Pharmacology: Diabetes & Endocrine Medications Flashcards

Vocabulary flashcards covering antidiabetic and endocrine medications, including insulins, sulfonylureas, biguanides, SGLT2 inhibitors, GLP-1 agonists, DPP-4 inhibitors, thyroid hormones, glucocorticoids, and mineralocorticoids.

NPH (Humulin N / Novolin N)

Intermediate-acting insulin administered subcutaneously for type 1 diabetes. Mechanism: $↓$ blood sugar by helping glucose move from blood into body cells for energy. Onset: $1\text{--}2\,\text{hr}$ ($1.5\,\text{hr}$ for Novolin N), Peak: $4\text{--}12\,\text{hr}$ ($*8\,\text{hr}$), Duration: $10\text{--}24\,\text{hr}$ ($16\text{--}24\,\text{hr}$ for Novolin N). Significant side effect: hypoglycemia.

Insulin Aspart (Novolog)

Rapid-acting insulin administered subcutaneously for diabetes. Onset: $15\,\text{mins}$, Peak: $1\text{--}3\,\text{hrs}$ ($*2$), Duration: $3\text{--}5\,\text{hr}$. Requires pre-administration assessment of blood sugar. Significant side effect: hypoglycemia.

Insulin Glargine (Lantus)

Long-acting insulin administered subcutaneously for diabetes. Mechanism: Stops liver from making and releasing extra glucose, binds to insulin receptors, and tells muscle and fat to absorb sugar from blood. Onset: $2\text{--}4\,\text{hr}$, Peak: None ($\phi$), Duration: $24\,\text{hr}$.

Regular Insulin (Humulin R / Novolin R)

Regular-acting insulin administered subcutaneously or IV for diabetes. Onset: $30\,\text{min}$, Peak: $2\text{--}4\,\text{hr}$ ($*3\,\text{hr}$), Duration: $5\text{--}7\,\text{hr}$. Significant side effect: hypoglycemia.

Insulin Lispro (Humalog)

Rapid-acting insulin administered subcutaneously for diabetes. Onset: $15\,\text{min}$, Peak: $1\text{--}3\,\text{hr}$ ($*2\,\text{hrs}$), Duration: $3\text{--}5\,\text{hr}$. Significant side effect: hypoglycemia.

Glipizide (Glucotrol)

Sulfonylurea antidiabetic oral medication given $30\,\text{min}$ before AM meal for type 2 diabetes. Mechanism: Stimulates insulin release from beta cells in the pancreas. Pre-admin assessment: Glucose levels, hepatic/renal function tests, sulfa allergies. Contraindications: DKA, type 1 diabetes, sensitivity to sulfonylureas.

Insulin Detemir (Levemir)

Long-acting insulin administered subcutaneously for diabetes. Onset: $1\text{--}2\,\text{hr}$, Peak: None ($-$), Duration: $24\,\text{hr}$. Pre-admin assessment: Blood sugar. Significant side effect: hypoglycemia.

Glimepiride (Amaryl)

Sulfonylurea antidiabetic oral medication for type 2 diabetes. Mechanism: Stimulates beta cells in pancreas to release more natural insulin. Contraindications: Sulfa allergy, type 1 diabetes, severe renal or liver disease. Side effects: Hypoglycemia, dizziness, hunger, confusion, anemia, liver dysfunction, tachycardia, sweating.

Iodine (Hyperthyroidism Treatment)

Medication classification for hyperthyroidism. Mechanism: Inhibits synthesis of thyroid hormones and inhibits the release of these hormones into circulation. Pre-admin assessment: TSH, TU/T3 levels. Side effects: Rash, hypothyroidism, goiter, allergic reactions, metallic taste, sore teeth & gums, stomach upset, diarrhea.

Metformin (Glucophage)

Biguanide antidiabetic oral medication taken in AM with meal for type 2 diabetes. Mechanism: $\uparrow$ peripheral use of glucose, $\downarrow$ production of insulin, $\downarrow$ hepatic glucose production, $\downarrow$ intestinal absorption of glucose. Pre-admin assessment: Renal function, blood sugar level, vital signs. Significant side effects: Hypoglycemia, lactic acidosis, GI upset, nausea, anorexia, diarrhea, heartburn, allergic reaction.

