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Flashcards in Endocrine Deck (70)
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1

define Diabetic Ketoacidosis (DKA)

Glucose is not available for the body to use as energy, so instead, fat is used for fuel, producing
byproducts - ketones.

2

most common Precipitating factor of DKA

infection, missing insulin, or unknown

3

Dehydration, Acetone smell on breath, Abdominal tenderness, Tachycardia/hypotension/shock, AMS, Kussmaul respirations and Coffee ground emesis

DKA

4

dx of DKA

Glucose level >250mg/dL
● Bicarbonate

5

management of DKA

1. fluids to dilute sugars
2. give potassium
3. know that sodium will be falsely low

6

role of insulin in DKA

Start 0.1 units/kg/hr IV drip. don't worry about returning glucose to a normal level, instead focus on stoping DKA

7

Drugs can cause glucose intolerance

Glucocorticoids, anti-hypertensives

8

how do you dx DM?

two different accounts of fasting glucose >126, or random glucose >200 + symptoms or A1C >6.5

9

is DKA an acid or base disorder

acidosis

10

complications of DKA therapy

hypoglycemia, cerebral edema!!!!!

11

Sulfonylureas

Squeeze-stimulate pancreas to release more insulin

12

Biguanides

(bite) suppress hepatic gluconeogenesis

13

Thiazolidenediones (TZDs)

Increases sensitivity to insulin

14

Glipizide®, Glyburide®

sulfonylureas

15

Actos®, Avandia®

Thiazolidenediones

16

Metformin®

Biguanides

17

SE of sulfonylureas / Glipizide®, Glyburide®

hypoglycemia

18

SE of biguanides / Metformin

GI issues and Can cause lactic acidosis

19

SE of Thiazolidenediones ( actos and Avandia)

hepatitis & edema

20

Incretins:

Hormones released by small intestine enteroendocrine cells in response to dietary glucose, delays gastric emptying.

21

names of incretins (they end in TIDE)

GLP-1 analogs [GLP-1 receptor agonists]):
Albiglutide (advantage: once-weekly dosing)
Exenatide (synthetic version of exendin-4 found in Gila monster saliva!; extended release version is also once-weekly dosing)
Liraglutide (advantage: once-daily dosing)

22

Main disadvantage of incretins

must be administered by subcutaneous injection and cause GI SE

23


● Main risks:

pancreatitis, thyroid C-cell tumors

24

when are incretins used

incretin mimetics are recommended as potential 2nd
line treatment options to add to metformin (or other agents, including insulin) in
patients not achieving glycemic goals

25

we can block the enzyme that breaks down incretins using;

“DPP-4 inhibitors”

26

gliptins):
o Sitagliptin
o Saxagliptin
o Linagliptin
what are these?

DPP-4 inhibitors

27

Sodium-glucose linked transporter (SGLT): effect

proximal tubule of the kidney

28

Dapagliflozin
o Canagliflozin
o Empagliflozin
what are these

Sodium glucose linked transporter, add on has 2nd of 3rd therapy with metformin

29

medications that contribute to hypercholesterolemia

thiazides, glucocorticoids, beta blockers

30

ANY condition that results in excess thyroid hormone

Thyrotoxicosis (ex: Graves disease, toxic goiter, thyroiditis, medication ingestion)