Mimetic
- GLP-1 Synthetic Analog
- Indications
- Type 2 Diabetes
- Side Effects
- Hypoglycemia
- Nausea and Vomiting
- Diarrhea
- Thyroid Cancer
- Pancreatitis
- Renal Failure
- Considerations
- (Give Exenatide) One Hour After Other Medications
- Adjunct Therapy
3 mins
Glucagon (GlucaGen)
- Mechanism
- Increases Glucose
- Indications
- Hypoglycemic Emergency
- Side Effects
- Nausea and Vomiting
- Considerations
- Reconstitute Powder
- Consume Oral Carbohydrates
- 50% Dextrose IV (If No Effect)
2 mins
Glyburide and Glipizide (2nd Generation Sulfonylureas)
- Mechanisms
- 2nd Generation Sulfonylureas
- Blocks Potassium Channels in Beta Cells
- Stimulate Release of Insulin
- Indications
- Type 2 Diabetes
- Side Effects
- Hypoglycemia
- Considerations
- More Potent
- Beta Blockers Reduce Effects
- Avoid Alcohol
- Avoid Breastfeeding
2 mins
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
2 mins
Levothyroxine
- Indications
- Hypothyroidism
- Myxedema Coma
- Mechanism of Action
- Isomer of Thyroid Hormone (T4)
- T3 has Higher Potency
- Side Effects
- Hyperthyroid Symptoms
57 secs
Metformin
- Indications
- Diabetes Mellitus Type 2
- Polycystic Ovary Syndrome (PCOS)
- Mechanism of Action
- Decreased Gluconeogenesis
- Increased Insulin Sensitivity
- Side Effects
- Lactic Acidosis
- GI Distress
- Weight Loss
- B12 Deficiency
- Contraindication
- GFR < 30 ml/min
2 mins
Metformin (Glucophage)
- Mechanism
- Decrease Glucose Production
- Increase Insulin Sensitivity
- Indications
- Type 2 Diabetes
- Polycystic Ovary Syndrome (PCOS)
- Side Effects
- GI Distress
- Decreased Appetite
- Lactic Acidosis
- Considerations
- IV Contrast
- Limit Alcohol Consumption
2 mins
Pioglitazone (Thiazolidinediones)
- -glitazones Suffix
- Mechanism
- Binds PPAR-Gamma
- Decreases Insulin Resistance
- Indications
- Type 2 Diabetes
- Side Effects
- Weight Gain
- Heart Failure
- Myalgia
- Hypoglycemia
- Upper Respiratory Infection
- Considerations
- Increased Risk of Bladder Cancer
- Increased Fracture Risk in Women
- Monitor Liver Enzymes
2 mins
Pramlintide (Symlin)
- Mechanism
- Synthetic Amylin Analog
- Indications
- Diabetes Type 1 and 2
- Supplement Mealtime Insulin
- Side Effects
- Nausea
- Skin Reactions at Injection Site
- Considerations
- Hypoglycemia When Combined with Insulin
- Delayed Absorption of Oral Drugs
2 mins
Propylthiouracil (PTU) and Methimazole (MMI)
- Indications
- Hyperthyroidism
- Mechanism
- Inhibits Thyroid Peroxidase
- PTU Blocks Peripheral Conversion of T4 to T3
- Side Effects
- Agranulocytosis
- Skin Rash
- Hepatotoxicity (PTU)
- Teratogen (MMI)
1 min
Repaglinide and Nateglinide (Meglitinides)
- Mechanisms
- Meglitinides
- Increased Insulin Release
- Indications
- Type 2 Diabetes
- Side Effect
- Hypoglycemia
- Considerations
- Eat Within 30 Minutes
- Gemfibrozil Increases Risk of Hypoglycemia
- Short Half-Life
2 mins
SGLT-2 Inhibitors
- -flozin
- indicated for T2DM
- inhibits Glucose Reabsorption in PCT
- promote glucosuria
- SFx: DKA, UTI, Yeast Infection (Candida), Hypotension
Sheehan's Syndrome
- Postpartum Pituitary Gland Necrosis
- Agalactorrhea
- Amenorrhea
- Secondary Hypothyroidism with Cold Intolerance
1 min
Sitagliptin (Januvia) and Saxagliptin (Onglyza) (DPP-4 Inhibitors)
- -gliptin Suffix
- Mechanisms
- DPP-4 Inhibitor
- Increases Insulin Release
- Indications
- Type 2 Diabetes
- Side Effects
- Pancreatitis
- Upper Respiratory Infection and Inflammation
- Stevens-Johnson Syndrome
- Considerations
- Used as Add-on Agents
2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
- Pathophysiology
- Hypersecretion of ADH
- Increased Sensitivity to ADH
- Signs & Symptoms
- Serum Hypoosmolality
- Coma and Seizure
- Dilutional Hyponatremia
- Cramps and Tremors
- Euvolemia
- Change in LOC
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
- Monitor Serum and Urine Osmolality
- IandOs with Daily Weights
- Restrict Fluid Intake
- Monitor Cardiovascular and Neurological Status
- Seizure Precautions
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
- Diuretics
- Hypertonic IV Fluids
- Demeclocycline
- Tolvaptan and Conivaptan
1 min
