Created by Elizabeth Then
about 7 years ago
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Question | Answer |
Insufficient hormone secretion | Diabetes: Insulin Hypothyroidism: Thyroxine |
Excessive hormone secretion | Tumours Cushing's disease: adrenal corticosteroids Hyperthyroidism: thyroxine |
Adrenal Steroids | mineralcorticosteroids, glucocorticoids (used as anti-inflammatory agents) |
Cushing's disease | excessive exposure to glucocorticoids symptoms: moonface, red cheeks, adbo fat, easy bruising, poor wound healing |
Insulin | hormone controlling intermediary metabolism, actions on liver, muscle, fat |
Diabetes | inability to control blood glucose due to inadequate insulin action |
Type 1 diabetes | lack of insulin secretion, usually in pts less than 20 years, sudden onset |
Type2 diabetes | resistance to insulin, usually in pts over 35 years, obese, late onset |
Goals of therapy for diabetes | replace insulin to physiological levels obtain metabolic control regulate glucose levels diet and exercise monitoring is pivotal |
Treatment for type 1 diabetes | replace insulin |
Treatment for type 2 diabetes | Insulin resistant Oral hypoglycemics Glucose lowering drugs e.g. sulfonylureas (giblenclamide)- enhance insulin release Biguanine(Metformin)- decrease glucose production, increase glucose utilisation in tissues Glitazones (rosiglitazone)- increase insulin sensitivity |
Insulin formations duration of action | ultra short acting- Afrezza, 15 min Short acting- injection insulin, 30 min Medium acting- zinc suspension, 1-3 hours Long acting- zinc suspension crystaling, 2-6 hours |
Insulin adverse effects | generally rare allergic reactions lipodystrophy overdose hypoglycemia symptoms fainting, sweating, tremor |
Insulin drug interactions | beta blockers- mask symptoms of hypoglycemia Corticosteroids, thiazide diuretics, produce hyperglycemia alcohol, produces hyporglycemia, intoxication causes loss of attention to glucose control CNS stimulants, hyperglycemia Smoking, hyperglycemia |
Type 2 Diabetes stepwise approach | Lifestyle changes- first step Start pharmacotherapy if pts do not achieve treatment start with oral medications glucose-lowering progressively intensify therapy by adding medication if treatment targets |
Oral Hypoglycemics -adverse effects | Metformin- GI upsets, hypoglycemia, anemia, interaction with alcohol, beta adrenoreceptors Sulphonylurea- hypoglycemia, GI upsets, weight gain, interaction with alcohol, NSAIDS, monoamine oxidase inhibitor Glitazones- weight gain, anemia, hepatic toxicity, heart failure |
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