Nathaniel Shared "Wk_8" - 22 Picmonics

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Wk_8

Levothyroxine
Indications
Hypothyroidism
Myxedema Coma
Mechanism of Action
Isomer of thyroid hormone (T4)
T3 has higher potency
Side Effects
Hyperthyroid symptoms
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56 secs
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)
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1 min
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)
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2 mins
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
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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
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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
Considerations
Beta-blockers Reduce Effects
Avoid During Pregnancy and Breast Feeding
Avoid Alcohol
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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
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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
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2 mins
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
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2 mins
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
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2 mins
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
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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
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2 mins
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
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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)
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2 mins
Polymyxins
Mechanism of Action
Cationic
Act Like Detergents
Bind to Cell Membranes of Bacteria
Disrupt Their Osmotic Properties
Indications
Resistant Gram-Negative Infections
Side Effects
Neurotoxicity
Renal tubular necrosis
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3 mins
Chloramphenicol
Mechanism
Bacteriostatic
Inhibits 50S Peptidyltransferase Activity
Indications
Meningitis
Rocky Mountain Spotted Fever in Pregnant Women
Side Effects
Anemia
Aplastic Anemia
Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
Resistance Caused by Plasmid Encoded Acetyltransferase
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2 mins
Imipenem
Mechanism
Resistant to beta lactamases
Broad Spectrum
Indications
Anaerobes
Gram-Negative Rods
Gram-Positive Cocci
Must administer with cilastatin
Cilastatin is inhibitor of renal dehydropeptidase I
Side Effects
Diarrhea
Skin rash
Seizures
Considerations
Meropenem
Stable to dehydropeptidase I
Reduced risk of seizures (Non seizure causing)
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2 mins
Metronidazole
Mechanism of Action
Bactericidal
Forms Free Radical Toxic Metabolites
Damages DNA
Indications
Giardia lamblia
Entamoeba Histolytica
Trichomonas
Gardnerella
Anaerobes
Side Effects
Metallic taste
Disulfiram like Reaction with Alcohol
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2 mins
Trimethoprim
Mechanism of Action
Bacteriostatic
Inhibits Bacterial Dihydrofolate Reductase
Causes Sequential Block of Folate Synthesis
Used in Combination with Sulfamethoxazole
Combination Used For Recurrent Urinary Tract Infections
Indications
Shigella
Salmonella
Pneumocystis Jiroveci Pneumonia
Side Effects
Decrease in Red and White Blood Cells
Alleviated with Leucovorin Rescue
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2 mins
Sulfa Drug Allergies
Sulfasalazine
Sulfonylureas
Thiazide Diuretics
Acetazolamide
Furosemide Diuretic
Celecoxib
Probenecid
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49 secs

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