Glucocorticoids

Steroid class taken once daily in AM. Mechanism: Stimulate an $\uparrow$ in glucose levels for energy. Pre-admin assessment: Blood pressure, fluid volumes, allergic reactions. Contraindications: Known allergy, acute infections, lactation, diabetes, peptic ulcer. Side effects: Vertigo, hypotension, fluid retention, masking infections, impaired wound healing, $\uparrow$ appetite, weight gain.

Empagliflozin (Jardiance)

Sodium glucose cotransporter 2 inhibitor ($10\text{--}25\,\text{mg}$ oral) for type 2 diabetes. Mechanism: Inhibits sodium glucose transporter in kidneys, which prevents sodium reabsorption $\rightarrow$ $\downarrow$ blood glucose levels. Pre-admin assessment: Renal function, A1C, blood sugar, dehydration. Side effects: Syncope, $\uparrow$ uric acid, hypotension, ketoacidosis, constipation, nausea, acute kidney injury, UTI, angioedema.

Mineralocorticoids

Hormone class indicated for blood pressure regulation. Mechanism: Holds sodium and water in body and causes excretion of potassium by acting on the renal tubule. Contraindications: Allergy, hypertension, CHF, cardiac disease, pregnancy, infection. Side effects: Edema, hypertension, heart failure.

Glucagon

Glycogenolytic agent used to treat low blood sugars. Mechanism: $\uparrow$ blood glucose levels by $\downarrow$ insulin release and accelerating the breakdown of glycogen in the liver to release glucose. Contraindications: Known allergy, pregnancy. Side effects: GI upset, vascular effects.

Rosiglitazone (Avandia)

Thiazolidinedione oral antidiabetic taken once or twice daily for type 2 diabetes. Mechanism: Binds to specific cell receptor called PPAR-gamma to make the body's tissues more sensitive to insulin. Contraindications: Acute liver disease, heart failure, type 1 diabetes, DKA. Side effects: Fluid retention, congestive heart failure, liver disease.

Levothyroxine (Synthroid)

Thyroid hormone oral medication taken on empty stomach before breakfast for hypothyroidism. Mechanism: $\uparrow$ metabolic rate of body tissues, $\uparrow$ oxygen consumption, respiration & heart rate, rate of fat, protein & carb metabolism. Pre-admin assessment: Biotin use, TSH, cardiovascular status. Contraindications: Hypersensitivity, myocardial infarction, thyrotoxicosis.

Semaglutide (Ozempic)

GLP-1 receptor agonist administered subcutaneously every 7 days for type 2 diabetes. Mechanism: $\uparrow$ insulin release & $\downarrow$ glucagon release in prep for nutrients that may be absorbed. Pre-admin assessment: Kidney & liver function tests, pancreatitis, thyroid markers status, A1C, fasting status. Side effects: Pancreatitis, epigastric pain, N/V, anorexia, constipation, diarrhea, weight loss.

Chlorpropamide (Diabinese)

Sulfonylurea antidiabetic oral medication taken once daily in AM with breakfast for type 2 diabetes. Mechanism: Targets beta cells in pancreas to stimulate & increase the release of natural insulin. Pre-admin assessment: Blood glucose, weight, nutritional status, renal/hepatic infections. Side effects: Low blood sugar, N/V, indigestion, loss of appetite, headache, dizziness, itching/rash, jaundice, low sodium.

Glyburide (Diabeta)

Sulfonylurea antidiabetic oral medication (max dose $20\,\text{mg}$) taken daily with AM meal for type 2 diabetes. Mechanism: Stimulates insulin release from beta cells in pancreas. Contraindications: DKA, type 1 diabetes, current therapy w/ bosentan. Side effects: Anxiety, headaches, arrhythmias, blurred vision, hypoglycemia, hepatic failure, anemia, dermatitis, hyponatremia, angioedema.

Sitagliptin (Januvia)

DPP-4 inhibitor oral medication ($100\,\text{mg}$) taken once daily at the same time every day for type 2 diabetes. Mechanism: Slows breakdown of GLP-1, which leads to insulin release, $\downarrow$ glucagon release & slowed GI absorption. Pre-admin assessment: Renal function test, eGFR, A1C. Contraindications: Type 1, kidney disease, pancreatitis, heart failure.